McKenna's Pharmacology for Nursing, 2e

44

Cardiotonic agents

Learning objectives Upon completion of this chapter, you should be able to:

1. Describe the pathophysiological process of heart failure and the resultant clinical signs. 2. Explain the body’s compensatory mechanisms that occur in response to heart failure.

3. Describe the therapeutic actions, indications, pharmacokinetics, contraindications and cautions, most common adverse reactions and important drug–drug interactions associated with the cardiotonic agents. 4. Discuss the use of cardiotonic agents across the lifespan. 5. Compare and contrast the drugs digoxin and digoxin immune Fab. 6. Outline the care considerations, including important teaching points, for people receiving cardiotonic agents.

Test your current knowledge of cardiotonic agents with a PrepU Practice Quiz!

Glossary of key terms cardiomegaly: enlargement of the heart, commonly seen with chronic hypertension, valvular disease and heart failure cardiomyopathy: a disease of the heart muscle that leads to an enlarged heart and eventually to complete heart muscle failure and death dyspnoea: discomfort with breathing, often with a feeling of anxiety and inability to breathe, seen with left-sided heart failure haemoptysis: blood-tinged sputum, seen in left-sided heart failure when blood backs up into the lungs and fluid leaks out into the lung tissue heart failure (HF): a condition in which the heart muscle fails to adequately pump blood around the cardiovascular system, leading to a backup or congestion of blood in the system nocturia: getting up to void at night, reflecting increased renal perfusion with fluid shifts in the supine position when a person has gravity-dependent oedema related to heart failure; other medical conditions, including urinary tract infection, increase the need to get up and void orthopnoea: difficulty breathing when lying down, often referred to by the number of pillows required to allow a person to breath comfortably positive inotropic effect: results in an increased force of contraction pulmonary oedema: severe left-sided heart failure with backup of blood into the lungs, leading to loss of fluid into the lung tissue tachypnoea: rapid and shallow respirations, seen with left-sided heart failure

CARDIOTONIC AGENTS Cardiac glycoside digoxin

DIGOXIN ANTIDOTE digoxin immune Fab

Phosphodiesterase inhibitor milrinone