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Gabie Gomez
Cardiotonics
Classification: Inotropes
(Digoxin)
Action: Cardiotonics are used to strengthen the contractions of the heart
so that the heart can pump more blood with fewer beats, cardiotonics
may be prescribed to slow the heart rate of people with an abnormally
fast heart rhythm.
Uses: They may be prescribed to strengthen the pumping ability of a
heart that is weakened, heart failure, and atrial fibrillation.
Adverse Reactions: Digoxin toxicity signs include anorexia (first sign),
nausea, vomiting, diarrhea, headache, visual disturbances, yellow vision,
delirium, and changes in pulses rate or rhythm.
Contraindications: patients with known hypersensitivity, ventricular
failure, ventricular tachycardia, or AV blocker and in the presence of
digitalis toxicity should not take cardiotonics.
Interventions: Before administrating each dose o d a cardiotonic the
nurse must take the apical pulse rate for 60 secs. Withhold the drug if the
pulse is below 60 and notify primary physician. Assess I&O, serum levels,
and electrolyte imbalances.
Antiarrhythmic Drugs
Classification: Antiarrhymics
Action: Class I-A:(Norpace) Antiarrhymic drug that shortens the sinus
node recovery time, lengthens the effective refractory period of the
atrium, and has a minimal effect on the effective refractory period of the
AV node. Little effect has been shown on AV-nodal and His-Purkinje
conduction times or QRS duration
Class I-B: (Lidocane) Antiarrhymic drug that stabilizes the neuronal
membrane by inhibiting the ionic fluxes required for the initiation and
conduction of impulses thereby effecting local anesthetic action.
Class I-C: (Rythmol) Antiarrhymic drug with local anesthetic effects, and a
direct stabilizing action on myocardial membranes. It prolongs
conduction time and refractory period in the atria, AV node and ventricles
dose-dependently.
Class III: (Cordarone) Antiarrhymic drug that convert atrial fibrillation or
flutter to normal sinus rhythm.
Class IV:(Calan) Antiarrhymic drug that inhibit the movement of calcium
through channels across the myocardial cell membrane and vascular
smooth muscle. By reducing the calcium flow, conduction through the
(SA) node and (AV) nodes is slowed and the refractory period is
prolonged, resulting in suppression of the arrhythmia.
Uses: these medications are use to treat and prevent cardiac arrhythmias,
such as premature ventricular contractions (PVC’s), ventricular
tachycardia (VT), premature atrial contractions (PACs), paroxysmal atrial
tachycardia (PAT), atrial fibrillation, and atrial flutter. In some cases they
can be used to teat pt. that have had myocardial infractions, which reduce
the chance of another happening.
Adverse Reactions: dry mouth, constipation, hypotension, headache,
chest pain, dyspnea, vomiting, anorexia, disturbed vision, ringing in the
ears, drowsiness, and palpitations tremors.
Contraindications: During pregnancy and lactation, pt. with second or
third degree AV block, severe congestive heart failure (CHF), aortic
stenosis, hypotension, cardiogenic shock.
Interventions: Hold any medication if pulse is above 120 or below 60
bpm, assess for any adverse reactions, Do not chew tablets; swallow the
whole, avoid drinking alcoholic beverages, if mouth becomes dry take
several sips of water or chew sugar free gum.