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What is Digoxin used for and what is its MOA?
- Heart failure
- Blocks NaK pumps so NaK is pumped out and Ca+ is moved in. The extra Ca+ in the myocytes allows the actin/mycin to contract harder.
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Which drug is inotropic and what three things does inotropy result in?
- Digoxin
- Decreased sympathetic tone, increased renal blood flow and urine output, and decreased renin release.
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What does inotropic mean and how do you remember this drug?
- Affecting the contraction of muscle, especially heart muscle
- Ina (inatropic) sees halos (s.e.) when she digs out NaK and puts in Ca2+ (moa).
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In addition to strengthening the contraction, what else does Digoxin do and who could benefit?
Slows heart, people with afib. (slows sympathetic tone)
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What are two nursing considerations for Digoxin? When do you hold Digoxin?
- Check K+ levels, should be 3.5-5.1
- Take APICAL pulse for 1 full minute; hold if <60, newly irregular, or >110
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What is the reversal agent for Digoxin?
Digoxin Immune Fab
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What is the theraputic range for Digoxin? When can digoxin become very toxic no matter the level of Digoxin?
- .5-2 (very narrow).
- when K+ is low, any digoxin can be toxic
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What is a serious drug interaction with Digoxin?
Do NOT give Digoxin with drugs like Furosemide or HCTZ that flush out K+.
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In Stage A of heart failure, what types of drugs do you give? What is added in Stage B? C?
- Stage 1: ACE ARB
- Stage 2: add BB
- Stage 3: Add drugs to increase contraction like Digitalis or Digoxin
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What is a class X drug? Name 2.
- Class X drugs have risk that outweigh benefits for many people; never give to preggers
- Atvorastatin and
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List four types of drugs you could administer for hypertension.
Thiazide diuretics (HCTZ), BB (metoprolol), ACE/ARB (enalapril and valsartan) and CCBs (nefidipine)
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What drug is used for Atherosclerosis?
Atorvastatin
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What is a thrombogenesis drug do? List one.
Decreases platelet aggregation: aspirin
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What does a vessel occlusion drug do? Name one.
Clot Buster: Alteplase or tissue plasminogen activator (tPA)
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Name different types of drugs that are all used to treat Cornonary Heart Disease.
- Hypertensive, vessel occlusion
- Atheroslerosis, inflammation, thrombogenesis
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What is the cause of angina pectoris?
low O2 supply and high demand leading to ischemia
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