Cardiovascular System Drugs

Cardiovascular System Drugs

Learning Objectives

• Describe major classes of drugs used to treat diseases/illnesses of the cardiovascular system.
• Describe the main nursing considerations related to these groups of drugs.

Key Principle

• "Identify the problem, then focus on treating it."

Major Classes of Cardiac Drugs

• Anti-anginal Drugs
• Heart Failure Drugs
• Anticoagulant Drugs

Anti-anginal Drugs

• Problem: Angina, caused by coronary artery disease, leading to chest pain or discomfort because the heart isn't getting enough oxygen-rich blood.
• Treatment Goal: Relax blood vessels, lower heart rate, decrease the workload of the heart, reduce blood clots, and prevent heart attacks.
• Mechanism: Alleviate chest pain by improving blood flow to the heart muscle.
• Drug Classes:
  • Nitrates (e.g., nitroglycerin): Relax blood vessels and improve blood flow to the heart.
  • Beta-blockers (“lol”): Lower heart rate and reduce the heart’s demand for oxygen.
  • Calcium channel blockers (“pine”): Relax blood vessels and decrease the heart's workload.
  • Antiplatelets: Prevent formation of blood clots that could lead to heart attacks and strokes

Heart Failure Drugs

• Problem: The heart cannot pump blood well, leading to the body not receiving enough oxygen and nutrients, and fluid buildup in the lungs, legs, or abdomen.
• Treatment Goal: Relax blood vessels, lower heart rate, lower blood pressure, reduce the heart’s workload, and remove extra fluid.
• Mechanism: Improve the heart’s ability to pump blood.
• Drug Classes:
  • ACE inhibitors (“pril”): Relax blood vessels, lowers blood pressure, reduce cardiac workload.
  • ARBs (Angiotensin II Receptor Blockers) (“tan”): Bind to and block AT receptors.
  • Beta-blockers (“lol”): Lower heart rate, lowers blood pressure, reduces the risk of arrhythmias.
  • Diuretics: Remove excess salt and water from the body.

Anticoagulant Drugs

• Problem: Increased risk of clot formation that could lead to a stroke or other complications, such as Atrial Fibrillation (AFIB), Deep Vein Thrombosis (DVT), Coronary Artery Disease (CAD), Stroke, Pulmonary Embolism (PE).
• Treatment Goal: Keep blood flow smooth and reduce the risk of dangerous clots.
• Mechanism: Used to prevent blood clots from forming or getting larger.
• Drug Classes:
  • Vitamin K antagonist: Inhibits vitamin K enzyme that produces clotting factors in the liver.
  • Xa inhibitor: Inhibits factor Xa, an enzyme for converting prothrombin to thrombin in the clotting cascade; inhibits clot formation.
  • Unfractioned Heparin: Activates antithrombin III which inactivates factor Xa, leading to inhibition of clot formation.
  • Low Molecular Weight Heparin (LMWH): Selectively inhibits Xa.

Case Studies

• Heart Failure Case Study:

  • Scenario: 65-year-old male with chronic systolic heart failure, history of high blood pressure, showing signs of fluid retention.
  • Likely Prescribed Drug Classes: (Choose 3-4)
    • ACE inhibitors
    • Beta-blockers
    • Diuretics

• DVT Case Study:

  • Scenario: 45-year-old woman post-knee surgery at risk for DVT due to limited mobility.
  • Drug Classes for Preventing DVT: (Select 2-3)
    • Xa Inhibitor
    • Low Molecular Weight Heparin (LMWH)

• HTN Case Study:

  • Scenario: 55-year-old male diagnosed with hypertension (160/95 mmHg).
  • Drug Classes for Treating Hypertension: (Choose 3)
    • ACE inhibitors
    • ARBs (Angiotensin II Receptor Blockers)
    • Diuretics