Digoxin is originated from the foxglove plant. It is usually given to patients who suffer from arrhythmias. Arrhythmia is a condition in which the myocardium beings to either beat too fast (tachycardia) or beat too slow (bradycardia). Antiarrhythmic drugs are given to the patient to correct these non-synchronous contractions and bring the myocardium back into a normal rhythm. Pharmacodynamics Digoxin is a cardiac glycoside; its pharmacological properties are related to its ability to inhibit the sodium-potassium ATPase. Digoxin upon administration causes the intracellular levels of sodium to increase, above normal physiological concentrations. This increase in sodium levels causes the sodium-calcium exchanger to be active. This then exchanges the intracellular sodium for extracellular calcium. This extracellular calcium upon entry into the myocardium induces intracellular calcium to be released due to calcium induced calcium release (CIRC). Digoxin has a negative chronotropic and positive inotropic effect on the myocardium; these can be explained by the electro-physiochemical changes which take place across the myocardium upon the application of digoxin. The negative chronotropy is due to the sodium-potassium ATPase being inhibited, this then leads to a less number of action potentials (APs) being generated and as a result if less APs are being generated this will have a negative effect on the rate at which the myocardium contracts (negative chronotropic effect). The positive inotropic effects are linked with the activation of the sodium-calcium exchanger, upon activation it introduces extracellular calcium into the myocardium, this extracellular calcium along with the intracellular calcium (CIRC) causes an increase in the forc... ... middle of paper ... ...). Stockley's Drug Interactions - Digoxin. [ONLINE] Available at: [Accessed 2 February 2012]. The Digitalis Investigation Group, (1997). The Effect of Digoxin on Mortality and Morbidity in Patients with Heart Failure. New England Journal Medicine, (issue 336). pp 525-533 The electronic Medicines Compendium (eMC), (2011). Capoten Tablets - Patient Information Leaflet (PIL). [ONLINE] Available at: [Accessed 15 February 2012]. The electronic Medicines Compendium (eMC), (2012). Digoxin Tablets BP 250 micrograms - Summary of Product Characteristics (SPC). [ONLINE] Available at: [Accessed 2 February 2012].
Antiarrhythmic agents are used to suppress abnormal rhythms of the heart. Many attempts have been made to classify antiarrhythmic agents. There is a problem from the fact that many of the antiarrhythmic agents have multiple actions, making any classification accurate. Betapace (sotalol) comes in tablets and solution for oral a...
Epinephrine can be added to NE if needed to maintain acceptable BP, or substituted if necessary. Vasopressin (0.03 units/min) can be used as an adjunct to increase MAP,or to lower NE dose; it should not be used as a single agent. Dopamine can be used as an alternative to NE, but only in patients meeting criteria due to risk of arrhythmias; low dose dopamine not to be used for renal protection. Phenylephrine not recommended in most cases; can be utilized if NE leads to serious arrhythmias, CO is known to be high yet BP continues to be low, or as salvage therapy when MAP target is not achieved by other means. An arterial cath should be placed ASAP in patients who require vasopressors. Inotropes can be added to vasopressors or used alone, with a doubatmine trial of up to 20 mcg/kg/min as an option if myocardial dysfunction is suspected by elevated cardiac filling pressures and low CO, or if hypoperfusion is still evident although intravascular volume and MAP are at goal. Bicarbonate should not be used in patients with pH greater than or equal to
Diprivan: Relaxes and sedates the patient before surgery / In order to insert the IABP and intubation on the patient.
...on and forms an inhibitory complex with caveolin-1 leads to decrease in activity of enzyme in the cells. Transcription of Cav-1 gene is regulated by cholesterol responsive elements. Exposure of fibroblast and endothelial cells to free cholesterol and LDL Cholesterol was found to up regulate Cav-1 expression. Ca+2 mobilizing agents cause disinhibiton of e NOS by promoting Ca+2/Calmodulin triggered dissociation of Cav-1.
Systolic and Diastolic are the two types of Heart Failure. Systolic dysfunction occurs when the heart muscle doesn't contract with enough force, which means there is less oxygen-rich blood that is pumped throughout the body. Diastolic dysfunction is the heart contracts normally, but the ventricle does not relax properly, reducing the amount of blood that can enter the heart and raise the blood pressure in the lungs. Heart failure is a progressive condition and can worsen over time. There are four stages of heart failure that have been classified by the AHA and ACC. Stage A are people that are at a high risk for developing heart failure. This includes people with high blood pressure, Diabetes, coronary artery disease and metabolic syndrome. Stage A also include people with a history of alcohol abuse, cardiotoxic drug therapy, rheumatic fever, and family history of cardiomyop...
