Drugs For The Heart

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Ace Inhibitors:
Vasotec-enalapril
Altace - ramipril
Monopril - fosinopril
Capoten - captopril
Prinivil/Zestril - lisinopril
Accupril - quinopril
Lotensin - benazepril
Aceon - perindopril- erbumine
Mavik - trandolapril

DESCRIPTION: Angiotensin (AN-jee-oh-ten-sin)-converting enzyme (ACE) inhibitors treat high blood pressure, certain heart conditions, and kidney disease. They also help keep the heart from remodeling.


Angiotensin-converting enzyme (ACE) inhibitors are first line therapy for CHF. ACE inhibitors prevent further worsening of heart function and lighten the heart's workload. There can be large price differences from drug to drug. Watch for lightheadedness and persistent, dry hacking cough.

For side effects, precautions and drug interactions please click HERE !

For more information on Ace Inhibs, @WebMD, click HERE !

Anti-Arrhythmia Drugs:

DESCRIPTION: Antiarrhythmia drugs are one of the ways that arrhythmias sometimes can be helped . (This section has been detailed from the Merck Manual and the drugs broken down by Vaughan Williams into different classifications.) All of these drugs have important safety limitations and can aggrevate or promote arrhythmias.

Antiarrhythmia Class Ia Drugs(Sodium channel blockers):

DESCRIPTION: These drugs are Na channel blockers and slow conduction. Class Ia drugs have intermediate onset and offset:
Quinidine
Procainamide
Disopyramide (See Merck Manual Here)

Antiarrhythmia Class Ib Drugs
DESCRIPTION: These drugs have short effects:
Lidocaine
Mexiletine
Tocainide
Phenytoin (See Merck Manual Here)

Antiarrhythmia Class Ic Drugs
DESCRIPTION: These drugs are among the most powerful antiarrhythmics:
Flecainide
Propafenone (See Merck Manual Here)

Class II Drugs
DESCRIPTION: These are beta blockers, (Listed below under a separate heading.) They are the least toxic and yet powerful. They are contraindicated (cannot be used) in bronchospastic airway disease. GI disturbances, insomnia and nightmares may occur.

  Class III Antiarrhythmia Drugs
DESCRIPTION: These drugs can be pro-arrhythmic.
Amiodarone
Racemic (D-L) sotalol
Ibutilide (newly approved Class III)
Bretylium (See Merck Manual Here)

Class IV Antiarrhythmia Drugs
Verapamil
Diltiazem (See Merck Manual Here)

ADP Inhibitors or Anti-Platelets:
Plavix - clopidogrel
Ticlid - ticlodipine

DESCRIPTION: Blood clotting is good when we cut orselves or get into an accident. However, a lot of cardiovascular problems arise from blood clotting inappropriately in blood vessels or the chambers of the heart. Doctors use blood thinning agents to prevent this. Aspirin is sometimes used. Ticlid is used for one month after a coronary stent has been placed--the main side effect of Ticlid is low white blood cell count. Plavix works similarly to Ticlid, but with less side effects. Plavix is also used in combination with aspirin for one month after placement of a coronary stent, or in patients with a severe form of angina and prevention of strokes.

Plavix Package Insert Information (side effects) Here.

Digoxin:
Lanoxin - digoxin- digitalis

DESCRIPTION:Cardiac glycosides have been used for centuries. Digoxin is still useful, especially in severe CHF. It helps your heart beat stronger and reduces CHF symptoms. Watch for confusion, nausea or visual disturbances. Also watch for swollen breasts (man or woman) and breast tenderness with long-term use. HERE !

Beta Blockers:
Coreg (carvedilol)
Toprol XL, Lopressor (metoprolol)
Tenormin (atenolol)
Betapace (sotalol)
Normodyne, Trandate (labeltolol)
Zebeta

DESCRIPTION:In heart failure, the nervous system is overstimulated. This raises levels of a hormone called norepinephrine. The increased level of circulating norepinephrine can cause heart remodeling. High levels of norepinephrine are directly toxic to heart cells and increase risk of death. Blocking beta receptors with drugs reduces these effects, so beta-blockers have been added to the standard of care for CHF.

Beta-blockers often reduce heart failure symptoms. They lower risk of all-cause mortality, heart-related mortality, sudden death, and death from progressive heart failure. Beta-blockers also reduce hospitalizations. This class of drugs may save more patient lives than ACE inhibitors. The most recent treatment guidelines list beta-blockers as standard therapy for CHF patients.

Trial results strongly support this idea. A recent meta-analysis showed that beta-blockers reduce all-cause mortality in CHF patients by 29%. Beta-blockers are not all the same but most are effective for treating CHF. It is very, very important to raise the dose gradually to prevent decompensation. Symptoms that may overwhelm patients if the dose is raised too fast include fatigue, low heart rate, low blood pressure, dizziness, drowsiness, diarrhea, nausea, and problems with sexual desire or performance.

For side effects, precautions and drug interactions please click HERE !

For more information on beta blockers @WebMD please click HERE!

