Hi everyone today i’m going to be presenting cardinal exercise and heart failure my name is photo so metal med mal and the classes nurse 312 carter galactus eyes are also known as the guitarist glycosides according to felicidade nando particle exercise have been used in the world for over 2,000 years the romans and egyptians used clint plants such as the you tell
Us for corrupt and then to tell us an answer to create natural medication that was first used by william weariness contemporary medication in 1785 for the treatment and symptoms of heart failure especially edema digoxin is currently the only cardiac glycoside that is approved for use in the united states digoxin is categorized as in control because it allowed for
Strong stronger cardiac contractions this in return causes increased cardiac output digoxin can also be used as antiarrhythmic because it slows down the heart rate and also slows ed conduction like jackson is considered a pregnancy category c as studies have shown that the dobson is able to cross the placenta there were no teratogenic effects notice on the fetus
Higher the fetus can also experience adverse affect the jackson else digoxin also enters with breast milk and therefore thin cause potentially affecting the neonate cardio galactus is work by inhibiting the sodium-potassium he faced pump this promotes sodium calcium exchange in the mars myocardial cells the increase in intracellular calcium allows for stronger
Contractions of the heart muscle this in return results in increased cardiac output indications for the johnson the main indication is for heart failure malcolm moderate heart failure digoxin increases left ventricular ejection fraction allows for equipment of signs and symptoms of heart failure this also allows for an increase exercise on the johnson can also
Be used for atrial fibrillation such as chronic atrial fibrillation i said 18 control ventricular responses and patients who are diagnosed with chronic atrial fibrillation it is contrary to cater for ventricular fibrillation and digoxin hypersensitivity power failures they find us an ability of the hearts ventricles to come for ejecting of blood this occurs
Due to functional or structure impairment of the ventricle when patients present with fluid overload is usually known as congestive heart failure heart failure occurs due to conditions that can cause the art to be damaged or overworked due to the increased workloads the heart begins accomplishing and developed and development of myocardial hypertrophy or first
This leads to changes in cardiac structures further increasing cardiac dysfunction so what causes heart failure according to the european society of cardiology coronary artery disease affects two-thirds of the patients that are diagnosed with heart failure the european society of cardiology also knows the diabetes and hypertension and contribute in many cases the
National heart lung and blood institute explains that there are other conditions that can cause and need to heart failure these include arrhythmias cardiomyopathy congenital birth defects and heart valve disease there are also other factors that may contribute to heart failure to include alcohol use illicit drug use hiv/aids and thyroid disorders so what are the
Symptoms of heart failure take football symptoms include shortness of breath orthopnea proceso small nocturnal dyspnea decrease exercise tolerance fatigue and they employ dima less typical signs and symptoms include coughing at night wheezing way to gain sympathy and publications so diagnosing heart failure it is very important for the medical providers to take
A comprehensive street to evaluate for heart failure the hottest we should include complaints past medical history social history and family history medical history is significantly important because there are many medical problems that can lead to heart failure including ischemic heart disease hypertension arrhythmias valve disease diabetes thyroid problems and
Others social history is also very important because smoking alcohol use illicit drug use in activity and that can also play important factors into development of heart disease so what is the goal of treatment the goal of digoxin treatment is to increase the cardiff workload and decrease the signs and symptoms of heart failure however treatments vary in digoxin if
It is used for atrial fibrillation for heart failure it allows for strong stronger cardiac contractions it increases the semetic left for circulation to you to increased cardiac up due to increased cardiac output it also includes the faces overall exercise tolerance it relieves symptoms of heart failure such as pulmonary and paranoid eema atrial fibrillation when
The johnson is used for atrial fibrillation it is used as a antiarrhythmic and it is proof for district gnaeus including atrial fibrillation in natural flutter digoxin allows for a decreased heart rate you to increase vagal tone from the sign up rachel and av node the johnson also slows av node conduction like all other medications the judson has various adverse
Effects the provider must evaluate and determine if the benefits outweigh the risk common adverse effects include fatigue and their ex yeah vomiting and nausea blacks training areas can occur with the johnson administration unfortunately the dutchman has a barrel narrow therapeutic cerium range basic book is varies from 0.5 to two point o nanograms per ml release
Is the rain algo explained that the johnson therapeutic level should be maintained as close to one pony nanograms per ml the most serious adverse effects that occurs with digoxin toxicity are av node locks and their extra cisco’s it is important to note that these affect me also accurate therapeutic level in patient should be monitored closely wounded octopus across
The city occurs the patient may also experience systemic signs and symptoms which include anorexia and nausea diarrhea headaches malaise liberation and yellow alert physician should be notified immediately so what is the antidote for the doctrine toxicity this will include the dr minus fam the incidence of the dachshund can toxicity varies from one to thirty percent
In order to avoid the dachshund patisserie the providers duties must include assessing all patient factors calculating current dosages appropriate administration family family education and education about signs and symptoms of the job complexity the anteaters include digibind nd chief m severe digoxin toxicity acquires immediate reversal in order to control
