62 Questions
What is the main indication for cardiotonics?
Heart failure
Which of the following is NOT a common adverse reaction of cardiotonics?
Muscle weakness
What is the recommended therapeutic level for serum digoxin in patients receiving cardiotonics?
0.8 - 2 ng/ml
In digitalization, what does a loading dose refer to?
A large initial dose to achieve therapeutic effect quickly
Which of the following electrolyte imbalances is NOT a factor that predisposes a patient to digoxin toxicity?
Hypernatremia
What is the antidote for serious digoxin toxicity?
Digoxin Immune Fab (Digibind)
Which of the following is a visual disturbance associated with cardiotonics?
Blurred vision
What is the route of administration for cardiotonics?
Intravenous push or by mouth
'Digitalization' refers to the process of giving a series of doses of a cardiotonic drug until:
The drug begins to exert full therapeutic effect
Which electrolyte imbalance slows digoxin metabolism?
Hypomagnesemia
What is the primary indication for the use of phosphodiesterase inhibitors in short-term management of heart failure?
Positive inotropic activity
What is a common adverse drug reaction associated with the Class I-A drug Quinidine?
Bone marrow suppression
Which drug is used for ventricular tachyarrhythmia and is associated with adverse effects like neurological symptoms and respiratory depression?
Lidocaine
What is the primary action of Beta Blockers in the treatment of arrhythmias?
Reduce sympathetic excitation in the heart
Which Class III drug is considered a first-line treatment for ventricular tachycardia, ventricular fibrillation, and pulselessness?
Amiodarone
What is a common adverse effect of Class IV Ca channel blockers?
Peripheral edema
Which anti-arrhythmic drug requires monitoring of K levels due to its potential to affect potassium levels?
Amiodarone
Which anti-arrhythmic drug should be avoided in patients with COPD, PVD, and heart disease?
Propranolol
What is the primary action of vasodilators in the treatment of cardiac conditions?
Relax arterial blood vessels
What is the main use of Digitalis glycoside drugs like Digoxin?
Control of atrial fibrillation
What are the adverse effects of nitrates?
Headache, hypotension, tachycardia
What is the recommended response if a patient experiences acute angina and nitroglycerin provides no relief?
Contact the healthcare provider or seek emergency assistance
Why is it crucial to take sublingual tablets sitting or lying down?
To enhance drug absorption through the mucous membranes
Which statement is true about the storage of nitroglycerin sublingual spray?
Storing in a dark, light-resistant bottle is recommended
Why is it important to remove nitroglycerin ointment during defibrillation?
To prevent burns caused by the electrical shock
Why should nitroglycerin transdermal patches be applied to clean, dry, and hairless areas on the chest wall?
To decrease the risk of skin irritation or reactions
Intravenous nitroglycerin is primarily used for emergency treatment of which condition?
Angina pectoris
Why is it important to educate patients to change positions slowly while on nitrates?
To minimize the risk of orthostatic hypotension
What is the purpose of prescribed headache relief (ASA, acetaminophen, ibuprofen) when taking nitrates?
To help manage the headaches caused by nitrates
Why should nitroglycerin be weaned or tapered off when it is discontinued?
To reduce the risk of rebound angina or blood pressure elevation
Which Class I-A drug originates from Cinchona bark and has adverse effects like cardiac hypotension, ventricular tachycardia, and hypersensitivity reactions?
Quinidine
Which Class I-B drug is indicated for treating post-myocardial infarction premature ventricular contractions (PVC) and digoxin-induced tachyarrhythmias?
Lidocaine
Which Class III antiarrhythmic drug is known for causing photosensitivity, pulmonary toxicity, and hepatotoxicity as adverse effects?
Amiodarone
What is the primary action of Class IV Ca channel blockers in the treatment of cardiac conditions?
Block Ca uptake by myocardial cells
Which type of vasodilators is specifically used for insufficient blood flow to the heart muscle due to narrowing of coronary arteries?
Coronary vasodilators
Which anti-arrhythmic drug requires monitoring of peripheral circulation, blood sugar levels, and signs/symptoms of congestive heart failure (CHF) as nursing implications?
Digoxin
'Cinchonism' is a condition associated with which Class I-A anti-arrhythmic drug?
Quinidine
'Cardiac: Hypotension, bradycardia, cardiac arrhythmia' are common adverse effects associated with which type of drugs?
