GROUP 6

Medications for
HEART FAILURE

NGOA
BAGUIO
CASTANOS
SUMBI
FERRER
LOPEZ
 DIGOXIN

Generic Name: Digoxin

Brand Name: Lanoxin
Dosage and Frequency:
0.5 mg IV x1
0.25 mg IV after 6 hours
0.125 mg by mouth daily
 MECHANISM OF
CLASSIFICATION INDICATIONS
ACTION

- Cardiac glycoside - Inhibits the sodium- - Treatment of heart failure

potassium ATPase pump, and atrial fibrillation/flutter.
leading to increased
- Antiarrhythmic intracellular calcium
concentration and
enhanced myocardial
contractility.

- Slows the heart rate by

stimulating the vagus nerve
and decreasing conduction
through the AV node.
CONTRAINDICATIONS SIDE EFFECTS ADVERSE EFFECTS

Hypersensitivity to Nausea/vomiting Cardiac Arrhythmias

digoxin or other Headache
cardiac glycosides. Hyperkalemia
Dizziness
Ventricular Visual disturbances Digitalis toxicity
fibrillation. (manifests as nausea,
(blurred or yellow- vomiting, confusion,
Uncontrolled tinted vision) visual disturbances,
ventricular Fatigue and arrhythmias)
arrhythmias.
Thrombocytopenia
Severe heart block.
Gynecomastia (in
males)
 NURSING RESPONSIBILITIES
BEFORE
Assess baseline vital signs
and cardiac rhythm.
Check serum potassium
levels
Assess patient's renal
function
Review patient's history
for any contraindications
or allergies to digoxin.
Educate patient on the
purpose of digoxin and
potential side effects to
report
DURING
Administer IV doses slowly over
at least 5 minutes to minimize
risk of adverse reactions.
Monitor cardiac rhythm and
vital signs continuously during
IV administration.
Observe for signs of digitalis
toxicity, such as nausea,
vomiting, or changes in vision.
Document administration time
and dose accurately in patient's
medical record.
Provide emotional support and
reassurance to patients who
may be anxious about receiving
the medication.
AFTER
Monitor patient for onset of
therapeutic effects, such as
improved cardiac output or
decreased heart rate.
Continue to monitor vital signs
regularly, especially heart rate
and rhythm.
Assess for any new adverse
reactions or signs of toxicity.
Document patient's response to
medication and any interventions
taken.
Educate patient on the
importance of compliance with
oral digoxin regimen and
schedule follow-up appointments
for monitoring.
 FUROSEMIDE

Generic Name: Furosemide

Brand Name: Lasix
Dosage: 40 mg
Route: IV
Frequency: BID
 MECHANISM OF
CLASSIFICATION INDICATION
ACTION

- loop diuretic Furosemide works by - Treatment of edema

inhibiting the reabsorption associated with congestive
of sodium and chloride in heart failure, liver cirrhosis,
the ascending loop of and renal disease
Henle in the nephrons of
the kidneys. This increases - hypertension
the excretion of sodium,
chloride, and water, leading
to diuresis (increased urine
production).
CONTRAINDICATIONS SIDE EFFECTS ADVERSE EFFECTS

CNS: dizziness, headache,

Hypersensitivity to Nausea/vomiting vertigo, tinnitus
furosemide
Headache
CV: orthostatic hypotension,
anuria (lack of urine Dehydration palpitations, syncope
production)
Electrolyte imbalance GI: nausea, vomiting,
electrolyte depletion
Hypotension diarrhea, constipation
hepatic coma
Dizziness Skin: rash, photosensitivity
reaction