Potential fatal side-effects the justinian fab fab binds to digoxin to form molecules that the body cannot absorb blood levels of digoxin must be obtained to calculate dosage of digoxin union fab 40 milligrams of digoxin in new cloud neutralizes about 0.5 milligrams the jobs so nursing considerations it is very important for the nurse to evaluate the patient for
Any comorbidities or korean drug treatments that may affect your appearances since that johnson is mostly excreted unchanged from the kinney it is very important to monitor renal function as patients with renal disease may require smaller dose it is also very important to monitor potassium sodium and magnesium as electrolyte imbalances may cause the patient to be
A risk of the dallas texas and cardiac dysrhythmia the apical course must be taken by the nurse to determine the actual heart rate if the heart rate is less than 60 beats per minute the nursery should immediately contact a physician monitoring monitoring the daily way and urine alpha can be indicators in progress of treatment as the jobson increases we know our
Perfusion which in return needs to increase urine output patient education it is very important for the nurses to remind patients with heart failure that they should limit their overall sodium intake patients for our risk of hypokalemia should be encouraged to eat foods that are high in potassium this includes fresh fruit this include includes fresh and dry fruits
Vegetable juice and potatoes the inertia teach the patient to take the apical calls and two with otto johnson if the pulse is less than 60 beats per minute the patient to our observation should also be added to educated to contract the position immediately if there is a way to gain or weight loss weight of the one kilogram the patient will also notify the provider
Patient should be explained the signs and symptoms of digoxin toxicity and informed to seek emergency medical treatment is the signs and symptoms are present plans and symptoms of digoxin digoxin toxicity will free we’re explained in previous slides due to the narrow therapeutic range of the jackson patient should be encouraged to wear a medical alert bracelet
Special populations and cultural considerations according to the manufacturer laakso smith kline pharmacokinetics and specific racial populations have not been formally studied the manufacturers does not expected racial differences as the datsun is excreted unchanged by the kidneys it is important important to note that there are no significant differences in
Creating clearance and on bracelets renal function must be monitored because patients with decreased renal function may quired decreased doses culture may influence compliance asthma medication of medication regimen as it is noted that patients can be non-compliant you to their beliefs to your side effects and healthcare illiteracy socioeconomic factors also play
An important role this can include financial resources the elderly population are also at risk for non-compliance due to memory impairment poor eyesight inability to open bottles and difficulty swallowing medications drug herbal product interactions george they may cause some dysfunctions many hood a mirror on the very map l-29 funny dine tetracycline erythromycin
And or that was boring the increase in critic effects here the patient is on diuretics potential potassium should be monitored due to increased risk of electrolyte imbalances which in cost cardiac arrhythmias verbal products herbal products include licorice and lol mean increased risk of potassium depletion and son joan san john’s war may decrease that i was up
And effects from the johnson so some research that was done for digoxin of the treatment of chronic and acute heart failure i was um one face on withdrawing the johnson on patients who are already receiving ace inhibitors in theoretical patients who were kept on the johnson show no decrease in exercise ability but as the patients to stop taking this toxin shorty
Creats exercise tolerance patients will stop taking the dots and also experience worsening symptoms of heart failure heart rate increased body weight and also a decrease in left ventricular ejection fraction patient taking only diuretics and stopping the job to show the quickest deterioration the conclusion of the study showed that the jocks and improves hemodynamics
And decreases signs and symptoms of heart failure when used with other agents another researched article that i read was digoxin toxicity and bioethics the aim of the study published in the journal in the british journal of clinical pharmacology was to assess the johnson in diuretic interact the study is significant because patients with heart failure tend to be
Prescribed i heretics the diuretic study who were in theoretical cybernetics and potassium sparing diuretics it is well known that the job sink and diuretics interact and cause serious cardiac arrhythmias however the cost me back relationship has not been established the results of the study suggests that the johnson diuretics was associated with people the risk
Of digoxin toxicity it is supported important to note that luther i ratings and hydrochlorothiazide have the highest ratings of the johnson toxicity lastly the last research article that i used was the jocks in music and toxicity these johnson used to be the previous medication of choice to treat symptoms and signs of heart failure however it is very not a failure
Medication due to production toxicity and new medication sometimes such as angiotensin-converting enzyme ace inhibitors carter leukocytes halford signs and symptoms of health rate of heart failure however it does not increase the heart rate it does not decrease the rate of patient mortality accumulation of the johnson week leading to toxicity candy huge living
Permit renal impairment in drug to drug incorrect as stated before the antidote for the job some fantasies you just leave that so this is the pamphlet i create i try to make it as simple as possible and included what your cardiac glycosides are how they work the name of the medication and how it affects the body what the dachshund is used for and then for example
Art fail and then also signs and symptoms of heart failure i also includes our side effects of the toxin the most common ones are in the box and then i also included our signs and symptoms of digoxin toxicity which include diarrhea headache malaise rotation and yellow halos what else i included food interactions directly in verbal interactions and then dosing
Usual maintenance those of 0.1 2520 pebble at work today and all day depends on on the patient and this is just the lips of the references that are use for all my research in the powerpoint engagement thank you for your time
Transcribed from video
Digoxin and HF By jorge salmeron