For more information on Coreg from the manufacturer, please click HERE!

Diuretics
Demadex - torsemide
Endecrin - ethacrynic acid
Lasix - furosemide
Bumex - bumetanide
Triameterene - dyrenium
Indapamine - indapamide
hydrachlorothiazide


DESCRIPTION:Diuretics drain the fluid out of your system the old fashioned way: they make you pee. The less fluid in your system, the less blood your heart has to pump and the easier you breathe. There are 2 types of diuretics: loop and thiazide. Loop diuretics are more powerful. Loop diuretics cause potassium, magnesium, and calcium loss but since ACE inhibitors slow potassium loss, they may offset each other. A very small dose (2.5 mg) of Zaroxolyn taken 30 minutes before your Lasix can really give a boost to the draining effect. If Lasix isn't working well enough, ask your doctor about this. Magnesium and calcium supplements are recommended.
There are new meds coming out and we will update this as soon as we can.
Use Search Engine at bottom of page for further information.

Statins
Zocor - simvastatin
Mevacor - lovastatin
Pravachol - pravastatin
Lescol - fluvastatin
Lipitor - Atorvastatin
Baycol - Cerivastatin -- THIS DRUG HAS BEEN RECALLED BY THE FDA!!!

 

DESCRIPTION:For those CHFers who have CAD (coronary artery disease), cholesterol control is crucial. Because less activity causes a rise in LDL, most CHFers are put on drugs to maintain healthier cholesterol levels. Watch for constipation, stomach upset, or muscle cramps. (Ginger has had some experience with muscle cramps and pain! Link to our Message Board is at End.) Many cholesterol lowering drugs lower your levels of CoQ10. The price of different cholesterol lowering drugs may differ drastically.
Use Search Engine at bottom of page for further information.

Vasodilators
Apresoline
hydralazine
Isordil/Sorbitrate
isosorbide - dinitrate
Many brand names of
nitroglycerin
Imdur
isosorbide
mononitrate


DESCRIPTION:Vasodilators expand the blood vessels, lowering the resistance against which the heart must pump. This is called reducing afterload. These can be powerful drugs, so use with care. Watch for headaches and dizziness. Alpha blockers are vasodilators and expand blood vessels, and Coreg has this effect to some extent. Morphine dilates veins - called reducing preload - and decreases anxiety, so it may (and probably should) be used in end-stage CHF.Altho it is not used enough in my opinion to let people die with dignity and no suffering.
Use Search Engine at bottom of page for further information.

Coumadin:
Coumadin - Warfarin

DESCRIPTION:Although commonly used in CHFers to prevent blood clots (strokes), there is little evidence that this is necessary unless you have a-fib (atrial fibrillation). If you have a-fib, you need a blood thinner. Coumadin is questionable for patients with heart failure in normal rhythm, unless they have a history of clots or stroke. Watch for a tendency to bleed easily. Report excessive bruising to your doc. You will need to have your blood tested regularly if on Coumadin.
Link from University of Michigan re Coumadin (informative).
Use Search Engine at bottom of page for more info.

Aldactone:
Aldactone - spironolactone

DESCRIPTION:Long approved as a diuretic, the RALES trial showed a new use for this old drug. Taken at low doses - 25mg daily - it does not act as a diuretic but it does make us less likely to die. I'm all for that! It affects potassium, like most diuretics, so a blood test should be done when the drug is started, at the very least. Watch for swollen breasts, whether you're a man or a woman. Studies at the present time are looking to combine ACE Inhibitors and Aldactone--not complete as yet.
Use Search Engine at bottom of page for further information.

IV Drugs:
Primacor IV
milrinone
Inocor IV
amrinone lactate
dobutamine
dopamine
Natrecor- nesiritide

DESCRIPTION:Usually given intravenously, inotropes and certain other IV (intravenous) drugs make the heart pump more strongly. They are usually used only in severe CHF and are fairly short acting. Since they speed up wearing out of the heart, they are not used in moderate heart failure patients. They do really help quality of life in severe or end-stage heart failure, though. They may be used in CHF clinics, hospitals or at home, with therapy started by a visiting nurse and then by the patient or a caregiver. Natrecor is a new drug that has the same benefit as inotropes but without many of the side effects - a big step forward. Use Search Engine at bottom of page for further information.

 

LINKS FOR MORE COMPLETE TECHNICAL
DRUG INFORMATION
(Side effects, contraindications, drug interactions, dosage, etc.)

 RxList.Com
RxList provides 'package insert' information on most drugs; indicating dosage, side effects, warnings, contraindications, and drug interactions.

 DrugInfoNet.Com
DrugInfoNet also provides 'package insert' information on most drugs.

Chf Drugs
More general information on CHF medications.

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Please note: We are not medical doctors
nor are we in the healthcare field!
Whatever you read here, or at any website
should not be misconstrued as medical advice.
ONLY your doctor can prescribe what is best for you.


Url is www.heart-help.net
Ginger@heart-help.net
Lee@NJDaisy@optonline.net


Last Modified on January 4, 2003