Study Notes – Cardiac Outcome Goals & Hallmark Drugs (ABCD)

Main Goal

• Always ask: What is the main patient outcome goal?
  → Increase cardiac output → increase oxygen delivery to the body.

• To achieve this, we use ABCD drugs — hallmark cardiac drugs (always show up on NCLEX!).

• These drugs calm the heart and drop BP or HR, each in different ways.

• Think of them as a toolbox: choose the right tool for the right situation.

A – ACE Inhibitors

• Examples: Lisinopril, Enalapril (all end in -pril).

• Action: ↓ BP, ↓ workload on the heart.

• Memory trick: A = Anti-hypertensive.

• “-Pril” = chill pill for the heart → less work, less pressure.

B – Beta Blockers

• Examples: Metoprolol, Atenolol (all end in -lol).

• Action: Block β-receptors → ↓ HR, ↓ BP.

• Memory trick: Beta Blockers Block the Beats.

• Think: pumping the brakes on the heart.

C – Calcium Channel Blockers

• Examples: Amlodipine, Nifedipine (-dipine), Diltiazem (Cardizem).

• Action: ↓ BP, vasodilation, relaxes vessels.

• Memory trick: Calcium Calms the Heart.

  • Dihydropyridines (-dipine): “helps BP decline.”

  • Diltiazem/Cardizem: like “zen yoga” → calming, relaxing.

D – Digoxin (Cardiac Glycoside)

• Action:

  • ↑ Contractility (positive inotrope → deeper squeeze).

  • ↓ HR (negative chronotrope).

• Memory trick: D = Deeper contraction (“Dig-oxin digs for deeper beats”).

Digoxin Safety Checks (high-priority NCLEX!)

1. Apical pulse: Hold if < 60 bpm.

2. Potassium levels: Must be 3.5–5.5.

3. Toxicity: > 2.0 = toxic.

   • First signs = vision changes (blurred, halos, yellow/green vision).

   • Action: Hold & report to provider.

 D – Diuretics

• Examples: Furosemide (Lasix), Hydrochlorothiazide (HCTZ).

• Action: Dehydrate body → ↓ BP.

• Memory trick: “-ide = makes the body dry.”

• Potassium-wasting! → ↓ K+.

Patient Education

• Encourage high potassium intake:

  • Green leafy veggies (spinach, kale).

  • Fruits (bananas, melons, oranges).

If Drugs Fail…

• Surgery: LVAD (Left Ventricular Assist Device).