Cardiovascular Medications

MedicationIndicationsSide EffectsAdverse EffectsNursing InterventionsContraindications
ACE Inhibitors
(e.g., Lisinopril, Enalapril)
Hypertension, heart failure, post-myocardial infarction.Cough, elevated blood urea nitrogen, hyperkalemiaAngioedema, renal failureMonitor blood pressure, renal function, and potassium levels.History of angioedema, bilateral renal artery stenosis.
Beta-Blockers
(e.g., Metoprolol, Atenolol)
Hypertension, angina, heart failure, arrhythmias.Fatigue, bradycardia, hypotensionHeart block, bronchospasmMonitor heart rate and blood pressure, teach patient to rise slowlyAsthma, bradycardia.
Calcium Channel Blockers
(e.g., Amlodipine, Diltiazem)
Hypertension, angina, arrhythmias.Peripheral edema, constipation, dizzinessSevere hypotension, bradycardiaMonitor blood pressure, heart rate, and signs of edema.Severe hypotension, heart block.
Diuretics
(e.g., Furosemide, Hydrochlorothiazide)
Hypertension, heart failure, edema.Electrolyte imbalances, dehydrationOtotoxicity (with loop diuretics)Monitor blood pressure, renal function, and electrolytes.Anuria, severe renal impairment.
Nitrates
(e.g., Nitroglycerin)
Angina, heart failure.Headache, dizziness, hypotensionReflex tachycardiaMonitor blood pressure, educate on appropriate use and storage.Use of phosphodiesterase inhibitors like sildenafil.
MedicationIndicationsSide EffectsAdverse EffectsNursing InterventionsContraindications
Anticoagulants
(e.g., Warfarin, Heparin)
Prevent and treat thromboembolic disordersBleeding, anemiaHemorrhage, heparin-induced thrombocytopenia (HIT)Monitor INR/PT (warfarin), aPTT (heparin), signs of bleedingActive bleeding, thrombocytopenia, severe hypertension
Antiplatelets
(e.g., Aspirin, Clopidogrel)
Prevent thrombus formation in arterial circulationGI upset, rashGI bleeding, thrombocytopeniaMonitor for signs of bleeding, platelet countPeptic ulcer disease, active bleeding
Statins
(e.g., Atorvastatin, Simvastatin)
Lower LDL cholesterolGI upset, muscle achesRhabdomyolysis, hepatotoxicityMonitor liver enzymes, CK levels if muscle painLiver disease, unexplained elevated liver enzymes
ARBs
(e.g., Losartan, Valsartan)
Hypertension, heart failure, diabetic nephropathyDizziness, hyperkalemiaRenal dysfunction, angioedemaMonitor blood pressure, renal function, potassium levelsPregnancy, bilateral renal artery stenosis
Alpha Blockers
(e.g., Doxazosin, Prazosin)
Hypertension, benign prostatic hyperplasiaDizziness, headacheOrthostatic hypotension, tachycardiaMonitor blood pressure, advise to rise slowly from sitting/lying positionsSevere hepatic impairment
MedicationIndicationsSide EffectsAdverse EffectsNursing InterventionsContraindications
Aldosterone Antagonists
(e.g., Spironolactone)
Heart failure, HypertensionGynecomastia, menstrual irregularitiesHyperkalemiaMonitor potassium levels, avoid additional potassium supplementationAcute kidney injury, hyperkalemia
Cardiac Glycosides
(e.g., Digoxin)
Heart failure, Atrial fibrillationFatigue, visual disturbancesDigoxin toxicity (arrhythmias, confusion)Monitor serum digoxin levels, check apical pulse before administrationVentricular fibrillation, digoxin toxicity
Direct-acting vasodilators
(e.g., Hydralazine, Minoxidil)
HypertensionHeadache, palpitationsReflex tachycardia, sodium retentionMonitor blood pressure closely, check for edemaCoronary artery disease, mitral valve rheumatic heart disease (for Minoxidil)
Class I Antiarrhythmics
(e.g., Quinidine, Lidocaine)
Ventricular arrhythmiasNausea, diarrheaTorsades de pointes (Quinidine), CNS effects (Lidocaine)Monitor for EKG changes, check for therapeutic plasma levelsHeart block, severe hypotension (for Lidocaine)
Class III Antiarrhythmics
