1 / 19

Chapter 17

Chapter 17. Cardiac Stimulants and Depressants. The Heart . The heart is a four-chamber organ located in the upper left thoracic cavity. Purpose Pumps the blood around the body so that oxygen and nutrients can be distributed to all areas of the body

javen
Download Presentation

Chapter 17

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Chapter 17 Cardiac Stimulants and Depressants

  2. The Heart • The heart is a four-chamber organ located in the upper left thoracic cavity. • Purpose • Pumps the blood around the body so that oxygen and nutrients can be distributed to all areas of the body • Maintains the blood pressure at an acceptable level Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

  3. Antiarrhythmics and Antianginals • Cardiac illnesses • Cardiac stimulants • Cardiac depressants Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

  4. Treatment of Heart Failure • Cardiac glycosides • Digoxin • Treat arrhythmias Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

  5. Digoxin • Decreases electrical conduction • Prolongs refractory period • Increases the force of the myocardial contraction • Positive inotropic action Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

  6. Digoxin: Dose Considerations • Duration of action • Method of administration • Other • Physical size of the client • Other medications • Renal or hepatic function • Advanced age • Presence of other illnesses Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

  7. Antiarrhythmics and Antianginals • Require a digitalizing dose • To bring serum levels to a therapeutic level • All glycosides have a low therapeutic level Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

  8. Gastrointestinal effects Nausea and vomiting Anorexia Diarrhea Cardiac effects Cardiac arrhythmias Antiarrhythmics and Antianginals: Side Effects (continues) Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

  9. (continued) Antiarrhythmics and Antianginals: Side Effects • Neurological effects • Restlessness • Irritability • Drowsiness • Vision changes • Headache Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

  10. Cardiac Glycoside Toxicity • Predispose to cardiac glycoside toxicity • Hypokalemia • Renal impairment • Rapid IV administration (continues) Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

  11. (continued) Cardiac Glycoside Toxicity • Treatment • Stop the drug • Physical assessment • Check potassium level • Administer if needed • Monitor heart rate • Administer antiarrhythmics Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

  12. Antiarrhythmic and Antidysrhythmic Drugs • Grouped together according to their similar actions Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

  13. Antiarrhythmics and Antianginals: Drug Action • Work three ways: • Decrease the automaticity of cardiac tissues in the ectopic sites • Alter the rate of conduction of electrical impulses through the heart. • Alter the refractory period of cardiac muscle between consecutive contractions Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

  14. Antidysrhythmic Agents • Group 1, 1A, 1B, 1C: decrease the influx of sodium ions, stabilizing membranes • Group 2: depress phase 4 in depolarization • Group 3: prolong repolarization in phase 3 • Group 4: depress phase 4 depolarization and prolong repolarization of phases 1 and 2 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

  15. Beta-adrenergic Blocking Agents • Inhibit beta1 and beta2 sympathetic receptors • Reduce heart rate • Reduce contractility • Decrease supraventricular and ventricular rhythms • Decrease blood pressure Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

  16. Antidysrhythmic Agents • Adverse effects • Cause bronchoconstriction • Cause heart failure • Examples: propanolol (Inderal), esmolol, bretylium tosylate (Bretylol) Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

  17. Calcium Channel Antagonists • Reduce the influx of calcium into the cell: • Prevention or reversal of spasms of the coronary blood vessels • Coronary artery dilation • Reduction of myocardial oxygen consumption • Example: verapamil Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

  18. Adenosine • Slow conduction through the AV node • Cardioverts paroxysmal supraventricular tachycardia (PSVT) • Side effects • Facial flushing • Shortness of breath • Headache • Nausea and vomiting Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

  19. Adrenergic or SympathomimeticDrugs • Affect alpha- or beta-adrenergic receptors • Treat shock • Mimic epinephrine and/or norepinephrine • Cause increase in heart rate • Cause vasoconstriction • Reverse hypotension from shock • Cardiac or trauma Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

More Related