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SubClass: Cardiac Glycosides
Prototype: digoxin (Lanoxin)
ACTION
- Action:
- +Inotropic - Inhibits the sodium thus increases Na+ and Ca+. Increases cardiac oitput and increases contraction.
- -Dromotropic - Decreases the rate of conduction velocity. Prolongs refactory period.-Chronotropic - Decreases HR, and increases filling time.
- Increases Stroke Volume -
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SubClass: Cardiac Glycosides
Prototype: digoxin (Lanoxin)
INDICATIONS
Indications: CHF, Atrial Fibrillation, Atrial Flutter
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SubClass: Cardiac Glycosides
Prototype: digoxin (Lanoxin)
SIDE EFFECTS
- Side Effects: Has a very narrow theraputic window
- Decreases K+, Ca+, leavels = increased toxicity
- GI: anorexia, nausea, vomiting, diarrhea
- Visual: Green/yellow halos
- CNS: confusion, fatigue
- CV: Bradycardia, Heart Block, disrhythmias
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SubClass: Cardiac Glycosides
Prototype: digoxin (Lanoxin)
NSG IMPLICATIONS
- Nsg Implications: takes 7 days to reach theriputic levels
- star with loading dose
- typical oral dose is 0.125 or .25 mg daily
- IV push over 5 min
- dig levels noramal is .5 to 2toxicity occures in as many as 20%
- Diet: No large amounts of brain, antacids and milk products should not be taken within 2 hours of dose
- Tape dose as needed
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SubClass: Cardiac Glycosides
Prototype: digoxin (Lanoxin)
TOXICITY
- Toxicity: S/S Cardiac Arrhythmia, anoxeria, nausea, vomiting, weakness, fatigue, green/yellow halos in vision
- TX: stop digoxin, treat arrhythmia, monitor leavels and EKG,
- Andidote: digibind and increase K+
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SubClass: Phosphodiesterase inhibitors
Prototype: milrinone (Primacor)
ACTION
- Action:
- + Inotropic: Inhibits phosphodiesterase type III (enzyme) founs in heart and smooth muscle thus - increases CAMP and increases Ca+
- Vasodilation: Decreases work load on heart
- +Lusitropic : relaxation of blood vessels
- +Chronotropic
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SubClass: Phosphodiesterase inhibitors
Prototype: milrinone (Primacor)
INDICATIONS
Indications: Short term management of CHF, for those who don't respond to digoxin, diuretics, vasodilators
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SubClass: Phosphodiesterase inhibitors
Prototype: milrinone (Primacor)
SIDE EFFECTS
Side Effects: Ventricular dysrhythmia, Hypotension, angina, hypokalemia, tremor, thrombocytopenia
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SubClass: Phosphodiesterase inhibitors
Prototype: milrinone (Primacor)
NSG IMPLICATIONS
Nsg Implications: Furosemide is contraindicated, infuse with pump ONLY, Continualy monitor EKG
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SubClass: Phosphodiesterase inhibitors
Prototype: milrinone (Primacor)
TOXICITY
- Toxicity: NO ANTIDOTE
- Hypotension most common toxic effect
D/C med, provide support Tx
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