Cardiac Glycosides & Heart Failure Practice Flashcards

Vocabulary-style flashcards covering pharmacology for heart failure, including adrenergic agonists, ARNIs, and cardiac glycosides.

Epinephrine (Adrenalin)

A prototype catecholamine and nonselective alpha-1, beta-1, and beta-2 adrenergic agonist used as a first-line emergency medication for anaphylaxis and cardiac arrest.

Alpha-1 Receptor Stimulation (Epinephrine)

Causes vasoconstriction, which raises blood pressure and reduces airway swelling.

Beta-1 Receptor Stimulation (Epinephrine/Dobutamine)

Increases heart rate and cardiac contractility.

Beta-2 Receptor Stimulation (Epinephrine)

Promotes bronchodilation and reduces the release of mediators from mast cells.

Epinephrine Extravasation

A serious complication causing severe local vasoconstriction and tissue necrosis, often treated with local phentolamine.

Dobutamine (Dobutrex)

An adrenergic agonist and prototype catecholamine that primarily stimulates beta-1 receptors to increase contractility and cardiac output in short-term low-output states.

Positive Inotrope

A classification for drugs like dobutamine and digoxin that increase the force of cardiac contraction.

Sacubitril / Valsartan (Entresto)

An Angiotensin Receptor-Neprilysin Inhibitor (ARNI) used for chronic heart failure to reduce hospitalization and cardiovascular death.

Neprilysin Inhibition

The mechanism of sacubitril that maintains active natriuretic peptides longer, promoting vasodilation and the excretion of sodium and water.

ARNI and ACE Inhibitor Interaction

These medications must never be given together; a 36-hour washout period is required when switching from an ACE inhibitor to sacubitril/valsartan.

Digoxin (Lanoxin)

A cardiac glycoside and Class VI rhythm medication that inhibits the sodium-potassium ATPase pump to increase intracellular calcium, making the heart beat slower but stronger.

Digoxin Therapeutic Level

The safe range for serum concentration is $0.6-1.2$. Levels exceeding $1.2$ (e.g., $2.8$ or $2.9$) are considered toxic.

Digoxin Toxicity Symptoms

Manifestations include nausea, vomiting, anorexia, confusion, and visual disturbances such as yellow/green vision or halos.

Digoxin Immune Fab

The treatment used for life-threatening digoxin toxicity.

Apical Pulse (Digoxin Nursing)

Assessment required for one full minute before administration; the dose should be held if the heart rate is less than $60\,\text{beats/min}$.

Loop Diuretics and Digoxin Interaction

Medications like furosemide or bumetanide cause potassium loss (hypokalemia), which increases the risk of digoxin toxicity.