Medications Sec 1


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Medications Sec 1

  1. 1. CARDIOVASCULAR HEALTH Presentor: Barbara Dalrymple, RN/ Director of Medical Rehab
  2. 2. CARDIAC MEDICATIONS - Never chew or crush time-released medications. - Never take medications ordered for another person. Likewise, do not give your medications to anyone else. Tell your physician or pharmacist if you are allergic to any medications. Carry a - Never take medications given to you medical identification card which lists all for a previous illness. medications you are currently taking and your diagnosis. Update the card each time - Do not take over the counter medicines medications are changed and reviewed for unless you have talked with your| accuracy at least every 2 – 3 months. physician first. Medications Consider safety measures when taking containing aspirin, cough suppressant, medications. antihistamines or combinations of - Only take medications ordered for you drugs may be harmful. by your physician. - Even some vitamins can alter the effects of medicine.
  3. 3. CARDIAC MEDICATIONS cont. Do not expect medications to Keep medications in their make you feel better immediately. original labeled containers. Give them time to work. Discard medications that you no longer need by flushing Make sure you keep an accurate them down the toilet. record of any reactions you have See your doctor regularly. experienced to a medication. Medication types or doses may Report unusual side effects or need to be changed. problems to your doctor immediately.
  4. 4. CARDIAC MEDICATIONS The Role Of Medications In The Prevention And Treatment Of Heart Disease Classes Of Medications: Beta Blockers Common Questions: Calcium Channel Blockers Not sure if I took my pills. Nitrates Remember to late. Too sick to take pills, Diuretics vomiting. ACE Inhibitors and ARBs Main Message: If you have questions about your Digoxin medications it is very important that you speak to your physician about those Anticoagulants: Coumadin /Warfarin, questions. Aspirin, others Cholesterol lowering medications: Statins, Niacin, others Antioxidants
  5. 5. CARDIAC MEDICATIONS Your doctor has told you that you have heart disease. As part of your treatment for heart disease you will need to exercise regularly, make dietary changes, and take medications as prescribed by your doctor. Taking your medication is extremely important to your recovery. Taking medications properly ensures maximum benefit. Follow these tips for safe, effective use of medicine.
  6. 6. CARDIAC MEDICATIONS cont. - Avoid drinking alcoholic beverages while taking medications. - Be careful when driving a car or operating dangerous machinery since some medications may cause Make sure you know exactly drowsiness. how to take each medication. - Store medications in a cool, dry place. - When given a prescription for a new medication, ask the doctor, nurse, or pharmacist for instructions on how it should be taken.
  7. 7. CARDIAC MEDICATIONS cont. Changes in medication dose or frequency should be done ONLY if instructed to do so by the doctor. Remember: Never take more medication, even if you think you need more. Never decrease the amount of Always call the doctor or nurse if medication you take. you feel there is a problem with medication dose or frequency. Never skip a dose. Never stop taking a medication on your own, even if you feel better.
  8. 8. CARDIAC MEDICATIONS cont. Here are some tips for taking your medication regularly Taking your medicine is an important part of the treatment of Coronary Heart Disease. Taking your medications on time each day is a Good Habit to form. If you have a problem remembering when to take your medications, here are some suggestions that might be helpful to you: 1. Keep your medicine in a place where you would see it often, such as the bathroom medicine cabinet or kitchen cabinet. This will remind you to take it. 2. Schedule your medicine at the same time you do certain other activities such as shaving, brushing your teeth, or eating a meal. 3. List the times of day you plan to take your pills on a large calendar. Place a check mark next to the time and day to show you took your pill.
  9. 9. CARDIAC MEDICATIONS cont. Your doctor might have you on a Drug Names medication that you must take 3 times a day. It is important that you take your medication on time as your doctor has prescribed. In order for your There are many medications available today for medication to work properly, a certain the treatment of Angina and Heart Disease. amount oft it must be circulating in Their names can be very confusing! Basically, your bloodstream. Different each drug has two names, a brand name and a medications have different strengths. generic name. The generic name is the This is why some medications must be chemical name for the drug. It is often long and taken 3 times a day while others need difficult to pronounce. only be taken once a day. For example: Acetaminophen is the generic If you skip a dose then the amount of name for Tylenol. the drug in your bloodstream will drop The generic drug is usually less expensive then and your medication will not work the brand name drug. Ask the doctor or effectively. On the other hand, if you pharmacist about this. Do not substitute decide that you are going to make up medication on your own. The brand name for for missing your morning dose of drugs refers to the name the pharmaceutical medication by taking twice the amount companies give to medications. These names are at noon-time, you will too much of this easy to pronounce. For example, Tylenol is the medication in your bloodstream and brand name for Acetaminophen. this can hurt you more than help you.