Hematological:
thrombocytopenia

EENT: ototoxicity
 NURSING RESPONSIBILITIES
BEFORE
Perform a thorough assessment
of the patient's medical history.
Evaluate the patient's vital signs,
including blood pressure, heart
rate, respiratory rate, and
temperature.
Prepare the appropriate dosage
of Furosemide according to the
prescription, ensuring accuracy
in measurement and
administration.
Check the patient's electrolyte
levels, especially potassium, as
Furosemide can cause
electrolyte imbalances.
Assess the patient's current fluid
status and weight to determine
the need for diuretic therapy.
DURING
Monitor the patient's vital signs,
including blood pressure, heart
rate, and respiratory rate,
throughout the administration of
Furosemide.
Assess the patient for signs of
dehydration, electrolyte
imbalances, and other adverse
reactions, such as dizziness,
nausea, or vomiting.
Measure and record the patient's
urine output to evaluate the
effectiveness of diuretic therapy.
Monitor the IV site for signs of
infiltration or phlebitis to ensure
proper drug delivery and prevent
complications.
Watch for adverse reactions such
as dizziness, headache, nausea, or
ototoxicity, especially during the
initial administration period or with
rapid intravenous infusion.
AFTER
Continue to monitor the patient's
vital signs, fluid status, and
electrolyte levels following the
administration of Furosemide.
Assess the patient for any delayed or
ongoing adverse reactions, including
changes in renal function or
electrolyte balance.
Evaluate the patient's response to
diuretic therapy by assessing
symptom relief, such as reduced
edema or improved respiratory
status.
Provide education on medication
adherence, dietary modifications,
and symptom recognition.
Record the patient's response to
therapy and any changes in
symptoms or vital signs.
 POTASSIUM
CHLORIDE
Generic Name: Potassium Cl
Brand Name: K-Lyte
Dosage: 10 mEq

Route: PO

Frequency: TID w/meals

 MECHANISM OF
CLASSIFICATION INDICATION
ACTION

- Electrolyte - Replenishes potassium - Treatment and prevention

levels in the body of potassium deficiency
-Potassium supplement (hypokalemia)
- An essential electrolyte
- Adjunctive therapy in
for various physiological patients receiving diuretics
functions including or digitalis
nerve transmission
muscle contraction - Used in certain medical
maintenance of normal conditions such as severe
cardiac rhythm. vomiting, diarrhea, or
metabolic alkalosis where
potassium loss is excessive
CONTRAINDICATIONS SIDE EFFECTS ADVERSE EFFECTS

Hyperkalemia Nausea/Vomiting CNS: paresthesia of limbs,

(high potassium levels) listlessness, confusion, weakness
or heaviness of limbs, flaccid
Abdominal Paralysis
Severe renal discomfort/pain .
impairment or renal
CV: postinfusion phlebitis,
failure Diarrhea arrhythmias, heart block,
cardiac arrest, ECG changes,
Addison's disease GI ulceration/bleeding hypotension.

Untreated Hyperkalemia GI: nausea, vomiting, abdominal

adrenal insufficiency if administered too rapidly pain, diarrhea.
or in excessive doses
Metabolic: hyperkalemia.
Concurrent use of
potassium-sparing Respiratory: respiratory
diuretics paralysis.
 NURSING RESPONSIBILITIES
BEFORE
Assess the patient's serum
potassium levels and renal
function
Review the patient's
medical history for any
contraindications or risk
factors for hyperkalemia.
Monitor vital signs,
particularly heart rate and
rhythm
Educate patient on the
purpose of digoxin and
potential side effects to
report
DURING
Administer orally with
glass of water & with
meals
Continuously assess
response to therapy,
including serum potassium
levels and clinical signs of
hypokalemia or
hyperkalemia.
Observe for any
gastrointestinal adverse
effects such as nausea,
vomiting, or abdominal
discomfort.
AFTER
Continue to monitor the patient's
serum potassium levels, & renal
function as indicated.
Monitor vital signs regularly,
especially heart rate and rhythm.
Educate patient about the
importance of maintaining proper
hydration and dietary potassium
intake.
Instruct the patient to report any
adverse effects or changes in
symptoms promptly.
Document the patient's response
to treatment and any
interventions taken.
 CARVEDILOL

Generic Name: Carvedilol

Brand Name: Coreg
Dosage: 6.25 mg
Route: PO
Frequency: OD
 MECHANISM OF
CLASSIFICATION INDICATION
ACTION