(e.g., Amiodarone)
Supraventricular and ventricular arrhythmiasPhotosensitivity, GI upsetPulmonary fibrosis, thyroid dysfunctionMonitor EKG, lung and thyroid function testsSevere sinus bradycardia, heart block
Beta-Adrenergic Blockers
(e.g., Carvedilol, Labetalol)
Hypertension, Heart failureFatigue, dizzinessBradycardia, hypotensionMonitor heart rate and blood pressure, advise against abrupt cessationAsthma, sinus bradycardia
Medication for Dysrhythmias
MedicationIndicationsSide EffectsAdverse EffectsNursing InterventionsContraindications
Class Ia Antiarrhythmics
(e.g., Quinidine, Procainamide, Disopyramide)
Atrial and ventricular arrhythmiasDizziness, nausea, blurred visionVentricular tachycardia, heart blockMonitor EKG regularly, observe for hypotensionMyasthenia gravis (Disopyramide)
Class Ib Antiarrhythmics
(e.g., Lidocaine, Mexiletine)
Ventricular arrhythmiasDrowsiness, tremorsCNS disturbances, respiratory arrestMonitor EKG and CNS status, ensure rapid IV accessThird-degree heart block
Class Ic Antiarrhythmics
(e.g., Flecainide, Propafenone)
Supraventricular and ventricular arrhythmiasDizziness, visual disturbancesWorsening heart failure, ventricular arrhythmiasMonitor EKG, observe for signs of heart failureRecent myocardial infarction, severe heart failure
Class II Antiarrhythmics
(e.g., Propranolol, Esmolol)
Supraventricular tachycardia, atrial fibrillation/flutterFatigue, dizzinessBradycardia, bronchospasmMonitor heart rate and blood pressure, check lung functionAsthma, second or third-degree heart block
Class IV Antiarrhythmics
(e.g., Verapamil, Diltiazem)
Supraventricular tachycardiaConstipation, headacheHeart block, hypotensionMonitor blood pressure and heart rate, assess for constipationSevere hypotension, heart block
Other Agents
(e.g., Adenosine, Digoxin, Magnesium)
Paroxysmal supraventricular tachycardia (Adenosine), atrial fibrillation/flutter (Digoxin)Flushing, chest discomfort (Adenosine); fatigue, anorexia (Digoxin)Heart block, ventricular fibrillation (Adenosine); digoxin toxicityMonitor EKG during Adenosine administration; monitor serum digoxin levels and EKG for DigoxinSecond or third-degree heart block (unless pacemaker present), Wolff-Parkinson-White syndrome
MedicationIndicationsSide EffectsAdverse EffectsNursing InterventionsContraindications
Potassium Channel Blockers
(e.g., Amiodarone, Sotalol, Dofetilide)
Atrial and ventricular arrhythmiasFatigue, nauseaPulmonary fibrosis (Amiodarone), torsades de pointes (Sotalol, Dofetilide)Monitor for respiratory issues, EKG changes; periodic ophthalmic exams for AmiodaroneHypokalemia, QT prolongation
AdenosineParoxysmal supraventricular tachycardia (PSVT)Flushing, chest discomfortArrhythmias, transient heart blockAdminister rapidly over 1-2 seconds in a large vein, monitor EKGAtrial fibrillation, atrial flutter, ventricular tachycardia
AtropineSymptomatic bradycardiaDry mouth, urinary retentionTachycardia, palpitationsMonitor heart rate and rhythm, blood pressureUncompensated shock, hypersensitivity
Digitalis Glycosides
(e.g., Digoxin)
Atrial fibrillation, heart failureVisual disturbances, fatigueDigoxin toxicity, arrhythmiasMonitor apical pulse, serum potassium, and digoxin levelsVentricular fibrillation, hypersensitivity
Magnesium SulfateTorsades de pointes, hypomagnesemia-related arrhythmiasDiarrhea, flushingHypotension, respiratory depressionMonitor serum magnesium levels, deep tendon reflexesKidney failure, heart block
DronedaroneAtrial fibrillation, atrial flutterDiarrhea, nauseaLiver failure, pulmonary toxicityMonitor liver function, respiratory statusPermanent atrial fibrillation, severe heart failure

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