Learning objectives
Upon completion of this chapter, you should be able to:
1.
Describe the pathophysiological process of heart failure and the resultant clinical signs.
2.
Explain the body’s compensatory mechanisms that occur in response to heart failure.
3.
Describe the therapeutic actions, indications, pharmacokinetics, contraindications and cautions, most
common adverse reactions and important drug–drug interactions associated with the cardiotonic agents.
4.
Discuss the use of cardiotonic agents across the lifespan.
5.
Compare and contrast the drugs digoxin and digoxin immune Fab.
6.
Outline the care considerations, including important teaching points, for people receiving cardiotonic agents.
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Cardiotonic agents
Glossary of key terms
cardiomegaly:
enlargement of the heart, commonly seen with chronic hypertension, valvular disease and heart failure
cardiomyopathy:
a disease of the heart muscle that leads to an enlarged heart and eventually to complete heart muscle failure and
death
dyspnoea:
discomfort with breathing, often with a feeling of anxiety and inability to breathe, seen with left-sided heart failure
haemoptysis:
blood-tinged sputum, seen in left-sided heart failure when blood backs up into the lungs and fluid leaks out into the
lung tissue
heart failure (HF):
a condition in which the heart muscle fails to adequately pump blood around the cardiovascular system, leading
to a backup or congestion of blood in the system
nocturia:
getting up to void at night, reflecting increased renal perfusion with fluid shifts in the supine position when a person has
gravity-dependent oedema related to heart failure; other medical conditions, including urinary tract infection, increase the need to
get up and void
orthopnoea:
difficulty breathing when lying down, often referred to by the number of pillows required to allow a person to breath
comfortably
positive inotropic effect:
results in an increased force of contraction
pulmonary oedema:
severe left-sided heart failure with backup of blood into the lungs, leading to loss of fluid into the lung tissue
tachypnoea:
rapid and shallow respirations, seen with left-sided heart failure
Test your current knowledge of cardiotonic agents with a PrepU Practice Quiz!
CARDIOTONIC AGENTS
Cardiac glycoside
digoxin
Phosphodiesterase inhibitor
milrinone
DIGOXIN ANTIDOTE
digoxin immune Fab
