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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.
Which drug is inotropic and what three things does inotropy result in?
- Decreased sympathetic tone, increased renal blood flow and urine output, and decreased renin release.
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).
In addition to strengthening the contraction, what else does Digoxin do and who could benefit?
Slows heart, people with afib. (slows sympathetic tone)
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
What is the reversal agent for Digoxin?
Digoxin Immune Fab
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
What is a serious drug interaction with Digoxin?
Do NOT give Digoxin with drugs like Furosemide or HCTZ that flush out K+.
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
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
List four types of drugs you could administer for hypertension.
Thiazide diuretics (HCTZ), BB (metoprolol), ACE/ARB (enalapril and valsartan) and CCBs (nefidipine)
What drug is used for Atherosclerosis?
What is a thrombogenesis drug do? List one.
Decreases platelet aggregation: aspirin
What does a vessel occlusion drug do? Name one.
Clot Buster: Alteplase or tissue plasminogen activator (tPA)
Name different types of drugs that are all used to treat Cornonary Heart Disease.
- Hypertensive, vessel occlusion
- Atheroslerosis, inflammation, thrombogenesis
What is the cause of angina pectoris?
low O2 supply and high demand leading to ischemia