ATI PHARMACOLOGY REVIEW EXAM - Verified Study Guide 2021

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ATI Pharmacology Review Cardiac Glycosides & HF Cardiac glycosides  Digoxin  Action: Positive inotropic effect- increased force of myocardial contraction; negative chronotropic effect- decreased... heart rate  Therapeutic uses o Tx of HF o Dysrhythmias (atrial fibrillation) o Can reduce manifestations, but does not prolong life  Complications o Dysrhythmias, cardiotoxicity- bradycardia o Digoxin toxicity- hypokalemia, nausea, vomiting, general weakness, teach pts to consume high potassium foods- green leafy vegetables, bananas, potatoes. Therapeutic serum level ranges from 0.5-2 ng/mL o GI effects: anorexia, N/V, abdominal pain o CNS effects: fatigue, weakness, vision changes (diplopia, blurred vision, yellowgreen or white halos around objects)  Contraindications/Precautions o Pregnancy risk category C o Contra in Ventricular rhythm, Vfib, Vtach, second and third degree heart block o Use cautiously in pts with hypokalemia, partial AV block, advanced HF, impaired kidney function  Interactions o Thiazide diuretics- hydrochlorothiazide, loop diuretics- furosemide, can lead to HYPOkalemia which increases risk of developing dysrhythmias- K+ supplements/K+ sparing diuretics o ACE inhibitors and ARBs increase risk of HYPERkalmeia, leads to decreased therapeutic effects of digoxin o Sympathomimetic meds- DOPAMINE increases rate and force of heart contraction. Increases risk of tachydysrhythmias o Quinidine increases risk of digoxin toxicity o Verapamil increases plasma levels of digoxin o Antacids decrease absorption of digoxin and decrease effectiveness [Show More]

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