Here are some notes on cardiac medications commonly asked about on the NCLEX and what is typically useful to know about them for the test.

For many of the cardiac medications, the following apply.

a) Can be used for multiple uses. Often a medication can lower blood pressure and be used in angina and treatment of arrhythmias. Such use is often decided on a case by case basis.

b) Requires careful monitoring for cardiac response. Many can cause new arrhythmias or unwanted and potentially fatal activity. Many involve teaching the patient how to self-monitor.

c) Sudden changes in position can cause disorientation.

d) Potentially interacts with, in particular, other cardiac medications. Many alter the chemistry of the heart and so can interact.

Also useful: psychiatric medications.

Amiodarone

Condition(s): Various cardiac - Class III antiarrythmic
Side Effects: See note, nausea, constipation, loss of appetite, uncommon thyroid
Note: Can take 2+ weeks to have full effect, may cause lung and/or liver damage, may worsen or cause new arrhythmia, note potential med interactions, multiple delivery methods

Atenelol

Condition(s): Heart pain and hypertension - betablocker
Side Effects: Slower heart beat, dizziness, nausea, anxiety
Note: Multiple cardiac uses, discontinue over 1-2 weeks, may mask signs of diabetes, preg cat D, used off label for anxiety

Atorvastatin (Lipitor)

Condition(s): Cholesterol - HMG-CoA inhibitor
Side Effects: Diarrhea, gas, headache
Note: Grapefruit interaction, may take month or longer for full effect, rare muscle problems, rare liver problems, may start low dose, gradual increase, other meds may affect absorption

Digoxin

Condition(s): Heart failure and arrhythmias - cardiac glycoside
Side Effects: Dizziness, vomiting, irregular heartbeat
Note: High fiber foods and other meds and OTC products may interact, monitor for heart activity, for weakness, breast tenderness in men and vision changes, note and asses diuretic use

Diltiazem

Condition(s): High blood pressure, angina - calcium channel blocker
Side Effects: Dizziness, nausea, headache
Note: Various cardiac uses, may take weeks to achieve full effect, should be used for prevention of angina, not response to, monitor for abnormal heart rhythm

Enalapril (Vasotec)

Condition(s): High blood pressure - ACE inhibitor
Side Effects: Cough, dizziness, tiredness, headache
Note: Can cause serious birth defects, strongly rec. to avoid pregnancy, use to prevent harm to kidneys from diabetes, may take 2-4 weeks for blood pressure effects, longer for heart failure use, may increase potassium

Furosemide (Lasix)

Condition(s): Reduce edema, high blood pressure
Side Effects: Cramps, headache, blurred vision
Note: Very strong diuretic, monitor carefully especially for dehydration, if taken at night, can cause waking to urinate, sudden position changes may cause disorientation

Lisinopril

Condition(s): High blood pressure - ACE inhibitor
Side Effects: Cough, dizziness, tiredness, headache
Note: Can cause serious birth defects, strongly rec. to avoid pregnancy, may take 2-4 weeks for blood pressure effects, longer for heart failure use, may increase potassium, has been used to prevent harm to kidneys from diabetes

Metoprolol

Condition(s): Blood pressure, angina - Beta blocker
Side Effects: Drowsiness, tiredeness, depression
Note: Stopping suddenly may cause heart problems, various cardiac uses, monitor heart carefully, teach patient self-monitor, may take several weeks for effect

Nifedipine

Condition(s): High blood pressure, angina - calcium channel blocker
Side Effects: Dizziness, swelling in limbs, headache
Note: Grapefruit juice potential interaction, monitor heart activity, for fainting, vision change, sudden position changes may cause disorientation

Spironolactone

Condition(s): High blood pressure - potassium sparing diuretic
Side Effects: Light-headedness, nausea, headache
Note: Best taken during day to avoid night waking to urinate, may take 2 weeks full effect, anti-androgen activity, potential feminizing effect men, note and assess consumption of foods high in potassium

Verapamil

Condition(s): High blood pressure, angina - calcium channel blocker
Side Effects: Dizziness, heartburn, low energy
Note: Can take week to achieve full effect, certain forms prefer take at night or morning, monitor heart activity, for fainting, vision change, grapefruit juice potential interaction, sudden position changes may cause disorientation

Others:

  • Losartan
  • Valsartan
  • Clopidogrel
  • Chlorothiazide
  • Minoxidil
  • Prazosin
  • (More...)

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