digitalis therapy

digitalis therapy

the administration of a digitalis preparation to a person with a heart disorder to increase the force of myocardial contractions; produce a slower, more regular apical rate; and slow the transmission of impulses through the conduction system. It may be used in treating many cardiac disorders, including atrial fibrillation, atrial septal defect, coarctation of the aorta, congenital heart block, congestive heart failure, endocardial fibroelastosis, great vessel transposition, malformation of the tricuspid valve, myocarditis, paroxysmal atrial tachycardia, and patent ductus arteriosus.
method Complete prescriptions include the name of the digitalis preparation, the dosage in milligrams, the route and intervals of administration, and the pulse rate under which the drug is to be withheld. It is administered before feeding and is never mixed with the formula or food. Before each administration the person's resting apical pulse is checked for rate and rhythm for a full minute. If the rate is slower than desired; if it is irregular or shows a rapid rise or fall; if there are any signs of toxicity, such as anorexia, nausea, or vomiting; or if there are visual disturbances, the drug is withheld and the problem is reported.
interventions The nurse participates in calculating the dosage volume ordered, administers the drug, and observes for and reports any undesirable effects. Once the dosage is stabilized and before discharge, the nurse or pharmacist ensures that the patient understands the proper method, time, and purpose of administering the drug, as well as the need and the time to give the complete dose, when to withhold medication, and how to recognize and report signs of toxicity to the drug.
outcome criteria In addition to promoting more forceful myocardial contractions and a slower, more regular apical beat, digitalis therapy can reduce venous pressure, improve pulmonary and systemic circulation, increase urinary output, reduce edema, and stop paroxysmal atrial tachycardia and atrial fibrillation.
References in periodicals archive ?
Prenatal digitalis therapy and other medications have been tried in cases of foetuses suffering from heart failure or arrhythmia.
Paradoxically, recent research has shown that digitalis therapy is more effective in men than women.
One patient under digitalis therapy who received additional treatment with hydrocortisone exhibited erroneously high digoxin values, up to 7.
Continuing digitalis therapy (which is not very costly) in patients with congestive heart failure has been estimated to prevent 185,000 clinic visits, 27,000 emergency room visits, and 137,000 hospital admissions every year.
3,4) Additional risk factors include recent conversion from atrial fibrillation, digitalis therapy, high medication concentrations, rapid rate of intravenous infusion of a QT-prolonging medication (including antiarrhythmics, tricyclic antidepressants, antipsychotic medications, macrolide antibiotics, fluoroquinolones, and antifungal agents), baseline QT interval prolongation, subclinical LQTS, and ion-channel polymorphisms (TABLE 1).
4 mEq/L), bradycardia, congestive heart failure, and digitalis therapy.
In a placebo-controlled multicenter study of patients with heart failure refractory to diuretic and digitalis therapy,[34] 50 patients had captopril (75 to 300 mg per day) added to their baseline therapy of digitalis and diuretics, while 42 patients (control group) received placebo in addition to their existing regimen.
Association of digitalis therapy with mortality in survivors of acute myocardial infarction: observations in the Beta-Blocker Heart Attack Trial.