cardiac meds

statins

lowers LDL and triglyceride levels → improves lipid panel & decreases CV risk!

-astatin

ex.

• atorvastatin (lipitor)

• fluvastatin (lescol XL)

• lovastatin (altoprev)

• rosuvastatin (crestor)

• simvastatin (zocor)

side effects: (mostly muscle implications)

• myalgia

• myopathy

• myositis

• rhabdomyolysis

• increased risk of DM

PT implications:

• screen for adverse effects

diuretics

promotes sodium & water excretion → inhibits sodium reabsorption → increases urine volume!

-thiazide & -ide

ex.

• thiazides → for HTN or HF

  • cholorthiazide or hydrochlorothiazide

• loop diuretics → for edema

  • bumetanide & flurosemide (lasix!!!!)

• potassium sparing diuretic

  • spironolactone

side effects:

• hypotension

• dizziness

• fluid/electrolyte imbalance

PT implications:

• fall risk

• monitor vitals

• risk for arrhythmias

nitrates

used for managing angina, acute MI, coronary spasms, or hypertensive crisis!

Nitroglycerin

• venodilator → decreases venous return (less preload)

• arteriolar vasodilator → decreases afterload

• coronary vasodilator → increases coronary blood flow → more blood to heart muscle!!!

side effects:

• headaches

• dizziness

• nausea

• orthostatic hypotension

• changes vital signs

  • decrease BP

  • increase HR (at rest & exercise)

  • increase exercise tolerance with angina

PT implications:

• monitor vitals

• avoid contact with skin patch

• if pt takes 3 tablets call 911

beta blockers

blocks beta receptors → decrease HR & contractility (less O2 demand) → blocks release of renin = decreased BP

-olol

used to treat:

• HTN

• MI

• CHF

• tachycardia

• CAD

• essential tremor

• migraine prophylaxis

side effects:

• bradycardia

• hypotension

• fatigue

• can mask the sings of hypoglycemia

Limits normal HR response to activity!!!

PT implications:

• use RPE to monitor intensity

• increased risk for heart blocks

• beware if pt has diabetes

calcium channel blockers

blocks inward flow of calcium to the heart/vascular smooth muscle → peripheral & coronary vasodilation + decreased cardiac conduction/contractility = lower HR & BP

often ends with -dipine

examples:

• amlodipine (norvasc)

• nifedipine (procardia)

• nicardipine (cardene)

• calan

• cardizem

used to treat:

• HTN

• coronary spasm

• peripheral vasospasm (raynauds)

• angina

• SVT

side effects: bradycardia, orthostatic hypotension, syncope

PT implications: monitor vitals & for arrhythmias

ACE inhibitors

prevents ACE enzymes from converting angiotensin I to angiotensin II

• decreases arterial vasoconstriction → lowers BP → decreases afterload

• limits sodium & water retention → decreases blood volume → decreased preload

-pril

ex:

• lisinopril

• captopril

• enalapril

treats: HTN, HF, post MI

side effects:

• hypotension

• fatigue

• dry cough

• angioneurotic edema (unilateral tongue swell → take ARBs)

PT implications: monitor vitals

ARBs

blocks angiotensin II receptors → arterial vasodilation → decreased fluid retention

usually used for pts that cant tolerate ACE inhibitors,, ACE induced cough, angioneurotic edema

commonly ends with -sartan

used to treat: HTN, HF, renal disease

side effects: dizziness, hypotension, hyperkalemia

digitalis

increases intracellular calcium concentration in myocardium → stronger contraction & decreases HR

digoxin

used for HF & afib/flutter WHEN other meds dont work!

blood concentrations MUST be monitored → want to prevent toxicity

other side effects: rash, headache, weakness, Vtach!!

vasopressors

used for conditions of low blood pressure - example: cardiac shock

-ephrine, OR vasopressin, OR dopamine

increases vasoconstriction → increased SVR → increased MAP = increased perfusion to organs

side effects:

• arrhythmias

• hypoperfusion/local tissue necrosis

• myocardial ischemia

• hyperglycemia

PT implications:

• can cause too much constriction

  • hypoxia/cyanotic → can lose toes or fingers

  • monitor for vascular changes

inotropes

used for conditions of low blood pressure - example: cardiac shock

ex.

• dubutamine (dobutrex)

• isoproterenol (isuprel)

• milrinone (primacor)

increases cardiac contractility → increases cardiac output → increased MAP

side effects:

• arrhythmias

• hypoperfusion/local tissue necrosis

• myocardial ischemia

• hyperglycemia

PT implications:

• can cause too much constriction

  • hypoxia/cyanotic → can lose toes or fingers

  • monitor for vascular changes

anticoagulants

prevents blood clots from forming; prevents embolization; used prophylactically

examples: warfarin, heparin, rivaroxaban, apixaban

used after a: stroke, PE/DVT, or a MI

• also used for: afib, heart valve surgery, orthopedic surgeries, and blood clotting disorders!

side effects: bleeding & bruising

PT implications:

• beware of INR & PT/PPT levels!!

• monitor for signs of bleeding

• work on fall prevention

antiplatelet agents

prevents platelets from sticking together; decreases ability to form clots

• reduces risk of stroke & MI

types: ASA (baby aspirin), plavix, brilinta

side effects: bleeding, bruising, dyspnea, bradycardia

PT implications: watch for signs of bleeding

metformin

type of diabetes type 2 med

lowers glucose production in liver → decreases blood glucose

GLP-1 receptor agonists

stimulates insuline secretion and slows digestion → regulates blood glucose & appetite

-utide ex: ozempic, trulicity

causes muscle atrophy

SGLT-2 inhibitors

affects filtering function of kidney → glucose is removed via urine → lowers blood glucose

-liflozin

used to improve outcomes in pts with HF or CKD

left ventricle heart failure

ACE inhibitors

ARBs

diuretics

beta blockers

post MI

beta blockers

calcium channel blockers

nitrates

lifestyle mods