digoxin.jpgDigoxin (Cardiac glycoside)
Generic: Lanoxin

Actions & Uses
This drug is used to treat HF, atrial tachycardia, flutter or fibrillation. Digoxin inhibits sodium potassiun ATPase, promoting incrased force of cardiac contraction, cardiac output and tissue perfussion. Also decreased ventricular rate.
Dosage: A:PO: 0.5-1 mg intially in 2 divided doses
This drug is given in liquid and capsule form.

Side Effects & Reactions
Overdose or sccumulation of digoxin causes digitalis toxity. Older adults are more prone to toxicity. Some side effects are anorexia, nausea, vomitting, headache, blurred vision, diplopa, photphobia, drowsiness,fatigue and confusion.
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Nursing Implications
A nurse needs to check the apical pulse rate before administering this drug. The signs of peripheral and pulmonary edema need to be determined. The serum digoxin level needs to be checked to make sure the level is appropriate for administering drug.

REFERENCES:
Kee, J. L., Hayes, E. R., & McCuistion, L. E. (2009). Pharmacology A Nursing Process Approach (6th ed.)
(pp. 624-627). St. Louis: Saunders Elsevier


Nitroglycerin (Antianginal)
Generic: Nitrostat, Nitro-Bid, Transdern-Nitro patch, NTG, Nitrogard SR, Nitrol Nitrate nitro.jpg

Actions & Uses
This drug is used to control angina pectoris (anginal pain). The action of this drug is to decrease myocardial demand for oxygen; decrease preload by dilating veins, indirectly decreasing afterload. This drug is the most commonly used nitrate.
Dosage: A:PO/SL: 0.3, 0.4, 0.6 mg; repeat q5min x 3 as needed. This drug is administed via IV, ointment, and patch.

Side Effects & Reactions
Headaches are a common side effect of nitroglycerin. Hypotension, dizziness, weakness and faintness are also side effects of this drug.
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Nursing Implications
A nurse should monitor vital signs, have client lie or sit down when taking a nitrate for the first time, offer sips of water before giving sublingual nitrates, apply Nitro-Bid ointment to the designated mark on paper and do not apply the Nitro-Bid ointment or the Transdern Nitro patch in any area on the chest in the vicinity of defibrillator-cardioverter paddle placement.

REFERENCES:
Kee, J. L., Hayes, E. R., & McCuistion, L. E. (2009). Pharmacology A Nursing Process Approach (6th ed.)
(pp. 629-634). St. Louis: Saunders Elsevier



Acebutolol HCI (Beta1, blocker, cardioselective beta-adrenergic, antagonist)
Generic: Sectral, Monitan acebutolol.jpg

Actions & Uses
Acebutolol is used to aid in the treatment of recurrent stable ventricular dyshythmias, angina pectoris, and hypertension. This drug blocks beta1, adrenergic receptors in cardiac tissues.
Dosage: Ventricular dysrhythmia A:PO: 200 mg b.i.d. q12h

Side Effects & Reactions
Some side effects consist of dizziness, nausea, headache, hypotension, diaphoresis, fatigue, constipation, diarrhea, and occasionally impotence. Some adverse reactions are palpitations with abrupt withdrawal.
Life threatening reactions can include agranulocytosis, brochospasm with high doses.
acebutololall.jpg
Nursing Implications
Vital signs should be monitored. Administer drug by IV push or bolus over a period of 2 to 3 minutes or as prescribed. Monitor patients ECG for abnormal patterns and report any findings that are abnormal.

REFERENCES:
Kee, J. L., Hayes, E. R., & McCuistion, L. E. (2009). Pharmacology A Nursing Process Approach (6th ed.)
(pp. 639-640). St. Louis: Saunders Elsevier