The Role of Cardiac Glycosides in Treating Heart Failure

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.
1. Explain how the cardiac glycoside will act to lessen the patient’s heart failure.
2. What type of cardiac glycoside do you expect the physician will most likely prescribe the patient and explain why?
3. Which medications should the patient be advised to avoid because they can potentiate glycoside toxicity?
4. Explain why the patient should also be counseled to avoid taking antacids while being treated with cardiac glycosides.

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