CARDIAC SYSTEM MEDICATIONS

CARDIAC COMMON USES WHAT I NEED TO KNOW AS A BRAND NEW

MEDICATIONS NURSE
Cardiac Glycosides Indicated for the treatment of * Monitor Digoxin levels, therapeutic levels should be between 0.5-
Common Examples: heart failure and dysrhythmias 2ng/ml.
Digoxin (Lanoxin, Digitek) * Monitor K+, low serum potassium levels can increase the potential
for toxicity.
* Monitor pulse and teach patient to take their pulse. Hold for pulse
< 60 BPM in adults.
* Administer IV doses slowly over 5 minutes
* A loading or “Digitalizing” dose may be given to get the serum
levels within therapeutic range.
*Common adverse effects include fatigue, anorexia and bradycardia.
Monitor for signs of toxicity which include: HA, vertigo,
photophobia, yellow-green halos, tachycardia and AV heart block
* Antidote: Digibind

Phosphodiesterase Indicated for the short-term * Adverse effects include ventricular arrhythmias, hypotension,
Inhibitors management of heart failure. chest pain, HA, hypokalemia, tremors and thrombocytopenia.
Common Examples: * Due to risk of toxicity theses are generally reserved for patients
Milrinone (Primacor) who do not respond to cardiac glycosides ore ACE inhibitors
Inamrinone (Inocor)
Direct Vasodilators Indicated for acute treatment * Common adverse effects include cardiac arrhythmias,
Nesiritide (Natrecor) of heart failure in patients with hypotension, HA, fainting, and anxiety.
dyspnea at rest and/or minimal * Reduce dose or stop administration with hypotension
activity. * Obtain a baseline creatinine level and continue to monitor, can be
nephrotoxic with acutely decompensated heart failure.
CARDIAC COMMON USES
MEDICATIONS
Organic Nitrate/Vasodilator Indicated for the treatment of
Common Examples: stable and unstable angina.
Nitroglycerin (Nitro-Bid), Isosorbide Rapid acting forms are
(Isordi)
indicated for the management
of acute angina episodes and
long acting forms are used for
the prevention of angina
attacks.
WHAT I NEED TO KNOW AS A BRAND NEW
NURSE
* HA is the most commonly reported adverse effect, others
include hypotension, tachycardia and contact dermatitis with
topical forms.
*Contraindicated with preexisting hypotension, head trauma or
increased intracranial pressure, and pericardial tamponaade.
*Adequate hydration status required for administration
* For IV administration: use IV pump, hold for systolic BP <
100
* For sublingual administration: store in dark, light resistant
container, replace supply every 6 months, may administer up to
3 tabs SL
* For topical administration: apply with gloves, use non-hairy
sites and rotate sites, avoid lower extremities

Beta-adrenergic Antagonists
(Beta Blockers)
Common Examples:
Atenlol (Tenormin), Metoprolol
(Lopressor), Propanolol (Inderal)
Indicated for the treatment of
angina, particularly angina
caused by exercise. Mainstay
treatment for the management
of hypertension, cardiac
dysrhythmias and MI.
Unlabeled uses include
migraines, and tachycardia
associated with stage fright.
*Well tolerated at low doses
* Adverse effects include: bradycardia, hypotension, second and
third degree heart block, fatigue, lethargy, depression, wheezing,
dyspnea, impotence and decreased libido, altered glucose and
lipid metabolism.
* Hold for HR < 60
* Withdraw gradually to avoid rebound hypertension, angina and
MI.
* Periodically monitor blood sugar, cholesterol and triglycerides.
* Use with caution in patient with history of asthma or diabetes
CARDIAC
MEDICATIONS
Calcium Channel Blockers
Common Examples:
Amlodipine (Norvasc), Diltiazem
(Cardizem),Ranolazine (Ranexa)
Alpha Adrenergic Agonists
Common Examples:
Clonidine (Catapres)
Methyldopa (Aldomet)
Angiotensin-converting enzyme
(ACE) Inhibitors
Common Examples:
Captopril (Capoten), Enalapril
(Vasotec), Lisinopril (Zestril, Prinivil)
Moexpril (Univasc) Ramipril (Altace)
Angiotensin II Receptor
Blockers (ARBS)
Common Examples:
Losartan (Cozaar), Olmesartan
(Benicar), Valsartan (Diovan)
COMMON USES
Indicated for the management
of angina, hypertension and
dysrhythmias. Also indicated
for migraines and Raynaud’s
disease.
Antihypertensive.
Management of opiod
withdrawal.
Indicated for hypertension MI
and heart failure.
Antihypertensive, adjunctive
therapy for heart failure.
WHAT I NEED TO KNOW AS A BRAND NEW
NURSE
* Adverse effects include: bradycardia or tachycardia, heart
block, hypotension, dyspnea, wheezing, GI complaints and
dermatitis.
*Reduce dose with known liver disease and use caution
* Taper dose
* Orthostatic hypotension is a common adverse effect, other
adverse effects include bradycardia, reflex tachycardia, sedation,
dizziness and HA.
* Do not discontinue abruptly.
* Aldomet often prescribed for pregnancy induced hypertension
* Adverse effects are generally mild and include dizziness,
fatigue, HA, hypotension, dry nonproductive cough, chest pain,
tachycardia, hyperkalemia, hypermagnesemia.
*Serious but rare adverse effect: Angioedema
* Monitor K+ and Mg levels.
*Enhance the effects of thiazide diuretics
* Adverse effects are generally mild and include HA, upper
respiratory infections, dizziness, GI complaints and fatigue.
* Potent vasodilator.
* Often used in combination therapy for the management of
hypertension
CARDIAC COMMON USES WHAT I NEED TO KNOW AS A BRAND NEW
MEDICATIONS NURSE
Direct-Acting Vasodilators Antihypertensive * Adverse effects include HA, dizziness, reflex tachycardia,
Common Examples: hypotension, rebound hypertension, hyperglycemia, Na+ and
Hydralazine (Apresoline), Nitroprusside water retention
(Nipride)
* Monitor I & O, blood glucose
* Nipride indicated for emergency management of hypertension,
titrated IV infusion. Monitor VS frequently with continuous
cardiac monitoring.
*Adverse effects eliminate use as drugs of first choice.

Diuretics Antihypertensive
*See Renal System*