List of Heart Medications
Medication Activity Sheet
List of Cardiovascular (Heart Related) Medications
| Drug Name (Trade and Generic) & Classification | Common Dose & Frequency | Reason for Med & How does it work? | Side Effects/ Adverse Reactions | Contraindications, Precautions, & Interactions | Nursing Considerations/ Implications |
| Cardizem Classification: calcium channel blockers | 30-120mg BID | CAD and Systemic Vasodilatation. It slows the electrical conduction of the heart by inhibiting calcium transport into myocardial and vascular smooth muscles cells to bring the normal heart rhythm. | Abnormal dreams, anxiety, blurred vision, disturbed equilibrium, cough, rhinitis, dyspnea, peripheral edema, rapid weight gain, gout, dark urine, clay-colored stools and jaundice. GI distress, liver dysfunction. | Contraindicated when BP is less than 90, currently using rifampin, and has a recent MI or pulmonary congestion. Caution with hepatic disorder patients. Rifampin increase metabolism of calcium hannel blockers. | Assess vital signs before administration for hypotension and respiration. Monitor inputs and outputs. |
| Inderal Generic name: Propranolol Classification: beta blockers | 40mg to start (usually need 160-480mg QD in divided doses) | CAD, HTN. It decreases heart rate, myocardial contractility and heart’s demand for oxygen. | Fast, slow or uneven heartbeats. SOB, swelling, numbness or cold feeling in lower extremities. | Aggravates breathing difficulties in COPD, asthma and bronchitis. Concurrent use with digoxin and halodol is not recommended because it can lead to hypertension and bradycardia to dangerous levels. | Monitor vital signs. Don’t stop medications abruptly but if undergoing surgery it might be stopped briefly. Assess for fluid overload for swelling, abnormal lung sounds and weight gain. |
| Tenormin Generic name: atenolol Classification: beta blockers | 25mg-100mg QD | CAD. It blocks response to beta adrenergic stimulation. | Slow or uneven heart rates. Dizziness, fatigue, insomnia and mental depression. Cold sensations in extremities. Fatigue, weakness, erectile dysfunction, bradycardia, CHF, rash, hyperglycemia, and arthralgia. | Caution when using digoxin and nitrates. Dosage might need to be reduced for hepatic or renal impairment. | Assess blood pressure, ECG and pulse. Monitor intake and output ratios daily along with weights. |
| Lipitor Generic name: Atrovastatin Classification: lipid lowering agent | 10-40mg QD | CAD. It inhibits the enzyme responsible for synthesizing cholesterol. | Dizziness, weakness, chest pain, peripheral edema, rhinitis, and rash. GI distress of abdominal cramps, constipation, diarrhea, flatus, heartburn and altered taste. | It has a drug induced hepatitis and elevated liver enzymes effect. So it is contraindicated in active liver disease. | Obtain dietary history and evaluate cholesterol and triglyceride levels for effective therapy. The med should be used with diet restriction, exercise and without smoking. |
| Isordil Generic name: isosorbide Classification: nitrates | 2.5-30mg QID | Angina. It increases coronary blood flow by dilating coronary arteries and improving flow to the ischemic regions. | Dizziness, headache, hypotension, tachycardia, syncope, flushing and urinary incontinence. | Contraindication of concurrent use with Viagra and related drugs. Drugs such as antifungals, cipro and clarithromycin will increase the effects. Drugs like phenytoin and Phenobarbital will decrease the effects. | Do not administer around the clock, take is exactly as prescribed. Take the medication same time during each day. |
| Nitrobid Generic name: nitroglycerin Classification: nitrates | 0.3-0.4mg SL Q 15min x 3 | Angina. It increases blood flow and decreases myocardial oxygen consumption. | Dizziness, headache, tachycardia, hypotension, SOB, rash, blurred vision and pale skin. | Contraindicated to be used with sildenafil, tadalafil, etc. Use very cautiously in glaucoma. | Do not drive, use machinery or any activities that require extreme alertness for this medication can make you dizzy. |
| Morphine Sulfate Brand name: Roxanol Classification: opioid agonists | 5-30(+)mg Q 30min-4hours PRN | MI. It binds to opioid receptors and inhibiting the pain perception and the responses. | SOB, bradycardia, seizure, confusion, cold clammy skin, weakness and light headedness. | Contraindicated in severe respiratory depression pts and drinking alcohol is no recommended. Patient has to be tolerant to morphine or being taking similar ones already. | Morphine can produce orthostatic hypotension similar to other narcotics. Take exactly as prescribed by the provider. |
