MEDICATIONS COMMONLY USED FOR CARDIAC OR VASCULAR DISORDERS
Nitroglycerin tablets or spray placed under the tongue are usually used to treat an attack of angina (chest discomfort). Long-acting nitroglycerin (tablets that are swallowed or patches applied to the skin) are used to PREVENT angina.
Examples: Nitrostat (nitroglycerin tablets), Nitrolingual spray (nitroglycerin lingual aerosol), Isordil (isosorbide dinitrate), Imdur (isosorbide mononitrate), ISMO (isosorbide mononitrate), Nitropatch.
Possible side effects: Headaches, lightheadedness, dizziness.
Platelets are found in the blood, and are important in the blood-clotting process. Anti-platelet agents are used to prevent platelets from “clumping” and forming clots. These mediations are an important part of treatment after angioplasty because they help keep the artery open.
Examples: Aspirin, Ticlid (ticlopidine), Plavix (clopidogrel).
Possible side effects: “Heartburn,” decreased white blood cell count, decreased platelet count.
Anti-coagulants slow down the blood-clotting process. Anti-coagulants are often prescribed after angioplasty of an artery that had a blood clot in it, or one that was completely blocked prior to angioplasty.
Examples: Coumadin (warfarin), Lovenox (enoxaparin sodium). NOTE: If Coumadin is prescribed for you, please read the Coumadin booklet to familiarize yourself with this medication.
Possible side effects: Any abnormal or prolonged bleeding: nosebleeds, blood in urine or stools, bruises, etc.
Calcium Channel Blockers
Calcium channel blockers are used to treat high blood pressure, prevent angina, prevent artery spasm, or control a rapid heart rate.
Examples: Norvasc (amlodipine), Cardizem (diltiazem), Procardia (nifedipine), Calan (verapamil).
Possible side effects: Constipation, swelling of ankles, headaches, flushing.
Beta-blockers may be used to treat high blood pressure, prevent angina or regulate heart rhythm. They are often prescribed after a heart attack because they “protect” the heart against additional damage or abnormal heart rhythms.
Examples: There are many beta-blockers. Among the more common are: Inderal (propranolol), Tenormin (atenolol), Corgard (nadolol), Lopressor (metoprolol), Visken (pindolol), and Coreg (carvedilol).
Possible side effects: Fatigue, weakness, slow heartbeat, depression.
Ace Inhibitors (and related medications)
ACE inhibitors lower blood pressure. They are also very useful in the medical management of heart failure by decreasing stress on the heart muscle and helping it to pump more effectively.
Examples: Capoten (captopril), Vasotec (enalapril), Prinivil or Zestril (lisinopril), Accupril (quinapril), Lotensin (benazepril), Cozaar (losartan), Diovan (valsartan).
Possible side effects: Rash, itching, dizziness or lightheadedness, muscle soreness, dry cough, impotence.
Cholesterol Lowering Agents
These medications are used to lower blood cholesterol levels. They reduce major events, heart attacks and death in patients with coronary artery disease.
Examples: Mevacor (lovastatin), Zocor (simvastatin), Lescol (fluvastatin), Pravachol (pravastatin), Lipitor (atorvastatin), Questran (cholestyramine), Colestid (colestipol hydrochloride), Lopid (gemfibrozil tablets), Niacin (nicotinic acid).
Possible side effects: Abnormal liver function, constipation, diarrhea, abdominal pains, muscle soreness.
Anti-arrhythmics are used to treat abnormal heart rhythms.
Examples: Cordarone (amiodarone), Norpace (disopyramide), Tambocor (flecainide), Rythmol (propafenone), Pronestyl (procainamide), Quinaglute (quinidine), Mexitil (mexiletine), Betapace (sotalol).
Possible side effects: Slow heart rate, flushing, headaches, weakness, increased heart rhythm disturbance.
These mediations strengthen the heart muscle; therefore, they are useful in treating heart failure because they increase the heart’s ability to pump blood through the body. Cardiac glycosides are also used to treat certain rapid heart rhythms such as atrial fibrillation.
Examples: Lanoxin (digoxin).
Possible side effects: Nausea, weakness, visual changes (especially seeing yellow or green halos around objects), irregular heartbeat, very slow heart rate.
Diuretics, frequently called “water pills,” are used to remove excess fluid from the body and to lower blood pressure.
Examples: Lasix (furosemide), Hydrochlorothiazide (HCTZ), Bumex (bumetanide), Zaroxolyn (metolazone), Aldactone (spironolactone).
Possible side effects: Lightheadedness, nausea, fatigue, decreasing blood potassium levels. Unless otherwise instructed, eat foods high in potassium such as oranges, bananas, potatoes, tomatoes, and dried fruit (not necessary with spironolactone).
Certain substances in the blood, when “oxidized” (chemically changed), may contribute to plaque formation in arteries. Anti-oxidants prevent this reaction and therefore may be useful in preventing restenosis after angioplasty or the development of new blockages.
Examples: Vitamin C and Vitamin E.
Possible side effects: Diarrhea (Vitamin C), increased bruising (Vitamin E). Excess Vitamin E should be avoided.
Medications to prevent or treat stomach irritation and ulcers are given in the hospital and may be continued after you go home, especially if you are taking Ticlid (a medication that often causes an increase in stomach acid).
Examples: Prilosec (omeprazole), Pepcid (famotidine), Axid (nizatidine), Zantac (ranitidine HCL), Tagamet (cimetidine).