flash cards

Pharm Heart Failure

Question Answer
What is the prototype loop diuretic? Furosemide
Generic name for furosemide Lasix
What do loop diuretics treat? heart failure and hypertension
How do loop diuretics work? sodium and chloride reabsorption in the loop of Henle is prevented, thus more sodium and water is excreted. This increase in urine reduces the blood volume and blood pressure decreases
Most heart failure is what type? Congestive heart failure : fluid volume overload
What should you monitor/assess with loop diuretics? assess allergy to sulfonamides, BP, orthostatic BP, HR, signs and symptoms of dehydration, potassium level
Why should you assess HR with loop diuretics? tachycardia may be associated with hypovolemia
Hypokalemia and loop diuretics Monitor potassium level and signs of hypokalemia. Don't administer if hypokalemia is present; notify HCP
What can happen if hypokalemia is present? Concurrent use of cardiac glycoside can put patient at risk for cardiac dysrhythmias if hypokalemia is present
What should you teach patients about loop diuretics? To report ototoxicity; about foods high in Ka; Report s/s of diabetes mellitis; take the diuretic early in the day; rise slowly to avoid dizziness and risk of injury; weigh themselves daily at the same time of day
What is the prototype direct vasodilator? Hydralazine
Generic name for hydralazine apresoline
What do direct vasodilators treat? heart failure and hypertension
What do direct vasodilators do? dilate arteriole smooth muscle, thus blood pressure is reduced. Veins not affected
what to assess/monitor with direct vasodilators Assess BP, orthostatic BP, cardiac status, HR, assess for fluid retention
Patients may be prescribed what to control HR when using direct vasodilators? a beta adrenergic blocker
What heart problems may occur with direct vasodilators? reflex tachycardia and palpitations
What is an example of fluid retention due to direct vasodilators? edema as hydralazine may result in sodium and water retention and counter act the antihypertensive action of hydralazine
Direct vasodilators: What can cause exaggerated hypotension? Concurrent use of drugs that lower BP
Direct Vasodilators: Monitor the patient for development of ______-like syndrome lupus
What does cardiac glycoside treat? Heart failure
Generic name for cardiac glycoside digoxin
How does cardiac glycoside work? Increases contractility of cardiac muscle. Increased contractility produces more forceful contraction and improves CO. this leads to improved urine output, reduced blood volume, and relief of pulmonary congestion and peripheral edema
What is positive inotropic effect? Increased contractility of cardiac muscle
What should you monitor when giving cardiac glycoside? Monitor HR for bradycardia, apical pulse, serum potassium levels, S/S of digoxin toxocity, serum digoxin concentration
Cardiac Glycoside: What signs should you be aware of when taking apical pulse? Take apical pulse for a full minute; if HR is <60 or there is a change in rhythm, do not administer digoxin/notify the HCP
Cardiac glycoside: Why monitor serum potassiun levels? Hypokalemia predisposes the patient to dysrhythmias
What are some S/S of digoxin? loss of appetite, nausea/vomiting, visual disturbances such as yellow-green tinge, or halos
What can concurrent use of diuretics with cardiac glycoside do? can predispose patient to digoxin toxicity
What can concurrent use of drugs that decrease HR mixed with cardiac glycoside do? can result in profound bradycardia
T or F margin of safety for Digoxin in narrow True
How to treat overdose of Digoxin Treat with digoxin immune fab (Digibind)
what should you teach patient when giving Digoxin? How to take the medication and what to report to HCP
What is the prototype phosphodiesterase inhibitor? Milrinone
What is the generic name for Milrinone? Primacor
What do phoshodiesterase inhibitors treat? Short term treatment of heart failure in patients who have not responded to ACE inhibitors or cardiac glycosides
How does milrinone work? Blocking phosphodiesterase results in increased calcium available for myocardial contraction; also causes vasodilation
What should you assess when giving phosphodiesterase inhibitors? assess/monitor HR and rhythm for dysrhythmias, BP for hypotension, Cardiac output
Phosphodiesterase Inhibitors: What kind of effect may occur with concurrent use of drugs positive inotropic effects? Effects can be additive

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