A client, diagnosed with insulin-dependent diabetes and acute heart failure, was admitted to the hospital for medical management. What are the appropriate pharmacological interventions to help reduce myocardial workload and improve ventricular pump performance?


• Morphine IV is often used for clients with acute heart failure. It is not only an anxiolytic and analgesic, but its most important effect is venodilation, which reduces preload.

• Beta-blockers are used to inhibit the effects of the sympathetic nervous system and reduce the oxygen needs of the myocardium.

• Dobutamine is a very useful medication for heart failure because it produces strong beta-stimulatory effects within the myocardium. It increases heart rate, atrioventricular conduction, and myocardial contractility.

• Leukotriene modifiers are used in the treatment of both acute and chronic asthma. This also does not help with workload or pump performance.

• Dantrolene is classified as a direct-acting skeletal muscle relaxant. It is currently the only specific and effective treatment for malignant hyperthermia.

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