  10. 10. CARDIAC MEDICATIONS cont. Drug Names Never double up on your medication! Remember, if you experience any side effects from your medication don’t stop taking them on your own but rather call your doctor and inform him of your symptoms and suspicions. If you are feeling good while taking your medications it is an indication that they are working properly to relieve your symptoms of Heart Disease.
  11. 11. CARDIAC MEDICATIONS cont. The following are different types of medications. Their uses, side effects, and general tips will be discussed. Beta Blockers Drugs: Inderol (Propanolol) Nadolol (Corgard) Use: Timolol (Blockadren) Pindolol (Viskin) Atenolol (Tenormin) Metoprolol Slow the heart rate and (Lopressor)(Toprol XL) decrease blood pressure causing a decreased demand for oxygen and blood by the Possible Side Effects: heart. Especially helpful with Fatigue, depression, sleep disturbances, angina induced by exertion. impotence, numbness or tingling of the Also used to treat high blood extremities, feeling of coldness. pressure. Helps prevent additional heart attacks.
  12. 12. CARDIAC MEDICATIONS cont. Beta Blockers Unwanted Side Effects: Check with your doctor should any of the following occur: breathing difficulty and / or wheezing cold hand and feet Irregular heart beat confusion nightmares and vivid dreams mental depression skin rash slow heartbeat swelling of ankles, feet and/or lower legs
  13. 13. CARDIAC MEDICATIONS cont. Do not discontinue these drugs suddenly. Your doctor will wean you off of this medication gradually. If stopped suddenly it may increase your chances of a heart attack. Beta-blockers can cause a If you miss a dose of this drop in blood sugar in medication, take it as soon as diabetics. They might mask possible. It is within 8 hours some of the signs of of your next dose, skip the hypoglycemia (low blood sugar). dose and resume your regular schedule. Some people become dizzy, drowsy, light-headed, or less alert when taking beta- Do not double the doses. blockers. Be sure you know how you respond to them before operating machines or driving.
  14. 14. CARDIAC MEDICATIONS cont. Use: Increase blood flow to the heart by dilating (opening up) the coronary arteries. Also opens up the other blood vessels in the body. It does this by blocking influx of calcium into the cell. Calcium is needed for muscle contraction. Decreases the force of the contraction of the heart and therefore the amount of work that it has to do. Dilates the peripheral arteries and reduces the resistance that the heart has to work against pumping blood out to the body. Especially effective in preventing angina induced by coronary artery spasm. Drugs: Possible Side Effects: Verapamil (Ispotin, Calan) Dizziness, headache that Cardizem (Diltiazem) persists, nausea, leg swelling (with Nefedipine), constipation Nefedipine (Procardia) (with Verapamil).
  15. 15. CARDIAC MEDICATIONS cont. Take the calcium channel blocker as directed by your doctor, even if you are feeling well and not experiencing angina. If you are taking an extended-release form of this medication (sustained-release, or SR) do not break, crush, or chew it. Swallow it whole. Take it with food or milk. Do not stop the medication suddenly. It could bring on symptoms of angina. Check with your doctor for a schedule to wean off gradually. Some people become dizzy or light-headed when rising from a lying or sitting position. Getting up slowly might help. Drinking alcohol can make these effects worse. If you are taking Diltiazem or Verapamil, ask your doctor about checking your heart rate before and after your medication. While you are taking this medicine, check your pulse regularly. It is much slower than your usual rate or often below the rate recommended by your doctor, report the occurrence.
  16. 16. CARDIAC MEDICATIONS cont. Antiarrhythmic Drugs: Amiodarone Quinidine Quinaglute Norpace Pronestyl (Procainamide, Procan) Procan SR (sustained release Pronestyl) Possible Side Effects: Nausea, vomiting, diarrhea, poor appetite, rash.
  17. 17. CARDIAC MEDICATIONS cont. ACE Inhibitors (Angiotensin-Converting Enzyme Inhibitors) Use: Angiotensin-converting enzyme (ACE) inhibitors are used to treat high blood pressure and congestive heart failure. They block an enzyme in the blood that causes blood vessels to constrict. Therefore the blood vessels are relaxed, thereby lowering blood pressure, reducing the workload of the heart, and reducing its need for blood and oxygen. Unwanted Side Effects: Drugs: Contact your doctor should the following occur: Captopril (Capoten) coughing Enalapril (Vasotec) difficulty in breathing Lisinopril (Prinivil) fever, chills, or sore throat Zestrol swelling of face, mouth, hands, or feet Accupril Tips: Dizziness or light-headedness might occur after taking the first dose of this medicine. Make sure you know how you respond before driving or operating machinery. This medicine does not cure high blood pressure, but is does control it. Continue to take it as prescribed.
  18. 18. CARDIAC MEDICATIONS cont. Digitalis and Digoxin Use: Improves strength of heart or to control rate and rhythm. Take as directed even though you feel well. Drugs: Brand names of Digoxin include Lanoxin and Lanoxicaps.