| Catapres Generic name: clonidine Classification: adrenergics | 0.1mg BID-TID increased by 0.1-0.2 until effective | Arrhythmia. It stimulates the adrenergic receptors that inhibits the neurons and eventually decreases the vascular resistance. | Bradycardia, hypotension, anxiety, delusion, drowsiness, dizziness, nausea, constipation and weight gain. | Use caution in renal insufficiency, cerebrovascular disease, and serious cardiac problems. | Monitor intake and output on a daily basis. Assess for swelling and pain in any locations. |
| Coumadin Generic name: warfarin Classification: anticoagulants | 2-10mg QD adjust to lab INR 2-3 or per MD order | AF, DVT, PE, Vascular Problems. It interferes with the hepatic synthesis of Vitamin-K dependent clotting factors. | Bleeding, dermal necrosis, fever, cramps, nausea, edema, hematuria, and stomach cramps. | Contraindicated in open wounds, active ulcers, recent surgeries, and renal and hepatic disorders. | Use PT/INR lab tests assessments for to determine the therapy. Monitor stool and blood for occult blood. |
| Lanoxin Generic name: digoxin Classification: antiarhythmics | 0.1-0.375mg QD | CHF, tachycardia and atril fibrillation. Inhibits sodium ATPase to increase the contraction strength and decrease the frequency. | Bradycardia, anorexia, nausea, vomiting, fatigue, enlarged breasts in men and rash. | Contraindicated in uncontrolled ventricular arrhythmias. Use cautiously in hypokalemia, hypothyroidism and hypercalcemia. | Do not stop taking the medication suddenly. Stay hydrated to prevent overdose. |
| Lasix Generic name: furosemide Classification: loop diuretics | 10-80mg QD up to max 600mg in divided doses | CHF, HTN and edema. Inhibits reabsorption of sodium and chloride, and increase renal excretion. | Dehydration, hypochloremia, hyponatremia, hypocalcemia, hypovolemia and metabolic alkalosis. | Renal clearance of lithium and other chemical reduced. It competes with aspirin for excretion in urine. Glucose tolerance maybe decreased in diabetic patients. Contraindicated with anuria. | It increases the risk for falls; monitor BP and pulse before administration. |
| Vasotec Generic name: enalapril Classification: antihypertensives | 5-40mg QD to BID | HTN, CHF and kidney problems. ACE inhibitors reduce aldosterone secretion and slow progression of heart failure. | Hypotension, taste disturbances, headache, bronchospasm, rhinorrhea, sore throat, cough, dizziness, and fatigue, | Concurrent use with NSAIDS is contraindication due to renal dysfunction. Risk of lithium toxicity, hyperkalemia and hypoglycemia. | Monitor blood pressure and renal functions frequently. Take meds on empty stomach. |
| Zestril Genereic name: lisinopril Classification: ACE inhibitors | 10-40mg QD-BID (2.5-5mg geriatric starting) | HTN and management of CHF. | Vomitting, diarrhea, hyperkalemia, dizziness and headache. | Same as Vasotec. | Avoid alcohol usage because it can further reduce BP. Monitor serum, BUN, WBC and potassium levels. |
| Calan Generic name: verpamil Classification: calcium channel blockers | 40-80mg TID | HTN and angina pectoris. It inhibits transport of calcium into myocardial and vascular smooth muscle to reduce excitation and contraction. | Irregular heartbeats, lightheadedness, dizziness, weak feeling, muscle, fatigue, cramps, swelling and constipation. | Contraindicated in liver dysfunction, sick sinus syndrome or AV block heart conditions and muscle dystrophy. | Do not eat or drink grapefruit. |
| Lopressor Generic name: metoprolol Classification: beta blockers | 50-100mg QD-BID (25mg geriatric starting dose) up to 450mg QD | HTN, angina pectoris and prevention of MI. It decreases the stimulation of myocardial activity. | Fatigue, weakness, nervousness, SOB, blurred vision, stuffy nose, bronchospasm and cold extremities. | Concurrent use with digoxin can lower BP and pulse to extreme. Caution when using with diabetic patients because it can mask hypoglycemic symptoms. | Monitor vital signs with I&O. Assess for signs and symptoms of dyspnea, weight gain, edema and other CHF related. |
| Hydrochlorothiazide (HCTZ) Classification: diuretics | 12.5-100mg QD-BID | HTN and treatment of edema associated with CHF. Increase excretion of sodium and water by inhibiting reabsorption. | Hypokalemia, photosensitivity, dizziness, lethargy, weakness, vomiting, muscle cramps and hyperglycemia. | Use caution in renal and hepatic impairment. Hypersensitivity to sulfonamide derivatives. It can cause electrolyte imbalances, so stay hydrated. | Monitor blood glucose more frequently. Get up slowly from sitting position to avoid orthostatic hypotensive effects. |
Books used:
References:
Davis’s Drug Guide for Nurses, 11th Edition by Judith Hopfer Deglin and April Hazard Vallerand.
Essentials of Pharmacology for Health Occupations, 5th Edition by Ruth Woodrow.
Internet sources:
umm.edu/medref/ http://www.drugs.com/ http://www.medicinenet.com/ http://www.webmd.com http://www.emedicinehealth.com/ http://www.mayoclinic.com
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