Pharmacotherapeutic: Reduces cardiac output - High blood pressure

- Beta Adrenergic and tachycardia, causes
Blocker vasodilation, and - Long-lasting, mild to
severe heart failure
decreases peripheral
Clinical: vascular resistance, which
- Antihypertensive - Left ventricular
reduces blood pressure dysfunction after a heart
and cardiac workload. attack
When given for at least 4
weeks, carvedilol reduces
plasma renin activity.
CONTRAINDICATIONS SIDE EFFECTS ADVERSE EFFECTS

Hypersensitivity to CNS: Asthenia, depression,

Frequent (6% - 4%): dizziness, fatigue, fever,
carvedilol - fatigue, dizziness headache
Bronchial asthma or
Occasional (2%): CV: Angina, AV block,
related bronchospastic bradycardia, edema, heart
conditions - diarrhea, bradycardia,
failure, hypertension
rhinitis, back pain
Decompensated Heart
GI: Abdominal pain, diarrhea,
Failure Rare (less than 2%): elevated liver function test
- orthostatic hypotension, results, melena, nausea,
Severe hepatic
drowsiness, UTI, viral vomiting
impairment
infection
Second or third-degree RESPIRATORY: Dyspnea,
increased cough
AV block
Severe bradycardia EENT: Blurred vision, dry eyes,
periodontitis, pharyngitis
 NURSING RESPONSIBILITIES

BEFORE DURING AFTER

Continuously monitor the patient's

Monitor B/P for Administer carvedilol vital signs, particularly blood
hypotension, orally as directed, pressure and heart rate, for any
respirations for dyspnea changes indicating a response to
ensuring correct dosage carvedilol.
and timing
Assess pulse for quality, Advise patient to change positions
regularity, rate; monitor Monitor the patient slowly to minimize orthostatic
for bradycardia hypotension, especially during
closely during initiation of therapy or when dose
administration for any is increased.
Monitor intake and signs of adverse
output ratios and daily reactions, such as Instruct patient to report excessive
weight. fatigue and prolonged dizziness.
hypotension or
bradycardia. Provide ongoing patient education
Assist with ambulation if and support regarding carvedilol
dizziness occurs therapy, addressing any questions
or concerns the patient may have.
 ASPIRIN

Generic Name: Aspirin

Brand Name: Bayer
Dosage: 81 mg

Route: PO

Frequency: q24
 MECHANISM OF
CLASSIFICATION INDICATION
ACTION

- NSAID - Inhibits the enzyme - Mild to moderate pain

cyclooxygenase (COX),
- Analgesic thereby reducing the - Fever
production of prostaglandin
- Antipyretic which reduces inflammation,
- Inflammatory conditions
relieves pain, and lowers
- Anti-inflammatory fever.
- Prevention of transient
- Antiplatelet - Inhibits platelet aggregation ischemic attacks
by acetylating the platelet
enzyme cyclooxygenase, thus - MI
inhibiting the formation of
thromboxane A2, a potent
platelet aggregator.
CONTRAINDICATIONS SIDE EFFECTS ADVERSE EFFECTS

Hypersensitivity or allergy Derm: hypersensitivity rashes,

Nausea/Vomiting
to aspirin/NSAIDs itching urticaria, anaphylaxis
History of gastrointestinal Heartburn GI: GI bleeding, ulcers,
ulcers or bleeding.
perforation, gastritis,
History of asthma induced Bruising/Bleeding abdominal pain, nausea,
by vomiting, heartburn.
aspirin/NSAIDs. Drowsiness
Hematologic: increased risk of
Severe liver or kidney bleeding
disease.
Mild headache

