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 limitedBETA-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
Ca channel blockers
Arrhythmias Na channel blockers
Beta-blockers
Ca channel blockers
Agents prolonging depolarization
CHF Cardiac glycosides (DIGITALIS)
Diuretics
ACE inhibitors
Vasodilators
HTN Diuretics
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 bodycausing 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 heart’s 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 decreaseskidneys release enzyme “renin”renin converts angiotensinogen (small
protein) into angiotensin Iit is inactive until it contacts an ACE located in the
lungsconverts Angio 1 into a powerful vasoconstrictor angiotensin IIincrease 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 contractionhelp 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 wallinhibit 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