Phosphodiesterase Inhibitors

Question 1

Phosphodiesterase Inhibitors Drug Names

Answer 1

Inamrinone: Approved only for use in patients with HF that has not responded to digoxin, diuretics, or vasodilators

Milrinone: Short-term management of HF in patients who are receiving digoxin and diuretics

Question 2

Phosphodiesterase Inhibitors Therapeutic Actions

Answer 2

• Blocks the enzyme phosphodiesterase, leads to an increase in myocardial cell cyclic adenosine monophosphate (cAMP), which increase calcium levels in that cell, causing a stronger contraction and prolonged response to sympathetic stimulation; directly relaxes vascular smooth muscle

Question 3

Phosphodiesterase Inhibitors Indications

Answer 3

• Short-term treatment of HF in patients unresponsive to digitalis, diuretics, or vasodilators

Question 4

Phosphodiesterase Inhibitors Contraindications and Cautions

Answer 4

Contraindication:
• Allergy
• Severe aortic or pulmonic disease, MI, fluid volume deficit, and ventricular arrhythmias

Caution:
• Pregnancy and lactation
• Elderly

Question 5

Phosphodiesterase Inhibitors DDI

Answer 5

DDI:

• Furosemide- can’t mix in same syringe or bag

Question 6

Phosphodiesterase Inhibitors Adverse Effects

Answer 6

• Arrhythmias
• Hypotension
• Nausea, vomiting
• Thrombocytopenia (decreased platelet count)
• Pericarditis
• Pleuritis
• Fever
• Chest Pain
• Burning in injection site

Question 7

Phosphodiesterase Inhibitors:

Assessment

Answer 7

Assess:
Hx: allergy, impaired kidney functions, ventricular tachycardia, heart block, sick sinus syndrome, or IHSS
Physical: vital signs, weight, heart & lung sounds, skin, perfusion(pulses), cardiac status and heart sounds(baseline)
Labs: CBC, electrolytes

Question 8

Phosphodiesterase Inhibitors:

Diagnosis

Answer 8

Dx:
- Decreased cardiac output related to the development of arrhythmias or hypotension
- Risk for injury related to CNS or CV effects
- Ineffective tissue perfusion related to change in cardiac output
Impaired gas exchange related to change in cardiac output
- Deficient knowledge

Question 9

Phosphodiesterase Inhibitors:

Implementation

Answer 9

Implementation:
• Protect the drug from light- brown vial, brown bag
• Monitor pulse and blood pressure frequently during administration
• Monitor input and output and record daily weight (more or equal output)
• Provide life support equipment on standby
• Provide thorough patient teaching

Question 10

Phosphodiesterase Inhibitors:

Evaluation

Answer 10

Eval:
Response to the drug
Adverse effects 
Effectiveness of comfort measures Compliance with the regimen
Effectiveness of the teaching plan