Viral infections due to the Respiratory: exacerbate

risk of Reye's syndrome. asthma symptoms
or trigger bronchospasm

Renal: impair renal function

 NURSING RESPONSIBILITIES

BEFORE DURING AFTER

Assess the patient's Administer aspirin Monitor the patient's

medical history for any according to the response to aspirin
contraindications to prescribed dosage and therapy
aspirin therapy. route
Educate on potential side
Review the patient's Monitor the pt for signs effects and adverse
current medications for
potential interactions of adverse reactions reactions
with aspirin.
Reinforce patient Encouragenpatient to
Assess for allergies to education and encourage report any unusual
aspirin or NSAIDs. patient to report any symptoms or side effects
unusual symptoms
Measure vital signs, Monitor renal and hepatic
especially if aspirin is function if used long-term
being used to treat fever or in high doses.
or inflammation.
 LISINOPRIL

Generic Name: Lisinopril

Brand Name: Prinivil, Zestril
Dosage: 2.5 mg
Route: PO
Frequency: q12hrs
 MECHANISM OF
CLASSIFICATION INDICATION
ACTION

- ACE Inhibitors Inhibition of ACE leads to - treatment for high blood

reduced formation of active pressure and used to help
angiotensin, which results in heart function after heart
inhibition of narrowing or attack
constriction of blood vessels,
which results in reduced
blood pressure, and reduced
aldosterone resulting in
reduced sodium and water
retention in the body.
Reduced sodium and fluid
volume in the body will lead
to reduced blood pressure
CONTRAINDICATIONS SIDE EFFECTS ADVERSE EFFECTS

Hypersensitivity or Cough CNS: syncope, weakness

allergy to the drug
Dizziness Respiratory: symptoms of
patients with a history Fatigue upper respiratory tract
of angioneurotic infections (URTI)
edema relating to Headache
previous treatment Nausea/Vomiting GI: diarrhea, abdominal
with an angiotensin pain, dry mouth, tooth
converting enzyme Rash/Itching pain
inhibitor.
EENT: angioedema
alopecia, dry skin

Metabolic: hyperkalemia
 NURSING RESPONSIBILITIES

BEFORE DURING AFTER

Assess medical history, Administer Lisinopril per Observe for delayed adverse
especially heart failure, healthcare provider's
hypertension, and coronary reactions after Lisinopril
instructions, ensuring correct administration
artery disease, to determine dosage and technique.
suitability for Lisinopril therapy. Monitor pre- and post- Check renal function and
Confirm Lisinopril dosage and Lisinopril administration blood electrolytes after Lisinopril to
pressure and heart rate to
administration route matches assess hypertension control. compare with baseline.
patient records for accuracy. Watch for hypotension,
hyperkalemia, or renal issues
Explain the importance of
Evaluate baseline renal continued Lisinopril therapy,
function and electrolytes due to during Lisinopril treatment.
Lisinopril's impact on kidney Educate patients on Lisinopril adherence, and follow-up.
function and potassium levels. compliance, emphasizing
missed dose risks and Record and report any
Inform the patient about monitoring necessity. unexpected events during
Lisinopril's purpose, potential Record Lisinopril Lisinopril treatment.
side effects, and emphasize administration, vital signs, and
adherence to the prescribed any effects in the patient's
regimen. medical file.
 ATORVASTATIN

Generic Name: Atorvastatin

Brand Name: Atorvaliq,
Lipitor, Lypqozet

Dosage: 20 mg
Route: PO
Frequency: q24hrs
 MECHANISM OF
CLASSIFICATION INDICATION
ACTION

- Inhibits HMG-CoA - As adjunct for

- Antilipidemic reductase enzyme, which primary
reduces cholesterol hypercholesterolemia,
synthesis; high doses lead dysbetalipoproteinemia,
to plaque regression elevated triglyceride
levels

- prevention of CV disease
by reduction of heart risk
in those with mildly
elevated cholesterol.
CONTRAINDICATIONS SIDE EFFECTS ADVERSE EFFECTS

