cardiac medications Flashcards
what is nitroglycerin?
- vasodilator
- used to treat angina symptoms
- chest pain
- pressure
- improves blood flow to the heart by opening up the arteries in the heart = improved symptoms and reduced how hard the heart has to work
how does someone take quick-acting nitroglycerin?
- includes tablets or oral sprays
- tablets placed under the tongue or between the cheek and gum
- spray is used on or under the tongue
- used in moment of angina attack
what is the purpose of long-acting nitroglycerin?
- used to prevent angina from happening
- not used to stop sudden symptoms of angina
- forms:
- pills
- tablets
- skin ointment
- skin patches
what do you do during an angina attack?
- lie down (nitro can lower BP = fainting if stand up)
- place tablet under tongue and let it dissolve OR
- place the between cheek-and-gum tablet and leave until it dissolves OR
- use the spray under or on top of the tongue once and close mouth right away
what are the side effects of nitro?
- warm of flushed feeling
- headache
- dizziness
- light-headedness
- dropped BP
what should you not take in conjunction with nitro and why?
- erection-enhancing medicine
- some of those medications drop BP since both are vasodilators
what are anti-platelets and who is prescribed this?
- stops platelets from being sticky or reducing viscosity
- reduces blood clots and reduces it’s ability to stick to arteries = cardiac event
- taken in combination w/nitro
- commonly prescribed for patients who have experienced any kind of cardiac event and are often administered to those with angina
what is the most widely prescribed anti-platelet and how is it taken?
- aspirin
- should not be taken on an empty stomach since it can bother the stomach
what are the side effects of anti-platelets?
- increase in bleeding
- headaches
- dizziness
- nausea
- diarrhea
- constipation
- indigestion
- abdominal pain from taking medication on empty stomach
describe beta-blockers
- work by reducing the load or the stress on the heart by reducing heart rate and blood pressure
- lower work heart has to do
- take medication at the same time each day since HR fluctuates throughout the day so it is good to track if medication is working
what are the side effects of beta-blockers?
- lower HR
- dizziness
- fatigue
- unusual swelling
- trouble breathing
what is an important note when taking beta-blockers?
- those with diabetes and taking beta-blockers should monitor their sugars closely since beta-blockers may dull the symptoms of low blood sugar
- ex: trembling or fast HR
describe calcium channel blockers
- vasodilators
- generally taken with other cardiovascular disease medications
what are calcium channel blocker side effects?
- fatigue
- dizziness
- heartburn
- swelling in ankles and feet
- avoid grapefruit and grapefruit juice
why do we need to avoid grapefruit/grapefruit juice when on calcium channel blockers?
- can interfere with the way certain drugs are metabolized
- allows a higher/too little amount of drug into the bloodstream
- as little as one glass of juice can cause an increased blood drug level and the effects can last for 3 days or more
- results in an unpredictable increase in blood drug level = serious side effects
describe statins
- type of medication commonly used in those with high cholesterol
- prevents the build-up of plaque in the arteries and reduce plaque that is already there from getting worse and lowers the long-term risk of experiencing a heart attack
- has a strong impact but their effects are slow
what are the side effects of statins?
- anti-plaque properties go away when statins are not taken regularly
- upset stomach
- constipation
- gas
- sore muscles/weakness
- avoid grapefruit juice
describe ACE inhibitors
- vasodilators
- taken life long in patients with coronary artery disease
- similar to beta-blockers (patients are encouraged to keep a record of their HR and BP)
- can increase the amount of potassium in the body
- avoid salt substitutes or potassium supplements
what are the side effects of ACE inhibitors?
- dizziness/faint
- dry couch/tickle in the throat
- may develop swelling of the face, mouth, or throat
- due to retaining a lot of fluid
- peeing less than normal
describe ARBs (Angiotensin II receptor blockers)
- mainly used to treat high blood pressure and heart failure
- better choice if a patient is experiencing side effects from ACE inhibitors
what are the side effects of ARBs?
- reducing the work of the heart
- lowers HR and BP
- increase potassium levels
- dizziness due to lowering BP
describe diuretics
- often referred to as “water pills” and typically taken with other medications
- used to treat high blood pressure and heart failure
- helps kidneys produce more urine
- increase urine output = excess salt/water also excreted = reduced workload of the heart
what are the benefits of diuretics?
- lowering bp
- relieve SOB
- reduce swelling and bloating
- increase urine output
- reduce time spent in hospital
- increase quantity of life in those with heart failure
what are the side effects of diuretics?
- dehydration
- not enough pee
- dry mouth
- decreased skin “springiness”
- muscle cramps
- weakness
- fever, sore throat, or skin rash
- dizziness
what are 3 approaches to treating AFib?
- rate control
- rhythm control
- risk reduction
what is cardioversion?
small electrical shock to give patients with AFib a regular heartbeat
what is radio frequency ablation?
putting tubes down towards the heart and zap all the short circuits causing AFib
describe anti-coagulants and name a common brand
- slows down clotting formation
- blood thinners
- common brand = warfarin
who uses anti-coagulants (blood thinners)?
- with artificial heart valves
- with AFib
- who have had a heart attack
- who have heart diseases, such as cardiomyopathy
- who are at risk of developing blood clots
what is the use of international normalized ratio (INR) testing?
- measures the time it takes for blood to clot
- especially important for patients on Warfarin or other anti-coagulants
- determines dose for patient
- timing of when to take it
- need extra blood to go if in surgery
what are side effects of anti-coagulants?
- unwanted bleeding
- monitor for:
- pink in the sink when brushing their teeth or shaving
- vomit that looks bloody or like coffee grounds
- pink or brown urine
- stool that is red or black
- nosebleeds
how do you avoid side effects of aunti-coagulants?
- avoid smoking and limit alcohol
- tell the dentist about the drug before a dental cleaning or other work
- if surgery is needed, tell the surgeon about the medication
- consider delaying non-essential dental or medical procedures
what is the purpose of antiarrhythmics?
prevent and treat abnormal heartbeats (arrhythmias)
what may be prescribed if the heart beats too slowly?
atropine
what are also anti-arrhythmics drugs and what are their purpose?
- potassium channel blockers
- slow down electrical impulse conduction in all heart cells
what drugs are included in potassium channel blockers?
- amiodarone - most common
- dronedarone
- sotalol
what are some side effects of antiarrhythmics?
- sun sensitivity
- dizziness
- urine retention
- blurry vision
describe digoxin
- used to control abnormal heart rhythms
- can also help to manage the symptoms of heart failure, usually with other medicines
- do NOT give if bpm < 60
what are side effects of digoxin?
- upset stomach
- diarrhea
- loss of appetite
- blurred vision
- patients might see yellow around objects