The second part of this lab was a computer simulation program to illustrate a frog’s electrocardiogram using various drugs in an isolated setting. The computer program entitled “Effects of Drugs on the Frog Heart” allowed experimental conditions to be set for specific drugs. The different drugs used were calcium, digitalis, pilocarpine, atropine, potassium, epinephrine, caffeine, and nicotine. Each of these drugs caused a different electrocardiogram and beats per minute reading. The calcium-magnesium ration affects “the permeability of the cell membrane”(Fox). When calcium is placed directly on the heart it results in three physiological functions. The force of the heart increases while the cardiac rate decreases. It also causes the appearance of “ectopic pacemakers in the ventricles, producing abnormal rhythms” (Fox). Digitalis’ affect on the heart is very similar to that of calcium. It inhibits the sodium-potassium pump activated by ATP that promotes the uptake of extracellular calcium by the heart. This in return strengthens myocardial contraction (Springhouse). Pilocarpine on the other hand
There has been an increase in the Misuse and Abuse of prescription drugs to treat Attention Deficit Hyperactivity Disorder (ADHD). the number of children on medication for ADHD has grown from 600,000 in 1990 to 3.5 million in 2013 according to the Centers for Disease Control and Prevention. But although there is an over-medication of ADHD drugs, there is actually and under-medication since not all the right people are getting medicated. Many individuals lack insurance or are insured with health plans that do not cover the outpatient prescription drugs they need and cannot afford.10 Therefore, Individuals covered by various health plans and programs, and those who have no prescription drug coverage, pay significantly different prices for the same medications. As the demand for ADHD drugs grows, higher prescribing rates and increasing drug prices result, which creates problems for these number of Americans who cannot afford the treatment they require.
Hochadel, M. (2014). Mosby's Drug Reference for Health Care Professionals (fourth edition ed.). : Elsevier.
In today days Atrial Fibrillation (AF) is the most common cardiac dysrhythmia that is often seen in clinical practice. There are 700,000 strokes in the USA each year and 15% of it caused by Atrial Fibrillation. For a long period of time warfarin was the only oral anticoagulant available in the US for patients with atrial fibrillation to prevent stroke events. Recently a new oral anticoagulants, including apixaban, dabigatran, and rivaroxaban have been developed and became available in the US for the stoke prevention and systemic embolism for patients with atrial fibrillation. Now, when all three new anticoagulants are available as an alternative to warfarin for the same indication, they make the health care providers question which agent is the best and for which patients. New agents have practical advantages over warfarin that has many limitations such as need for monitoring, regular dose adjustment, food and drug interaction and side effects. The major goal of the health care providers is to prescribe the safest and the most effective alternative drug and dose to each individual patient with AF. However, the approval for clinical use by the Food and Drug Administration (FDA) and the European Medicine Agency differ for anticoagulants and their dosages, and for the individual indication (Harenberg & Kraemer, 2012). Thus, more research needs to be done regarding the monitoring tools for new anticoagulant agents, and extend the use of these agents to other patient population.
One of the leading causes of death in the United States is heart disease. “Approximately every 29 seconds one American will have a heart attack, and once a minute one American will die from a heart attack” (Ford-Martin and Odle, 915). According to the Gale Encyclopedia of Alternative Medicine men over the age of 45 and women over the age of 55 are considered at risk for heart disease. Heart disease is a major cause of death. It is beneficial to individuals who seek to prevent heart disease to recognize the risks leading to heart attacks as they are one of the primary indications of developing heart disease; especially those that fall into the at risk age groups. These risks consist of some that cannot be changed such as heredity risks, or those that can change such as smoking habits. It is very important to know these specific risks for prevention and to understand the symptoms of heart attacks, such as sweating or the feeling of weakness so if these or other symptoms occur people are aware. Finally heart disease treatment is of vital importance if you experience a heart attack so you can learn how to prevent another one from occurring.
Digoxin (Lanoxin) 250 mcg daily: In heart failure, increases contractility by inhibiting sodium/potassium ATPase pump in myocardial cells promoting calcium influx via sodium –calcium exchange pump ("Digoxin," 2015, p. 6).
Cardiac dysrhythmias come in different degrees of severity. There are heart conditions that you are able to live with and manage on a daily basis and those that require immediate attention. Atrial Fibrillation is one of the more frequently seen types of dysrhythmias (NIH, 2011). The best way to diagnosis a heart condition is by reading a cardiac strip (Ignatavicius &Workman, 2013). Cardiac strips play an chief part in the nursing world allowing the nurse and other trained medical professionals to interpret what the heart is doing. In a normal strip, one can clearly identify a P wave before every QRS complex, which is then followed by a T wave; in Atrial Fibrillation, the Sinoatrial node fires irregularly causing there to be no clear P wave and an irregular QRS complex (Ignatavicius & Workman, 2013). Basically, it means that the atria, the upper chambers of the heart, are contracting too quickly and no clear P wave is identified because of this ‘fibrillation’ (Ignatavicius & Workman, 2013).
Corlanor use is indicated to reduce the risk of hospitalization for worsening heart failure in patients with stable, symptomatic chronic heart failure with left ventricular ejection fraction ≤ 35%, who are in sinus rhythm with resting heart rate ≥ 70 beats per minute and either are on maximally tolerated doses of betablockers or have a contraindication to beta-blocker use.
... patients with heart failure: Impact on patients. American Journal of Critical Care, 20(6), 431-442.
In light of the findings of the study, the pharmacokinetic parameters of this drug would v...