Chapter 25

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por Gary Zawadzki

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por Courtney Rockwood

Chapter 25

Digoxin

Prolongs refractory period of the AV node

Slows the heartbeat (negative chronotropic effect)

Allows more time for blood to enter the heart during diastole, which increases preload, allowing for a larger cardiac output

Larger cardiac output leads to improved pumping action of the heart, reducing the need to increase the heart rate to compensate for inefficient pumping

Decreased oxygen needs

Decreased workload on the heart!

Increases force of myocardial contraction (without increasing oxygen demand)

Improves efficiency of contractions without placing extra stress on cardiac muscle

Increases contractility and cardiac output

Improves overall circulation

Decreased afterload, relieving workload of the heart.

Less oxygenation needs of the heart

Patient doesn't need to breathe so hard anymore

Increased blood flow through lungs, aiding in proper oxygenation and gas exchange.

Helps to relieve central venous pressure and reduce peripheral edema (Jung Soo's case is severe as he has gained 9 kg in the past month, likely due to his edema)

Calcium Channel Blockers

Vasodilation of peripheral arteries

Decreased blood pressure

Decreased afterload

Decreased workload for the heart

Prevents worsening of heart failure

Increased blood flow and oxygenation to the periphery

Reduced peripheral edema

Vasodilation of coronary artery

More oxygen to the heart allows the heart to pump blood more efficiently, leading to improved circulation

Increases blood flow through the lungs, reducing pulmonary pressure and edema. Also increases oxygenation in the blood

Reduced pulmonary edema leads to easier breathing

Increased oxygen supply to the heart

Reduces the risk of myocardial cell death and progression of heart failure

Furosemide

Inhibits reabsorption of sodium and chloride from the loop of Henle and distal convoluted tubule

Increased renal excretion of water, sodium, chloride, potassium, and calcium

Helps to get rid of excess fluids within the bloodstream, decreasing blood pressure.

Decreased blood pressure leads to:

Decreased pulmonary blood pressure, which leads to reduced pulmonary edema, which leads to improved breathing and gas exchange.

Higher return of interstitial fluid to capillaries in the periphery

Decreased workload and oxygen consumption of the heart