1
|
- by Pat Woodbery, MSN, ARNP
|
2
|
- Congestive Heart Failure (CHF)
- Heart cannot pump enough blood.
- Impaired myocardial contraction
- Impaired filling of ventricles
|
3
|
- Increased catacolamines
- Increased force of contraction
- Increase HR
- Increase vasoconstriction
|
4
|
- AFTERLOAD: Force against which
the ventricles eject blood
- PRELOAD: Blood return to the
heart (Diastolic filling pressure)
- WORKLOAD: Actual ejection
|
5
|
- Cardiotonic Effect
- Improvement of cardiac pumping
- Increased emptying of ventricles
- = Increased CARDIAC OUTPUT=
|
6
|
- Inhibits cardiac muscle enzyme
- Na,K-adenosine triphosphatase
- Decreased movement of Na out of the
myocardial cells after contraction
- Calcium enters the cell in exchange for sodium
- This stimulates more Calcium = activated contractile proteins
- Increased myocardial contractility
|
7
|
- Slows the rate of ventricular contractions
- Depresses cardiac conduction tissues
- Depresses AV node
- Stimulates Vagus Nerve
|
8
|
- Heart Failure
- Atrial Fibrillation
- Atrial Flutter
|
9
|
- ORAL
- Onset 30 minutes to 2 hours
- Peak 6 hours
- Intravenous (IV)
- Onset 10-30 minutes
- Peak 1-5 hours
|
10
|
- Administration of an amount of Digoxin sufficient to produce therapeutic
effects
|
11
|
- Nonspecific Early Symptoms
- Anorexia, nausea, confusion
- Signs and Symptoms of Heart Disease
- Atrial Fibrillation
- Rapid Ventricular Rate
- Rapid Ventricular Response
|
12
|
|
13
|
- Discontinue Drug
- Treat Cardiac Arrhythmias
- Digoxin immune fab (Digibind)
|
14
|
- Check Dosing CAREFULLY
- Check Apical Pulse
- Give with food or after meals
- Inject slowly (over 5 minutes)
|
15
|
|
16
|
|
17
|
|