References
Emergency cardiac pharmacology for nurses
Abstract
Cardiac emergencies are a relatively common occurrence in emergency practice, and cardiac drugs are essential in the management of these patients. Knowledge and understanding of the pharmacology of these drugs is important for the veterinary nurse, so that they can support the veterinary surgeon and give the best care to their patient, by being prepared and organised. Each medication needs to be carefully considered by the veterinary surgeon before use and each patient assessed accordingly. These medications have the potential to do great good, but as with most drugs, can cause harm. This article will discuss some of the more commonly used cardiac drugs in the emergency room.
Deepening the veterinary nurse's knowledge of pharmacology and mechanism of action (MOA) allows for a better understanding of drug choices, and subsequent monitoring, in an emergency situation. The veterinary nurse can often receive emergency patients arriving at the hospital with cardiac dysfunction. Cardiac emergencies can present with cardiogenic shock with or without congestive heart failure (CHF), cardiac arrhythmias, or in cats, paralysis as a result of aortic thromboembolism. Arrhythmias can be a result of underlying and pre-existing cardiac disease, systemic or infectious disease, trauma, electrolyte imbalance or pain. Medications discussed in this article pertain specifically to CHF, cardiogenic shock and cardiac arrhythmias.
The heart contains four chambers, the left and right atria and left and right ventricles. These four chambers receive and send blood through several vessels and valves to keep the body perfused with oxygenated blood and help remove carbon dioxide (Figure 1).
Deoxygenated blood comes into the heart from the body through the vena cava. This blood moves from the right atrium to the right ventricle through the tricuspid valve. It then flows to the lungs via the pulmonary artery where it will be oxygenated.
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