Class II Beta Blockers
Which Class V anti-arrhythmic drug is indicated for bradycardia and acts as an anti-cholinergic?
Atropine
Which medication should be administered with food to avoid GI side effects like N&V, anorexia, and diarrhea?
Lidocaine
What is the purpose of Digitalization in cardiotonic therapy?
To increase cardiac output through positive inotropic activity
Which electrolyte imbalance does NOT predispose a patient to digoxin toxicity?
Hypophosphatemia
What adverse visual effects are associated with cardiotonics like Digoxin?
Yellow and green colored vision
In the context of cardiotonics, what does the term 'Digitalis Immune Fab (Digibind)' refer to?
An antibody that treats digoxin as an antigen
What is the primary route of administration for cardiotonics such as Digoxin?
PO (by mouth)
Which adverse reaction is NOT typically associated with cardiotonics?
Neurological symptoms
What is the optimal therapeutic serum level range for Digoxin when used as a cardiotonic?
$1.0 - 3.0$ ng/ml
'Digitalization' refers to which process in cardiotonic therapy?
'Digitalizing' a series of doses until full therapeutic effect
'Digoxin Immune Fab (Digibind)' functions as an antibody that:
Treats digoxin as an antigen
'Digitalization' loading dose of Digoxin typically ranges between:
$0.5 - 1.25$ mg every 6 to 8 hours initially
What is the significance of a throbbing headache when administering nitroglycerin sublingual tablets?
Indicates potency of the drug
Why is it advised to avoid eating, drinking, or smoking for approximately 20 minutes after taking nitroglycerin sublingual tablets?
To allow the tablet to fully dissolve
Which action should be taken if a patient experiences no relief from acute angina after taking three doses of nitroglycerin sublingual tablets?
Consult a healthcare provider immediately
What is the primary indication for using nitroglycerin intravenously?
Emergency treatment in conditions like post MI and during cardiac surgery
Why is it essential to monitor blood pressure, EKG, and oxygen saturation continuously when administering nitroglycerin intravenously?
To monitor for adverse drug reactions
In which location should nitroglycerin transdermal patches be placed to preserve skin integrity?
Clean, dry, and hairless area on the upper chest wall
What should be done to prevent burns during defibrillation when a patient is wearing nitroglycerin ointment?
Remove ointment before defibrillation
What is the recommended interval between doses for acute angina when administering nitroglycerin sublingual tablets?
30 minutes
Which adverse effect indicates the potency of nitroglycerin administration when a patient experiences it under the tongue?
Burning sensation
What should be done to prevent tolerance development when using nitroglycerin transdermal patches?
Remove the patch at night for 8-12 hours
When applying nitroglycerin ointment, why is it crucial to avoid rubbing it into the skin?
To minimize skin irritation
What is the primary indication for using nitroglycerin intravenously in emergencies?
For hypertension and cardiac-related emergencies
Study Notes
- Cardiotonics, also known as cardiac glycosides or digitalis glycosides, are used for conditions like heart failure, atrial fibrillation, atrial flutter, and supraventricular tachycardia.
- They work by enhancing the movement of calcium into myocardial cells, increasing cardiac output through positive inotropic activity, and decreasing conduction velocity through the SA and AV nodes.
- Digitalization involves a series of doses given until the drug exerts its full therapeutic effect, with loading doses ranging from 0.5 to 1.25 mg every 6 to 8 hours initially.
- Adverse reactions of cardiotonics include gastrointestinal issues, CNS symptoms like headache and confusion, visual disturbances, and cardiac effects such as bradycardia and tachycardia.
- Digoxin toxicity can be caused by factors like hyperkalemia, hypokalemia, hypercalcemia, hypomagnesemia, renal impairment, recent MI, IV administration, hypothyroidism, and concurrent treatment with other heart medications.
- Treatment for digoxin toxicity involves holding the dose, treating dysrhythmias with medications like atropine or Dilantin, and administering the antidote Digoxin Immune Fab (Digibind).
- Nursing implications for cardiotonics include monitoring apical heart rate, blood pressure, lung sounds, daily weights, extremities for edema, neck for jugular vein distention, and potassium levels, along with ensuring consistent medication timing, avoiding antacids, and monitoring for adverse effects.
Learn about cardiotonics, also known as cardiac glycosides or digitalis glycosides, their indications, drug actions, and effects on myocardial cells and cardiac output.
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