Potent cardiovascular agents require precise administration and diligent safety monitoring due to their narrow therapeutic windows.
1. Digoxin (Lanoxin)
- Indication: Heart failure, atrial fibrillation.
- Nursing Action: Measure apical pulse for 1 full minute prior to administration. Hold if apical pulse is < 60 bpm in adults (or < 90 bpm in infants).
- Therapeutic Level: 0.5 - 2.0 ng/mL. Toxicity signs: Nausea, vomiting, diarrhea, bradycardia, and visual disturbances (yellow-green halos).
2. Nitroglycerin
- Indication: Angina pectoris.
- Nursing Action: Sublingual tablet can be given 3 times, spaced 5 minutes apart. Monitor for severe orthostatic hypotension and headaches.
