Drugs that increase cardiac output Cardiac  glycosides(digoxin)  act  by  inhibiting sodium and potassium ATP  and then making more calcium available  to activate contracted proteins.  Cardiac  contractility and cardiac output are increased. Onset,  peak, and duration vary widely among  products.  Most products are metabolized  in the liver and excreted by the kidneys. The most common  side  effects  are  cardiac  disturbances,  headache,  hypotension,  and  GI  symptoms.  Also common are blurred vision  and yellow-green halos. Assess: Cardiac  system:  B/P,  pulse,  respirations, and increased urine output Apical pulse for 1 min before giving  product; if pulse ,60 bpm, take again in  1 hr; if still ,60 bpm, notify prescriber Electrolytes: K, Na, Cl, Mg; renal function studies, including BUN and creatinine; and blood studies Evaluate: Therapeutic  response:  decreased  weight,  edema,  pulse,  respiration;  increased urine output

1. CHIRAYU COLLEGE OF NURSING,
BHOPAL
Subject- Pharmacology
Topic- Cardiotonics
Placement Of Student- Bsc Nursing II Year
Prepared By
Mr. Migron Rubin
Lecturer

2. DEFINITIONS
 Drugs that increase cardiac output

3. CLASSIFICATION
Digoxin
Milrinone
Dexazoxane
Phenyephrine
Lisinopril
Dopamine
Dobutamin

4. Mechanism Of Action
 Cardiac glycosides(digoxin) act by inhibiting
sodium and potassium ATP and then making
more calcium available to activate contracted
proteins.
 Cardiac contractility and cardiac output are
increased.

5. Pharmacokinetics
 Onset, peak, and duration vary widely among
products.
 Most products are metabolized in the liver and
excreted by the kidneys.

6. Side Effects
 The most common side effects are cardiac
disturbances, headache, hypotension, and GI
symptoms.
 Also common are blurred vision and yellow-
green halos.

7. USES
 Deep venous thrombosis, MI, openheart surgery,
disseminated intravascular clotting syndrome; atrial
fibrillation with embolization, transfusion, and
dialysis.

8. CONTRAINDICATIONS
 Hypersensitive reactions may occur, and allergies
should be identified before these products are
given.
 Also, persons with ventricular tachycardia,
ventricular fibrillation, and carotid sinus
syndrome should not use these products.

9. Nursing Implications
 Assess:
 Cardiac system: B/P, pulse, respirations, and
increased urine output
 Apical pulse for 1 min before giving product;
if pulse ,60 bpm, take again in 1 hr; if
still ,60 bpm, notify prescriber
 Electrolytes: K, Na, Cl, Mg; renal function
studies, including BUN and creatinine; and
blood studies
 Evaluate: Therapeutic response: decreased weight,
edema, pulse, respiration; increased urine output

10. FAMILY TEACHING
 Teach How to take pulse before taking product
 Patient should record or graph pulse to
identify changes
 To avoid hazardous activities until stabilized on
this product; dizziness commonly occurs
 About the need for compliance in all areas
of medical regimen, including diet, exercise,
stress reduction, product therapy

11. REFERENCES
 Wilson Et.al. (2007), Drug Guide Prentice Hall Health, retrieved on 21/9/18
from http://www.robholland.com/Nursing/Drug_Guide/data/
 Stanley(2001),The timeline , A brief history of pharmacology retrieved on
21/9/18 from
http://pubs.acs.org/subscribe/archive/mdd/v04/i05/html/05timeline.html#aut
h
 Katzung(2011), Katzung basic clinical pharmacology.pdf, retrieved on
21/9/18 from http://www.bio-
nica.info/biblioteca/katzungbasicclinicalpharmacology.pdf
 ScheindlAmy M Karch (2001) . Lippincott nursing drug guide :
Philadelphia ; Lippincott Williams and Wilkins
 Beatrice B. (2005). Drug information for nurses ; Philadelphia . Lexi-coms
 Brenda Barness (2002) . Saunders drug handbook for health professionals :
United states of America ; WB Saunders company
 Linda Skidmore (1997) . Mosby drug guide : St Louis, Missouri Mosby
publication
 Tara V shanbhag (2004) . Pharmacology for nurses : New delhi : Sanat
printer Kundli