Questions and Answers
What is the primary action of Cardiotonics?
Anticoagulants increase blood clotting.
False
Digoxin is commonly used for patients with __________.
CHF (Congestive Heart Failure)
What is the normal range for Digoxin blood levels?
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Which side effects are associated with digoxin toxicity?
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What should you do if a patient has a pulse of 60 bpm or less before administering digoxin?
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Which medication is classified as an anti-dysrhythmic?
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Calcium Channel Blockers can help in treating hypertension.
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What is the antidote for Warfarin?
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Name one common side effect of nitrates used for angina.
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Match the following cardiac drug classifications with their primary effects:
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Study Notes
Types of Cardiac Medications
- Cardiotonics (Cardiac Glycosides): Enhance heart contraction and efficiency.
- Anti-Dysrhythmics/Anti-Arrhythmics: Classified by effects on cardiac conduction; manage irregular heartbeats.
- Anti-Anginals: Includes beta blockers and calcium channel blockers; relieve heart pain.
- Antihypertensives: Various classes including ACE inhibitors and diuretics; lower high blood pressure.
- Anticoagulants: Prevent blood clotting through different mechanisms; may require monitoring.
- Anticoagulant Antagonists: Counteract anticoagulant effects; examples include protamine sulfate and vitamin K.
Cardiotonics
- Digoxin (Lanoxin): Common cardiotonic derived from foxglove plant; increases cardiac output and decreases heart rate.
- Effects: Positive inotropic (strenthens heart contractions) and negative chronotropic (slows heart rate).
- Uses: Heart failure symptoms include shortness of breath, cough, and edema.
- Safety Measures: Check radial pulse for one full minute; do not administer if pulse is 60 bpm or less.
- Toxicity Signs: Anorexia, nausea, blurred vision, green/yellow vision, and dysrhythmias. Normal blood levels: 0.5-2 ng/ml.
- Digibind: Used for reversing digoxin toxicity.
Anti-Dysrhythmia Drugs
- Dysrhythmia Types: Include atrial flutter, atrial fibrillation, premature ventricular contractions (PVC), ventricular tachycardia, and ventricular fibrillation.
- Class I: Sodium Channel Blockers: Examples are Norpace and Xylocaine; used for various ventricular dysrhythmias.
- Class II: Beta-Adrenergic Blockers: Reduce heart rate and are beneficial post-myocardial infarction; include Inderal and Atenolol.
- Class III: Potassium Channel Blockers: Used for life-threatening ventricular dysrhythmias; include Cordarone (amiodarone).
- Class IV: Calcium Channel Blockers: Dilation of coronary and peripheral blood vessels; monitor blood pressure and heart rate.
Anti-Anginals
- Purpose: Relieve chest pain due to reduced oxygen to the heart.
- Organic Nitrates: Such as Nitroglycerin and Isordil for vasodilation effects.
- Administration: NTG sublingually, ensuring freshness and proper storage.
- Calcium Channel Blockers: Relax vascular smooth muscle and are also used for hypertension; avoid grapefruit juice.
Antihypertensives
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Blood Pressure Classifications:
- Normal: <120/80
- Pre-hypertension: 120-139/80-89
- Stage I HTN: 140-159/90-99
- Stage II HTN: >160/100
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Classes of Antihypertensive Drugs:
- Diuretics: Reduce blood volume (e.g., hydrochlorothiazide).
- Beta Blockers: Such as propranolol and atenolol affect heart rate and blood pressure.
- ACE Inhibitors: Block conversion of angiotensin; linked to cough and angioedema.
- ARBs (Angiotensin II Receptor Blockers): Like losartan and valsartan; help lower blood pressure.
Anticoagulants
- Function: Prolong bleeding time to prevent clots; includes oral and parenteral types.
- Oral Anticoagulant: Warfarin (Coumadin); requires monitoring of PT and INR.
- Parenteral Anticoagulant: Heparin (given SQ or IV); low molecular weight heparin like Lovenox for prophylaxis.
- Antidotes: Vitamin K for warfarin; protamine sulfate for heparin.
Anti-Platelet Drugs
- Mechanism: Prevent platelet aggregation; include aspirin and Plavix for stroke and heart attack prevention.
- Monitoring: Watch for signs of bleeding; ensure no mixing with other anti-inflammatory drugs.
Thrombolytics
- Purpose: Dissolve blood clots; utilized in conditions like DVT, PE, MI, and CVA.
- Examples: Streptase and Activase.
Patient Education
- Regularly monitor pulse and blood pressure before medications.
- Avoid abrupt cessation of antihypertensive drugs to prevent rebound hypertension.
- Be cautious about potential interactions with food and other medications.
- Maintain awareness of signs and symptoms that require immediate medical attention, especially regarding bleeding and toxicity.
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Description
This quiz covers various types of cardiac medications, including cardiotonics, anti-dysrhythmics, anti-anginals, and antihypertensives. It's presented by Cynthia Bartlau, RN, PHN, MSN.