  19. 19. CARDIAC MEDICATIONS cont. Digitalis and Digoxin Ask your doctor about checking your heart rate. While taking this medicine, check your pulse regularly. If your pulse is suddenly higher or lower than usual, if it is regular, or if it is often below the rate suggested by your doctor, report the occurrence. If you forget a dose of this medication and remember within 12 hours, take it immediately. If it is more than 12 hours,skip that dose and resume your regular schedule. Do not double the next dose. Take this medication just as your doctor prescribes. The amount needed to help most people is very close to the amount that can cause problems from overdose. Some early warning signs of overdose are: loss of appetite nausea vomiting diarrhea extremely slow heartbeat
  20. 20. CARDIAC MEDICATIONS cont. Diuretics Reduces water in the Lasix (Furosemide) body. In doing so, they Aldactone (Spironolactone) – spares potassium lower blood pressure, Dyrenium (Triamterene) reduce the workload of Hydrodiuril (Chlorothiazide) the heart, and reduces Aldactazide (combination of Aldactone and Hydordiuril) Dyazide (combination of Triamterene and Hydrodiuril) its need for blood and oxygen. Unwanted Side Effects: Contact your doctor should the following occur: skin rash sore throat or fever muscle cramping irregular heart beat weak pulse confusion unusual tiredness or weakness
  21. 21. CARDIAC MEDICATIONS cont. Diuretics TIPS: A diuretic can make you feel tired when you begin to take it. You might also notice an increase in the amount of urine and in your frequency of urination. If you miss a dose take it as soon as possible. If it is close to your next schedule dose, skip the missed dose and resume your regular schedule. Some diuretics cause a loss of potassium; others conserve it. Check with your doctor about the need for potassium supplement and/or blood test to check your potassium level.
  22. 22. CARDIAC MEDICATIONS cont. Anitcoagulants Use: Prevents clot formation by interfering in the clotting mechanism. Drugs: Coumadin Aspirin – has a mild anticoagulation effect. Is prescribed after a heart attack to help prevent formation of small clots, which may block coronary arteries already narrowed by atherosclerosis. Possible Side Effects: Bruising, bleeding. Important: Call your doctor if you notice blood in your urine, black stools, or bleeding from your gums or other abnormal places.
  23. 23. CARDIAC MEDICATIONS cont. Potassium Supplements Use: Maintaining good health. Sometimes needed to replace potassium last as a result of illness or medication. Drugs: Potassium bicarbonate and potassium chloride (K-Lyte/CL) Potassium bicarbonate and potassium citrate (K-Lyte, K-Lyte DS) Potassium chloride (Kaochlor, Kaon-CL, Kay Ciel, K-Dur, K-LOR, Klotrix, K-TAB, Micro-K, Slow-K, Ten-K) Unwanted Side Effects: Should you notice any of the following, contact your doctor: nausea, vomiting, and/or diarrhea stomach pain red or black stools irregular heartbeat unusual tiredness or weakness confusion
  24. 24. CARDIAC MEDICATIONS cont. Potassium Supplements Too much potassium can also cause health problems, so take this medication only as directed. If you are taking the liquid or powder form of this medicine, it must be diluted in at least four ounces of cold water or juice to reduce stomach irritation. Allow any fizzing to stop before taking the dissolved medication. If you are taking the extended-release form of this medicine, swallow the tablet whole without crushing, breaking, or chewing. If you miss a dose of this medicine and remember in 2 hours, take the missed dose right away with food or liquid. Then go to regular dosing schedule. If you do not remember until later, skip the missed dose and go back to your regular dosing schedule. Do not double these doses.
  25. 25. CARDIAC MEDICATIONS cont. Nitroglycerin Use: Relieves anginal pain by temporary widening the arteries and veins. This brings more blood and oxygen to the heart when it needs it the most and your hear doesn’t have to work so hard. Nitroglycerin relaxes the blood and lowers the blood pressure. Drugs: There are two major types of nitrates: Short-acting and long-acting.
  26. 26. CARDIAC MEDICATIONS cont. Nitroglycerin Short-acting nitrates are: . sub-lingual nitroglycerin or nitroglycerin spray Long-acting nitrates are: nitroglycerin patch, nitroglycerin ointment, or Isodril. These medications are worn continuously and are used during the day and night to prevent angina. If you are using a long-acting nitroglycerin you should still take a quick acting nitroglycerin tablet anytime you feel angina. The other forms of nitroglycerin (paste, patch, capsule) are not replacements for taking nitroglycerin under the tongue should angina occur If you experience angina, follow these instructions  Stop whatever activity you are performing and rest.  Sit or lie down.
