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Cardiac Glycosides: Avoid Calcium-Channel Blockers and Prophylactic Use of Antiarrythmics

This document summarizes key information about several classes of drugs used to treat chronic or acute congestive heart failure (CHF), including cardiac glycosides like digoxin, diuretics, vasodilators, beta blockers, and IV inotropes. For each class, it provides details on pharmacodynamics, pharmacokinetics, adverse effects, drug-drug and drug-disease interactions, and uses for treating CHF. It emphasizes treating CHF to relieve congestion and edema, reduce diastolic stress on the heart, and improve cardiac function and outcomes.

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iuytrer
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9 views

Cardiac Glycosides: Avoid Calcium-Channel Blockers and Prophylactic Use of Antiarrythmics

This document summarizes key information about several classes of drugs used to treat chronic or acute congestive heart failure (CHF), including cardiac glycosides like digoxin, diuretics, vasodilators, beta blockers, and IV inotropes. For each class, it provides details on pharmacodynamics, pharmacokinetics, adverse effects, drug-drug and drug-disease interactions, and uses for treating CHF. It emphasizes treating CHF to relieve congestion and edema, reduce diastolic stress on the heart, and improve cardiac function and outcomes.

Uploaded by

iuytrer
Copyright
© © All Rights Reserved
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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ClassDrugPharmacodynamicsPharmokineticsAdverse EffectsDrug-Drug Int.Drug-disease Int.

UsesChronic or acute
CHFCardiac glycosidesDigoxinPositive inotropic effect leading to increased cardiac output for CHF, CNS actions
(vagal stimulation) to counteract atrial fibrillation. n!ibits Na"# $%Pase, increasing Ca&& flux t!roug! Na& c!annel.
Decrease in intracellular #&small t!erapeutic index, indistinct t!erapeutic endpoints, long t'() (*+"*, !rs). -ral
bioavailabilit. /+"0+1, elimination b. 2idne. (measure clearance). %oxic doses3 4C5 c!anges, #& loss (causing fatigue),
anorexia, vomiting, altered vision, confusion. %reat 6( 7 potassium, lidocaine (for arr.t!mias)8uinidine and verapamil bloc2
upta2e into cells, increasing plasma concentration, so reduce digoxin dose /+1. $"7 bloc2 if used 6it! 9uinidine, verapamil,
or :"bloc2ers. H.po2alemia if used 6it! #"6asting diuretics. %reat 6( 7 potassium to displace from $%Pase or 6it! anti"
digoxin abs.;enal insufficienc.3 possible !.po2alemiaAtrial fi!rillation "ith ra#id ventricular res#onse $!ut does not
return to sinus rhythm%& CHF $decreases mor!idity& not mortality% !y shrinking the heart& diuresis& decreasing !lood
volume.bot!Diureticst!ia<ides, loop diuretics (furosamide), or #& sparing diuretics (spironolactone)See appropriate
worksheet for further details, spironolactone antagonizes aldosteroneFatigue, !.potension, a<otemia,
!.po2alemia!.per2alemia if used 6it! $C4 in!ibitor (monitor serum # levels)$void NS$DS 6!en using #"sparing diuretics
to prevent !.per2alemia.CHF' relieves congestion and edema& reduces diastolic stress on ventricular "all.
(#ironolactone also reduces sym#athetic tone& !arorece#tor dysfunction& fi!rosis.bot!, spironolactone for
c!ronicClassDrugPharmacodynamicsPharmokineticsAdverse EffectsDrug-Drug Int.Drug-disease Int.UsesChronic or
acute CHFVasodilatorsACE inhi!itors& sodium nitro#russide& I) nitroglycerin& hydrala*ine + isosor!ide
dinitrateSee appropriate worksheet for further details$C4 in!ibitors3 !.potension, renal insufficienc., coug!CHF' reduces
#reload and afterload to im#rove ventricular contraction efficiency and em#tying. ACE inhi!itors im#rove mor!idity
and mortality $#revents cardiac structural changes induced !y ang II%.bot!Beta blockersSee appropriate worksheet
for further detailsCHF' im#roves mor!idity and mortality. Administer to all #atients that can tolerate it. ,akes months.
Also use ACE inhi!itor.c!ronicIV inotropesdopamine, dobutaminedopamine: intermediate doses induces N release
dobutamine: alpha and beta agonistdopamine acts as an alp!a"' adrenergic agonist, causing vasoconstrictionCHF'
im#roved contractility =AVOID CALCIUM-CHANNEL BLOCKER AND !RO!H"LAC#IC UE O$
AN#IARR"#HMIC

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