BISOPROLOL (CONCOR) Prescribed for the treatment of high blood pressure, angina, and congestive heart failure.

ailure. Belongs to a class of drugs called beta-adrenergic receptor blocking agent (beta blockers). Bisoprolol selectively and competitively blocks -1 receptors but has little or no effect on -2 receptors except at high doses. Bisoprolol prevents the neurotransmitters (chemicals that nerves use to communicate with other nerves), norepinephrine and epinephrine (adrenaline), from binding to beta receptors on nerves reduce heart rate and the force with which the heart contracts and reduce blood pressure by dilating blood vessels ------------------>>>>>decrease oxygen demand of the heart. Inhibits renin secretions lowering the blood pressure Watch out for: o BRADYCARDIA o HYPOGLYCEMIA o HYPOTENSION o WORSENING OF ASTHMA NURSING CONSIDERATION Check patients vital signs prior to administration; inform concerned doctors with any abnormalities. Be keen enough to compare and counter check all medications the patient is taking; any doubt, ask prescribing doctors. Teach patient to report difficulty breathing, night cough, swelling of extremities, slow pulse, confusion, depression, rash, fever, sore throat. Monitor VS after that.

TRIMETAZIDINE (VASTAREL ) Anti-anginal agent Anti-ischemic metabolic agent Long treatment of coronary insufficiency, angina pectoris. Also used in the treatment of vertigo and tinnitus as well as visual disorders with a circulatory origin. Improves myocardial glucose utilization through inhibition of fatty acid metabolism. Acts by directly counteracting all the major metabolic disorders occurring within the ischemic cell; action include limitation of intracellular acidosis, correction of disturbances of transmembrane ion exchanges, and prevention of excessive production of free radicals. In some cases, myocardial oxygen delivery is increased thru reversing coronary arterial spasm. Watch out for signs and symptoms of heart failure or hypertension. Use cautiously with elderly patients. Tablets should be taken at mealtimes with a full glass of water to avoid possible GI discomforts.

Cindy172012A

IVABRADINE (PROCOLARAN) Indicated for the symptomatic treatment of chronic stable angina pectoris in patients with normal sinus rhythm who cannot take beta blockers. Reduces cardiac pacemaker activity in the sinus node, slowing the heart rate and allowing more time for blood to flow to the myocardium. Eeffects are selective to the sinus node and has no effect on intracardiac conduction, myocardial contractility or ventricular repolarization. Contraindicated in sick sinus syndrome, and cannot be used concominantly with inhibitors of CYP3A4 such as azole antifungals (such as ketoconazole), macrolide antibiotics, nefazodone and the anti-HIV drugs nelfinavir and ritonavir.