Pregnancy, Diarrhea CNS: Headache, asthenia,

breastfeeding, Runny or stuffy nose insomnia
hypersensitivity, active Joint pain
hepatic disease Insomnia EENT: Lens opacities
UTI
Precautions: Gl: Abdominal
Nausea
Previous hepatic cramps, constipation,
Loss of appetite
disease, alcoholism, diarrhea, flatus, heartburn,
Indigestion dyspepsia, liver dysfunction,
severe acute infections,
trauma, severe Muscle Spasm pancreatitis
metabolic Musculoskeletal pain
disorders Chest pain GU: Impotence, UTI
electrolyte imbalance Mouth and throat pain
Allergic reaction for INTEG: Rash
atorvastatin
 NURSING RESPONSIBILITIES

BEFORE DURING AFTER

Assess the patient's medical
history, including any allergies
or contraindications to statins.
Ensure it does not interact
adversely with any other
medications the patient is
taking.
Provide information about the
purpose, how it works,
potential side effects, and the
importance of compliance
with the prescribed regimen.
Do not crush, dissolve, or
divide atorvastatin.
Obtain LFTs as a baseline and
periodically during therapy.
Implement safety and fall
precautions
Administer atorvastatin orally Encourage a low-fat, low
as instructed by the healthcare cholesterol diet.
provider, usually with or
without food, depending on Evaluate Therapeutic response:
the specific instructions. decrease in LDL, total
cholesterol, triglycerides, CAD;
Administer at bedtime increase in HDL; LDL ratio
Do not take with grapefruit
Prescribed regimen will continue:
juice. exercise program and smoking
cessation
Do not skip or double the
dose Accurately document the
administration of atorvastatin,
Observe the patient for any including the dosage given, route
immediate adverse reactions of administration, any observed
or signs of intolerance during
and shortly after side effects, and the patient's
administration response
 NITROGLYCERIN

Generic Name: Nitroglycerin

Brand Name: Nitrostat
Dosage: 0.4 mg
Route: SL
Frequency: q5 mins 3x PRN
 MECHANISM OF
CLASSIFICATION INDICATION
ACTION

- Decreases preload and - Chronic stable

- Antianginal afterload, which are
responsible for decreasing - Angina pectoris,
left prophylaxis of angina pain,
ventricular endiastolic heart failure, acute MI
pressure, systemic vascular
resistance; - Controlled hypotension for
dilates coronary arteries, surgical procedures, anal
improves blood flow fissures
through
coronary vasculature, dilates
arterial and venous beds
systematically
CONTRAINDICATIONS SIDE EFFECTS ADVERSE EFFECTS

Hypersensitive to Headache CV: severe orthostatic

nitrates and in those hypotension, tachycardia,
with early MI, severe Transient flushing of palpitations, fainting.
anemia, increased face/neck
intracranial pressure, EENT: burning
angle-closure Dizziness
glaucoma, orthostatic GI: nausea, vomiting
hypotension Weakness
SKIN: cutaneous
Orthostatic vasodilation, contact
Hypotension dermatitis, rash

OTHER:
hypersensitivity
 NURSING RESPONSIBILITIES

BEFORE DURING AFTER

Review the patient's medical Administer as prescribed Monitor the patient for any
history, focusing on heart by the healthcare lingering effects or delayed
failure, hypertension, and adverse reactions especially
coronary artery disease, to provider, ensuring regarding changes in blood
assess the appropriateness of accurate dosage and pressure or heart rate.
Nitroglycerin therapy in the proper administration
absence of angina. technique Assess for Nitroglycerin
tolerance or rebound
Verify the prescribed dosage, hypertension, which may
route of administration, and Monitor the patient's require adjustments to the
frequency against the patient's vital signs, especially dosage or regimen.
medical record to ensure blood pressure and
accuracy. heart rate Provide patient education on
Assess the patient's baseline the proper use of
vital signs, including blood Assess for signs and Nitroglycerin, and importance
of keeping it accessible for
pressure, heart rate, and symptoms of related immediate use
respiratory rate adverse reactions,
Educate patient about its Document administration, vital
mechanism of action, signs, and any observed effects
intended effects, potential side or adverse reactions in the
effects, and proper patient's medical record.
administration.
Thank you for
your attention!