Cardio conditions and drugs
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| digoxin (Lanoxin) | Cardiac glucoside/Inotrope - treats chronic HF
Slows rate of ventricular contraction (a-fib, a-flutter); allows for fewer but more efficient contractions; HOLD IF APICAL PULSE <60
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| furosemide (Lasix) | Loop diuretic - treats mod to severe HF Used when rapid effects needed
Reduces edema→pulls off fluid; Daily weight, I&O; Electrolytes monitored→K+ wasting
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| spironolactone (Aldactone) | Potassium-sparing diuretic - treats advanced HF with inadequate renal function
Reduces ascites, edema(→pulls off fluid), hypokalemia, HTN, and hyperaldosteronism; Daily weight, I&O;
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| hydrochlorothiazide (Esidrix, Oretic) | Thiazide diuretic - treats early or mild HF
Reduces edema→pulls off fluid, aldosterone antagonist
Assess for adventitious lung sounds, heart for S3, and peripheral edema; Electrolytes, fluid status, daily weight (>2 lb/24 hours)
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| propranolol hydrochloride (Inderal) | Beta-blockers ("Lols") - treats chronic HF
Slows HR (atrial flutter, atrial fib, pervent v-fib); decreases excitability of heart, cardiac workload, oxygen consumption; SIDE EFFECT: DRY COUGH→caution in asthmatics
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| enalapril maleate (Vasotec) | ACE Inhibitors ("Prils") - treats HF, HTN, asymptomatic L ventricular dysfunction, and acute coronary syndrome/MI
Promotes vasodilation (decreasing BP); decreases aldosterone secretion (increasing K+ and reducing Na+ and H2O retention)
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| valsartan (Diovan) only ARB with FDA approval for HF losartan potassium (Cozaar) | Angiotensin II-receptor blocker (ARB) - treats mod to severe HF
Blocks vasoconstriction effect of renin-angiotensin→decrease in BP
HOLD IF BP IS LOW
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| milrinone lactate (Primacor) | Phosphodiesterase inhibitors (cardiotonic-inotropic agents) - treats acute to severe HF
Increases the force of myocardial contraction; used for pts who do not respond to routine pharm therapy; reserved for those with severe ventricular dysfunction
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| dobutamine hydrochloride (Dobutrex) | Selective Beta-1 adrenergic agonist - treats acute to severe CHF, cardiac decompensation, shock, Angina pectoris
Usually used with milrinone lactate for treatment of HF
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| atorvistatin (Lipitor) rosuvastatin (Crestor) simvistatin (Zocor) | HMG-CoA reductase inhibitor (statin) - treats CAD
Blocks production of cholesterol in liver
Must monitor liver enzymes
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| niacin (Nicolar) | Nicotinic acid (vitamin) - treats CAD
Lowers LDL and increases HDL
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| cholestyramine (Questran) | Bile acid resin - treats CAD
Binds bile from the liver and prevents it from being reabsorbed into the circulatory system; bile is made mostly from cholesterol
Constipation, gas and upset stomach
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| fenofibrate (Tricor) | Fibrate - treats CAD
Reduces the production of triglycerides and can increase HDL cholesterol
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| nitroglycerin (Nitro-bind, Nitro-Dur) | Nitrate - treats angina pectoris Potent vasodilator: venous→↓ venous pressure, return to heart, preload; coronary artery→↑ blood flow to ischemic areas of heart; Arteriole→ ↓afterload (↓BP, cardiac workload), DO NOT USE w/ Viagra
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| diltiazem (Cardizem) | Calcium channel blocker - treats angina pectoris, tachycardia
Block calcium from entering myocardial cells→slows conduction through SA and AV nodes to ↓HR
Assess for bradycardia before and after
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| clopidogrel (Plavix) | Antiplatelet - treats angina pectoris
Decreases platelets "sticking together"
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| heparin, warfarin (Coumadin) | Anticoagulants - treats angina pectoris
Reduces viscosity of blood to reduce risk of clots
Bleeding risk, need to monitor blood levels (labs)
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| MONA | Morphine, oxygen, nitro, aspirin (given in ED)
Treats acute coronary syndrome/MI
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| Heart Failure Medications | digoxin (Lanoxin) cardiac glycoside/inotrope;diuretics= loop=furosemide(Lasix); K+sparing spirolactone(
Aldactone); thiazide hydrochlorothiazide (HCTZ);
Beta blockers(Lols); ACE inhibitors(Prils); ARBs; milrinone; dobutamine
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| Coronary artery disease Medications | Statins; Niacin; Bile acid resins; Fibrates
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| Angina pectoris Medications | Nitrates (nitro); Beta-blockers (Lols); Calcium channel blockers; Antiplatelets; Anticoagulants
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| Acute Coronary Syndrome/MI Medications | MONA (morphine, oxygen, nitro, aspirin) in ED; ACE inhibitors (Prils)
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| Pulmonary edema Medications | Diuretics and vasodilators (nitro)
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| Cardiogenic shock Medications | Diuretics, digoxin, vasopressors (dobutamine)→raise BP by constricting blood vessels
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| Peripheral artery disease (PAD) | Need to improve circulation in extremities→vasodilators, antiplatelet, anticoagulant, statins (reduce cholesterol and plaque accumulation)
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| Hypertension Medications | Diuretics, Beta-blockers, vasodilators, ACE inhibitors, ARBs, calcium channel blockers Want to ↓ blood volume (diuretics), control HR, and maximize efficiency of contractions. START WITH LOW DOSES,↑GRADUALLY IF NEEDED. Pair drugs with lifestyle changes
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