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Antiarrhythmics are used to treat arrhythmia (irregular, increased, or slow heartbeats). Examples of these drugs include amiodarone and flecainide. Amiodarone prevents irregular heartbeat by blocking the potassium, calcium, sodium channels, and alpha-adrenergic receptors. Flecainide is used in patients with paroxysmal supraventricular tachycardia. Patients on these drugs need awareness of the side effects of the drugs, which include nausea, shortness of breath, chest pains, and impact on different organs like the kidney, liver, lungs, and thyroids (Kaski & Kjeldsen, 2019). The patient is to get regular checks of organ function and avoid intake of grapefruit-containing products.
Diuretics work by reducing the number of fluids in the blood vessels. The drugs are used in treating hypertension and congestive heart failure. Examples of these drugs include hydrochlorothiazide and chlorthalidone. Patients need to be informed of the side effects of the drug-like headaches, dizziness, thirst, diarrhea, gout, skin rash, and muscle cramps, all of which are drug-specific. The patient needs to give details of other medications being used to avoid drug-to-drug interactions.
Nitrates work as vasodilators and prevent angina. Nitroglycerin and isosorbide mononitrate are among the commonly used drugs. Nitroglycerin is used to treat angina pectoris, hypertension, acute coronary syndrome, and heart failure. Isosorbide mononitrate is used in only chronic angina pectoris. Patients on nitrates should avoid using sildenafil, tadalafil, or vardenafil since they lower the activity of nitrates (Kaski & Kjeldsen, 2019). The drugs are also category C in pregnancy with side effects like headaches, dizziness, light-headedness, flushing, nausea, and feeling of burning or tingling on the tongue. Patients should ensure that they state other drugs they are taking to avoid drug interactions.
Anticoagulants work by preventing clot formation in the blood. The drugs are used to treat and prevent atrial fibrillation and stroke (Kaski & Kjeldsen, 2019). Dabigatran and rivaroxaban are common non-vitamin K oral anticoagulants used. Patients are advised to watch for any signs of internal bleeding as well as indicate other medications that they are on to avoid drug-to-drug interactions.
A nursing assessment should include reviewing the patient’s history and risk factors when considering using these drugs. Tests required include ECG, angiography, cardiac catheterization, and lipid panel tests. Lab tests like lipoprotein A and High-sensitivity C-reactive protein tests are also necessary. Nursing interventions include administering the medications and monitoring how they manage their conditions and side effects. Lack of improvement prompts for combination therapy or change of medication.
Reference
Kaski, J. C., & Kjeldsen, K. P. (Eds.). (2019). The ESC handbook on cardiovascular pharmacotherapy. Oxford University Press.
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