Cardiovascular Medications

Peripheral vasodilation can produce HYPOTENSION, DISSINESS, SYNCOPE

when combined with PT interventions like (hydrotherapy, aquatics, aerobic exercise)
Cardiovascular response to exercise can be limitedBETA-BLOCKERS
limits the increase in HR that can occur as exercise increases workload on the heart
NSAIDs used to treat inflammatory conditions can counteract antihypertensive effects of ACE
INHIBITORS (angiotensin- converting enzyme)
must closely monitor during exercise for elevated BP
NSAIDs have the ability to decrease secretion of DIGITALIS glycosides (Lanoxin, Crystodigin)
producing digitalis toxicity (fatigue, confusion, GI problems, arrhythmias)

Condition

Drug Class

Angina Pectoris

Organic nitrates (nitroglycerides)

Beta-blockers

Arrhythmias

Ca channel blockers
Na channel blockers
Beta-blockers
Ca channel blockers
Agents prolonging depolarization
Cardiac glycosides (DIGITALIS)

CHF

Diuretics
ACE inhibitors
Vasodilators
Diuretics

HTN

Beta-blockers
ACE inhibitors
Vasodilators
Ca channel blockers
Alpha blockers
Diuretics (Thiazides, Loop Diuretics, Posstium-sparing diuretics)

water pills

lower BP by eliminating sodium & water, thus reducing blood volume

some diuretics remove potassium from bodycausing life-threatening arrhythmias
ADVERSE EFFECTS:
o fluid and electrolyte imbalance
o muscle weakness, spasms, dizziness, headache, nausea

Beta-Blockers
end in olol (propranolol, metoprolol) Inderal, Lopressor, Tenormin

block beta receptors on the SA node & myocardial cells-heart

relax blood vessels & heart muscle
o decrease sympathetic stimulation-by blocking B1 receptors from catecholamines
(NE, epinephrine)
produce decline in force of contraction & reduce HR (eases the strain on the heart)
reduces hearts workload & oxygen consumption
decreased BP
monitor RPE (rating of perceived exertion), watch for bradycardia, depressed cardiac
function
ADVERSE EFFECTS:
o depression
o worsening of asthma
o sexual dysfunction
o fatigue

Alpha-1 Blockers
end in zocin (Prazocin, Terzocin) Minipress, Hytrin, Cardura)

A1 receptors located on vascular smooth muscle prevent catecholamines from

vasoconstricting
lower BP by dilating blood vessels
o decrease peripheral vascular resistance
observe for signs of hypotension & reflex tachycardia (HR increases to compensate
for hypotension)

ACE Inhibitors (angiotensin-converting enzyme)

end in pril (benazepril, captopril) Lotensin, Capoten, Vasotec, Prinivil, Zestril

highly selective drugs that interrupt a chain of molecular messengers that constrict blood
vessels
can improve cardiac function in individuals with heart failure
used for individuals with diabetes & early kidney damage
ADVERSE EFFECTS
o rash
o dry cough

Renin-Angiotensin System
helps maintain BP & regulate vascular perfusion throughout body
if BP decreaseskidneys release enzyme reninrenin converts angiotensinogen
(small protein) into angiotensin Iit is inactive until it contacts an ACE located in the
lungsconverts Angio 1 into a powerful vasoconstrictor angiotensin IIincrease in
vascular resistance, which increases BP
angiotensin II also stimulates release of Aldosterone helps maintain vascular fluid
volume by increasing sodium & water reabsorption

Calcium Channel Blockers

inhibit calcium from entering the blood vessel walls

o reduce strength of vascular muscle contractionhelp reduce BP
o Calcium works to CONSTRICT blood vessels
regulates cardiac rhythm
o help control arrhythmias
ADVERSE EFFECTS
o swelling in feet & ankles
o orthostatic hypotension
o headache
o nausea
2 Groups:
1. Interact w/ calcium channels on smooth muscle of peripheral arterioles
a. end in pine (amlodipine, felodipine) Norvasc, Plendil, Sular, Adalat,
Procardia
2. Calcium channel blockers work to dilate coronary arteries to lower BP & suppress
arrhythmias
a. verapamil (Verelan, Calan, Isoptin)
b. diltiazem (Cardizem, Dilacor)

Nitrates (Nitroglyerin)

dilates coronary arteries

o converts nitric oxide w/in vascular wallinhibit smooth muscle contraction
used to prevent & relieve symptoms of ANGINA
o angina pain should subside w/in 1-2 min of nitroglycerin administration & rest
angina usually less than 10 min, never more than 30 min, avg 3-5 min
o women may gets similar results from an antacid
ADVERSE EFFECTS
o headache
o dizziness
o tachycardia
o orthostatic hypotension

Anticoagulant Drugs
(heparin, warfarin) Coumadin, aspirin

prevent platelet aggregation & clot formation

Thrombolytic Drugs
streptokinase, urokinase,(t-PA)

used to break down & dissolve clots already formed in coronary arteries

Statins
Lescol, Mevacor, Pravachol, Zocor

inhibit a key enzyme responsible for cholesterol biosynthesis in the liver

decrease plasma LDL levels
can help reduce atherosclerotic plaque formation
ADVERSE EFFECTS
o myalgia: unexplained muscle pain & weakness