-
positive inotropic
increase heart contraction
-
positive chronotropic
increase HR
-
positive dromotropic
accelerate cardiac conduction
-
ACE inhibitors
- -Pril
- inhibits aldosterone secretion> prevents H20 and Na reabsorption > diuresis > decreases the preload
-
ACE inhibitor A/E
- hyperkalemia
- DRY COUGH!
- do not take when pregnant
-
Angiotensin II receptor blocker
- -Sartan
- vasodilator > Decrease SVR
- No cough
-
B-type natriuretic peptides
- Nesiritide
- Vasodilator
- increases CO
- used for life threatening HF
-
B-type natriuretic peptide A/E
- hypotension
- dysrhythmias
- headache
- abdominal pain
-
phosphodiesterase inhibitors
- -Rinone
- +inotropic drug
- vasodilator
- makes the heart more effective
- not for severe valuvlar disease and diastolic HF
-
phosphodiesterase inhibitors A/E
- thrombocytopenia
- dysrhythmias (ventricular)
- hypotension
- angina
- hypokalemia
- tremors
-
cardiac glycosides
- Digoxin: increases heart contractility, decreases HR and conductivity
- increase SV
- diuresis
-
digoxin
- 0.5 - 2 ng/ml
- low K levels cause digoxin toxicity
- drug levels and electrolytes must be monitored
- wait for labs (afternoon)!!
-
cardiac glucosides A/E
- dysrhythmias
- increase/decrease HR
- Head ache
- fatigue
- confusion
- colored halo : flickering light vision
- N/V
- diarrhea
-
digoxin toxicity
- digoxin level >10ng
- yellow vision
- hyperkalemia (5mEq)
- cause heart dysrhythmias
- antidote: digoxin immune Fab
-
hold meds when HR is
under 60 and above 100
-
nitrates
- Nitro-, isosorbide
- vasodilator
- prevention and treatment of angina
-
Nitrate A/E
- HA, so take Tylenol
- tachycardia
- hypotension: LIE DOWN!
- tolerance, so take patch off at bedtime
-
Beta-Blocker
- -lol
- decrease HR
- decrease contractility
- block harmful effects of catecholamines after an MI
- long term prevention of angina (not immediate)
-
beta blocker A/E
- bradycardia
- hypotension
- wheezing!
- impotence
- dyspnea
- drosiness
-
calcium channel blockers
- -ine, verapamil, diltiazem
- vasodilation > decrease SVR > decrease the workload on heart > decrease myocardial 02 demand
-
Calcium channel blockers A/E
- hypotension
- palpitations
- Nausea
-
report a wt gain of
2 lbs in a day, 5 lbs in a wk
-
avoid alcohol and hot tubs because
the cause hypotension > fainting
-
expected outcome associated with digoxin
decreased HR
-
pts should avoid this food with digoxin
wheat bran. (bran decreases drug absorption)
-
nurse should assess what when receiving a positive inotropic drug.
- lung sounds
- daily weights
- pulse and serum electrolytes (bradycardia, hypokalemia)
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