  27. 27. CARDIAC MEDICATIONS cont. Nitroglycerin Procedure For Taking Nitroglycerin Tablets: 1. Place the tablet under your tongue. Let it dissolve completely and hold the saliva in your mouth 1 – 2 minutes before swallowing. 2. If the pain persists take 1 nitroglycerin tablet every 5 minutes up to 15 minutes. If angina persists longer than 15 minutes, you may be having some heart damage or a heart attack. 3. Call 911 immediately. Do not drive yourself and do not have family drive you to the hospital. Ambulance with professional staff only! 4. Because nitroglycerin lowers the blood pressure you may want to sit down when you take it. 5. Keep nitroglycerin with you at all times. You never know when you might need it. If an activity often causes angina you may want to take a nitroglycerin before starting the activity. This may help prevent angina.
  28. 28. CARDIAC MEDICATIONS cont. Nitroglycerin Procedure For Taking Nitro-Ointment or Skin Patches 1. Keep the medicine at room temperature. 2. Remove old ointment before applying the next dose. 3. Change skin patches after 24 hours or ointment after 4 – 6 hours. 4. Put it on a part of the body most convenient for you (upper arm, legs, thigh, shoulder, abdomen or just below your collar bone). 5. Apply only as much ointment as prescribed. Measure directly from the tube onto the paper that comes with the tube. 6. When using ointment, place a clear plastic cover (saran wrap) over the paper with the paste. Tape all edges to protect your clothes from the paste as it melts with your body heat. 7. Put on the daily patch the same time each day. 8. Make sure your skin is dry and free of hair, rashes, cuts, scars or calluses. Use a different spot if you notice skin redness. 9. If the patch gets wet while you are swimming or bathing, remember water will not keep it from working. 10. Don’t put the patch/paste in a skin fold such as under the breast or at the elbow joint. Check with your pharmacist, he may have available ready made covering for Nitroglycerin paste users .
  29. 29. CARDIAC MEDICATIONS cont. Nitroglycerin Nitroglycerin will lose its strength if exposed to light, moisture or heat. In order to keep nitroglycerin effective, follow these rules: Store them in a cool, dark, dry place away from ovens, heaters and sun heat. Keep the pills in their own dark colored container with the cotton removed. Remove cotton as soon as possible to be able to get to the pills quickly if needed. Keep closed tight to prevent the tablets from being exposed to the air and moisture. Carry them in an outside pocket our purse away from your body heat. Get fresh ones after 3 months. Make sure to date the bottle. Fresh pills produce a slight burning sensation under your tongue. Never stop taking your pills altogether without your doctor’s permission. However, don’t worry about taking them as needed because they are not habit forming. Don’t drink alcohol without talking to your doctor first. Alcohol and vasodilators don’t mix and the combination may cause lightheadedness or fainting.
  30. 30. CARDIAC MEDICATIONS cont. Nitroglycerin Headache may occur, but usually subsides quickly. Headaches may no longer occur after you’ve been using the pills for a while. You may feel warm and flushed, but the feeling usually goes away quickly. Dizziness may occur, but can be prevented if you lie or sit down while taking the drug. Should you notice any of the following, contact your doctor: pain unusually severe or prolonged severe throbbing headache persistent flushing severe dizziness or fainting
  31. 31. CARDIAC MEDICATIONS cont. Cholesterol Lowering Medications Use: Reduces the low-density lipoproteins (LDL) and total cholesterol levels in patients with primary hypercholesterolemia. Usually taken once a day. Drugs: Zocor Mevacor Tips: Lopid Lescal Need to review with your doctor any interaction Pravachol Lipitor with other medications you take. Questran Colestid Liver function tests should be done before and Crestor Altoprev during treatment. Best if taken before your evening meal since it will be absorbed better. Possible Side Effects: Report any adverse side effect to your physician. Headaches, nausea, vomiting, diarrhea, abdominal pain, high liver enzyme, blurred vision, muscle aches and pains.
  32. 32. CARDIAC MEDICATIONS cont. Generic versus brand name Range Atorvastatin vs. Lipitor 10 mg - 80 mg Rosuvastati vs. Crestor 5 mg - 40 mg n Lovastatin vs. 20 mg - 80 mg Mecavor Simvastatin vs. Zocor 10 mg - 40 mg Provastatin vs. Provocal 10 mg - 40 mg Fluvastatin vs. Liscol 10 mg - 80 mg
  33. 33. CARDIAC MEDICATIONS cont. ASA Use: In low doses. ASA appears to slow down clotting. This has shown to help in the reduction of heart attack. The usual dose is 160 – 325 mg once a day. Possible Side Effects: Nausea, GI bleeding, prolonged bleeding tine. Tips: Do not use ASA with other anticoagulants, like Coumadin. As always, consult with your doctor about any concerns As with other medications, check with your you may have about your doctor for possible interactions. medications. It is a good idea to take this medication with food to decrease the irritation on your stomach.