Heart Drugs

Front 1

Drug:lisinopril (generic), Prinivil, Zestril (trade)
Dose: (hypertension) PO 10-40mg, (CHF) PO 5mg
Action: selectively supresses renin-angiotensin-aldosterone system; inhibits ACE, preventing conversion of angiotensin I to angiotensin 2
Side Effect: (severe) stroke, protienuria, renal insufficiency, angioedema, (common) vertigo & fatigue

Back 1

Contra: pregnancy, hypersensitivity, & angioedema
Teaching: Not to discontinue product abruptly, to rise slowly to sitting or standing position to minimize orthostatic hypotension, to avoid > potassium in the diet

Front 2

Drug: amiodarone (generic) Cordarone, Pacerone (trade)
Dose: PO 600-800 mg, IV load 150mg, 360mg over 6hr, 540 over next 18hr infusion 0.5mg/min
Action: prolongs duration of action potential & effective refractory period, noncompetitive a & b adrenergic inhibition: > PR & QT intervals, < sinus rate, < PVD
Side Effects: (severe) sinus arrest, CHF, dysrhythmias, SA node dysfunction, corneal microdeposits, hepatotoxicity, toxic epidermal necrolysis, pulmonary fibrosis, ARDS

Back 2

Contra: pregnancy, breastfeeding, 2nd & 3rd degree AV block, bradycardia, severe sinus node dysfunction, neonates & infants
Teaching: take product as directed, avoid missed dose, do not use with grapefruit jucie, to use sunscreen, to report side effects immediately, that skin discoloration is usually reversible, that dark glasses may be needed for photophobia.

Front 3

Drug: clopidogrel (generic), Plavix (trade)
Dose: PO 75mg
Action: inhibits first & 2nd phases of ADP-induced effects in platelet aggregation
Side Effects: (severe) GI bleeding, pancreatitis, Glomerulonephritis, bleeding, neutropenia, aplastic anemia, intercranial hemorrhage, toxic epidermal necrolysis, Steven-Johnson's syndrome, bronchospasm (common) none listed

Back 3

Contra: hypersensitivity & active bleeding
Teaching: that blood work will be necessary during treatment, to report any unusual bruising or bleeding to HCP, to take with food or just after eating, to report diarrhea/skin rashes/subcutaneous bleeding/chills/fever/ sore throat, to tell all HCP that Plavix is being used.

Front 4

Drug: warfarin (generic)Coumadin, Jantoven, Warfilone (trade)
Dose: PO/IV 2.5-10 mg/day
Action: interferes with blood clotting by indirect means, depresses hepatic syntnesis of vit K
Side Effects: (severe) hepatitis, hematuria, hemorrhage, agranulocytosis, leukopenia, eosinophilia, anaphylaxis, exfoliative dermatitis, purple toe syndrome (common) fever, diarrhea, & rash
Contra: pregnancy, breastfeeding, hypersensitivity, hemophilia, PUD, thrombocytopenic purpura, hepatic disease severe, malignant hypertension, bactrial endo-carditis, acute nephritis,

Back 4

Contra cont.: blood dyscrasia, eclampsia, hemorrhage & bleeding tendencies, surgery of CNS, strock, aneurysms, pericardial effusion, spinal puncture, major regional/lumbar block anestesia
Teaching:to avoid OTC products containing asprin unless approved by a HCP,to use soft bristle tooth brush & electric razor, to carry Emergency ID identifying product, the importance of compliance, to avoid hazardous activities or work, the importance of avoiding unusual cahnges in diet/ vit intake or life-style, to inform dentists and other HCP of treatment.

Front 5

Drug: enoxaparin (generic) Lovenox (trade)
Dose: PO 1-30 mg
Action: binds to antithrombin 3 inactivating factors Xa/2a resulting in higher ratio of anti-factors Xa/2a
Side Effects: (severe) hemorrhage, hypochromic anemia, thrombocytopenia, bleeding (common) none listed

Back 5

Contra: hypersensitivity, to this product, benzyl alcohol, heparin or pork, hemophilia, leukemia with bleeding, PUD, thrombocytopenic purpura, haparin induced
thrombocytopenia
Teaching: to use soft bristle tooth brush & electric razor, to report any signs of bleeding, to avoid OTC products containing asprin unless approved by a HCP

Front 6

Drug: metoprolol (generic) Betaloc, Lopressor, NU-Metop, Novometoprol, Toprol-XL (trade)
Dose:hypertension PO 50mg, MI IV BOL 5mg q2minx3 then PO15mg, Angina PO 100mg
Action: lowers BP by B-blocking effects.
Side effects:(severe) depreesion, bradycardia, CHF, carrdiac arrest, AV block, pulmonary/peripheral edema, chest pain, agrangulocytosis, esoinophilia, thrombocytopenia, purpura, bronchispasm, (common) insomnia, dizziness, nausea, vomiting, diarrhea, hiccups & palpitations

