Dave is a 70 year old patient with heart failure. He has been treated with ACE inhibitors and diuretics. Recently, his symptoms have worsened and become life threatening despite pharmacologic treatment. He has been hospitalized for evaluation and stabilization on a cardiac glycoside.
- Explain how the cardiac glycoside will act to lessen the patient's heart failure.
- What type of cardiac glycoside do you expect the physician will most likely prescribe the patient and explain why?
- Which medications should the patient be advised to avoid because they can potentiate glycoside toxicity?
- Explain why the patient should also be counseled to avoid taking antacids while being treated with cardiac glycosides.
Full Answer Section
Dave's doctors will need to carefully monitor his condition and adjust his medications as needed. They may also consider other treatment options, such as a heart transplant or a ventricular assist device.
In the meantime, it is important for Dave to rest and avoid activities that could put a strain on his heart. He should also follow his doctor's instructions carefully and take all of his medications as prescribed.
Here are some additional tips for Dave:
- Eat a healthy diet that is low in salt and saturated fat.
- Exercise regularly, but start slowly and gradually increase the intensity and duration of your workouts over time.
- Maintain a healthy weight.
- Do not smoke or drink alcohol.
- Get enough sleep.
Dave should also be aware of the signs and symptoms of worsening heart failure, such as:
- Shortness of breath, especially when lying down or at night
- Fatigue
- Swelling in the legs, feet, and abdomen
- Rapid or irregular heartbeat
- Coughing or wheezing
- Chest pain
If Dave experiences any of these symptoms, he should contact his doctor immediately.
Sample Answer
Dave's situation is concerning, as his heart failure has worsened despite pharmacologic treatment. This means that his heart is not pumping blood as effectively as it should be, and his body is not getting enough oxygen.
The fact that he has been hospitalized and placed on a cardiac glycoside suggests that his heart failure is now severe. Cardiac glycosides are a type of medication that helps the heart to beat more strongly. They are often used in patients with severe heart failure who are not responding to other treatments.