Positive Inotropic drugs: cardiac glycosides (5 points)-pathopharm II - exam 3

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nika.steffan
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Positive Inotropic drugs: cardiac glycosides (5 points)-pathopharm II - exam 3
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2012-10-29 22:54:50
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Positive Inotropic drugs cardiac glycosides points pathopharm II exam
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Positive Inotropic drugs(5 points)-pathopharm II - exam 3
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  1. Positive inotropic agents _____ myocardial contractility. They are used in disease states where there is _____ ______.
    • increase
    • heart failure
  2. What are the two main classes of positive inotropic agents? 
    • 1. cardiac glycosides
    • 2. phosphodiesterase inhibitors 
  3. What are two beta-adrenergic stimulators used in heart failure? 
    • Dobutrex
    • Dopamine - Intropin
    • -- increase contractility
    • -- only continous IV drip
  4. Which drug has been around a very long time and used to treat "dropsy" ?
    Cardiac glycosides

    "dropsy"= fluid accumulation or HF
  5. What are the different types of cardiac glycosides? 
    • Deslanoside- Cedilanid-D
    • Digitoxin- Crystodigin
    • Digoxin-Lanoxin
  6. What is the most common form of cardiac glycosides?
    Digoxin- Lanoxin
  7. Cardiac glycosides are naturally occuring compounds coming from ____
    • leaves of -
    • digitalis purpurea (purple foxglove)
    • digitalis lanata (white foxglove)
  8. Cardiac glycosides act on the heart muscle by effecting the function by....
    • 1. + inotropic action
    • 2. - chronotropic action
    • 3. - dromotropic action
  9. The side effects of cardiac glycosides include: 
    • yellow-green halo around lights
    • heart block
    • bradycardia
    • anorexia
    • Diarrhea + N&V, HA, arrhythmias, fatigue
  10. True or False: Cardiac glycosides are very potent in low doses. 
    true
  11. these drugs are the classic treatment for heart failure: 
    cardiac glycosides: digoxin, digitoxin, deslanoside
  12. How do you screen for toxicity in glycosides?
    • Hypokalemia,
    • hypercalcemia,
    • hypomagnesium
    • Renal failure
    • elevated digitalis levels
  13. What are the contraindiactions and precautions associated with cardiac glycosides? 
    • Bradycardia
    • Heart block
    • Renal failure
    • Liver failure
    • Hypothyroidism
    • Elderly
    • Electrolyte imbalance
  14. What is the antidote for digitalis glycoside toxicity?
    • Digoxin Immune FAB - Digibind
    • -- Electrolytes should also be checked and returned to normal
  15. What time are cardiac glycosides given at SLH?
    1800 (6pm)
  16. What should you do if patients pulse is below 60? 
    Hold medication and call doctor. 
  17. Nursing considerations: 
    • Monitor: 
    • K, BUN, CR
    • I&O
    • Dig Levels: should be 0.5-2.5
  18. What is the normal digitalis level? 
    0.5 - 2.5 ng/ml
  19. Client teaching when taking cardiac glycosides:
    • -taking pulse
    • -med same time each day
    • -don't make up for missed doses
    • -do not change brands
    • -digoxin and lanoxin are the same drug
    • -take 1-2 hours before meals : diet high in fiber will reduce absorption
  20. What is the onset of action and duration of digibind? 
    • onset <1 minute
    • duration 15-20 hours
  21. After administering _____ improvement from digitalis toxicity can be seen in _____. 
    • digibind
    • 15-30 minutes

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