Back 6

Contra: hypersensitivity to B-blockers, cardiogenic shock, heart block 2nd &3rd, sinus bradycardia, bronchial asthma
Teaching: take immediately after meals, do not discontinue abrupty, not to use OTC products with a-adrenergic stimulants, report bradycardia/dizziness/fever/sore thraot & SOB to HCP, to take pulse & BP at home regularly, to avoid alcohol/smoking & NA+ intake, to comply with wt./ dietary adjustments, to avoid hazardous activities when dizziness presents, to report signs of CHF, to take med at bedtime to prevent orthostatic hypotension, combate effects of orthostatic hypotension with support hose.

Front 7

Drug: atorvastatin (generic) Lipitor (trade)
Dose: PO 10-80mg
Action: inhibits HMG-CoA reductase enzyme, which reduces cholesterol synthesis
Side Effects: (severe) liver dysfunction, rhabdomyolysis (common) abdominal cramps, constipation, diarrhea, flatus, heartburn

Back 7

Contra: pregnancy, hypersensitivity, breastfeeding, active bleeding,active hepatic disease
Teaching: that blood work and eye exam will be necessary during treatment, to report blurred vision/ severe GI symptoms/ headache/ muscle pain & weakness, to continue low-cholesterol diet/ exersise program & smoking cessation, not to take if pregnant, to stay out of the sun or to use sunscreen

Front 8

Drug:fenofibrate (generic) Antara, Lofibra, Tircor, Triglide
Dose: PO tircor 48-145mg
Action increases lipolysis and elimination of triglyceride-rich particles from plasma.
Side Effects: (severe) dysrhythmias (common) nausea, rash, myalgias, arthralgias

Back 8

Contr: hypersensitivity, severe renal/hepatic disease, primary biliary cirrhosis, preexisting gallbladder disease
Teaching: that compliance is needed, that risk factors should be decreased ie high fat diets/ smoking/ alcohol use/ absence of exercise, to notify HCP if pregnancy is suspected or planned, to report GU symptoms, to notify HCP of muscle pain/ weakness/ fatigue/ fever or epigastric pain

Front 9

Drug: furosemide (generic) Furoside, Lasix, Myrosemide, Novosemide, Uritol
Action: inhibits reabsorbtion of sodium and chloride at proximal and distal tubule & in loop of henle.
Dose: PO 20-80mg, IV/IM 20-40 mg
Side Effects: (severe) circulatory collapse, loss of hearing, renal failure, thrombocytopenia, aranulocytosis, leukopenia, neutropenia, anemia, Stevens-Johnson syndrome, (common) hypokalemia, hypochloremic alkalosis, Hypomagnesemia, hyperuricemia, hypocalcemia, hyponatremia, hyperglycemia, nausea, poluria, rash & pruritus

Back 9

Contra: hypersensitvity to sulfonamides, anuria, hypovolemia, infants, breastfeeding, dehydration, severe renal disease, cirrhosis, ascites
Teaching: to discuss the need for high potassium diet, to rise slowly from lying or sitting postion, to report reactions of muscle cramps/ weekness, to take with food or milk, to use sunscreen or protective clothing while in the sun, to take early in the day to prevent sleepiness, to avoid OTC meds unless directed.

Front 10

Drug: bumetanide (generic) Bumax (trade)
Dose: PO 0.5-2.0 mg, IV/Im 0.5-1.0 mg
Action: acts on ascending loop of henle by inhibiting reabsorbtion of chloride & sodium
Side effects: (Severe) chest pain, circulatory collapse, acute pancreatitis, jaundice, renal failure, thrombocytopenia, aranulocytosis, leukopenia, neutropenia, anemia, Stevens-Johnson syndrome, (common) hypokalemia, hypochloremic alkalosis, Hypomagnesemia, hyperuricemia, hypocalcemia, hyponatremia, hyperglycemia, nausea, loss of hearing, glycosuria, poluria, rash & pruritus

Back 10

Contra: hypersensitvity to sulfonamides, anuria, hepatic coma, severe electroyte deficiency
Teaching: to increase fliud intake to 2-3 L/day, to take potassium supplements, to rise slowly, report reactions of muscle cramps/ weekness, to take with food or milk, to use sunscreen or protective clothing while in the sun, to take early in the day to prevent nocturia.