by EBSCO Medical Review Board

Here are the basics about each of the medicines below. Only the most common reactions are listed. Ask your doctor if you need to take any special steps. Use each of these drugs as advised by your doctor or the booklet they came with. If you have any questions, call your doctor.

Treatment with medicine starts on the way to the hospital and continues after you get home. They are used to open blood vessels and prevent blood clots, and treat high blood pressure or cholesterol. The medicines used will change over time depending on your needs.

Prescription Medicine

Opioids

  • Morphine
  • Dilaudid
  • Fentanyl

Nitrates

  • Nitroglycerin

Thrombolytic Agents

  • Tissue plasminogen activator (tPA)
  • Streptokinase
  • Reteplase
  • Tenecteplase
  • Lanoteplase

Heart Rhythm

Angiotensin-converting enzyme (ACE Inhibitors)

  • Enalapril
  • Lisinopril
  • Quinapril

Angiotensin II Receptor Blockers (ARBs)

  • Candesartan
  • Irbesartan
  • Losartan
  • Valsartan

Antiplatelet Drugs

  • Ticlopidine
  • Clopidogrel
  • Prasugrel

Anticoagulants

  • Heparin
  • Warfarin
  • Bivalirudin

Statins

  • Atorvastatin
  • Pravastatin
  • Lovastatin
  • Simvastatin
  • Fluvastatin
  • Rosuvastatin

Over-the-Counter Medicine

Prescription Medicine

Opioids

Common names:

  • Morphine
  • Dilaudid
  • Fentanyl

Opioids are are used to ease pain and anxiety.

Possible problems are:

  • Constipation
  • Nausea and vomiting
  • Itching
  • Lightheadedness
  • Sedation
Nitrates

Nitroglycerin

Nitrates ease chest pain by widening the arteries. This lets more blood to flow to the heart muscle. There are many ways to take nitrates.

Possible problems are:

  • Low blood pressure
  • Headache
Thrombolytic Agents

Common names:

  • Tissue plasminogen activator (tPA)
  • Streptokinase
  • Reteplase
  • Tenecteplase
  • Lanoteplase

These will break up blood clots in the arteries of the heart to improve blood flow.

Possible problems are:

Heart Rhythm

These drugs help regulate heart rhythm so the blood can get to the heart muscle.

Sodium Channel Blockers

Common names:

  • Procainamide
  • Quinidine
  • Disopyramide
  • Lidocaine
  • Flecainide
  • Tocainide
  • Amiodarone
  • Mexiletine
  • Propafenone
  • Moricizine
Beta-blockers

Common names:

  • Acebutolol
  • Atenolol
  • Betaxolol
  • Metoprolol
  • Nadolol
  • Pindolol
  • Propranolol
  • Timolol
  • Carvedilol
  • Nebivolol

Beta-blockers ease the heart's workload and lowers blood pressure. They can also be used to regulate heart rhythm.

Possible problems are:

  • Low blood pressure
  • Slow heart rate
  • Fatigue
  • Problems having sex
Action Potential-Prolonging Agents

Common names:

  • Bretylium
  • Sotalol
  • Dofetilide
Calcium Channel Blockers

Common names:

  • Amlodipine
  • Felodipine
  • Isradipine
  • Nicardipine
  • Nifedipine
  • Verapamil
  • Diltiazem

These lower blood pressure and slow the heart rate. They can also be used to regulate heart rhythm.

Possible problems are:

  • Low blood pressure
  • Lightheadedness
  • Constipation
ACE Inhibitors

Common names:

  • Enalapril
  • Lisinopril
  • Quinapril

ACE inhibitors lower blood pressure. They can also extend life in those with severe heart damage.

Possible problems are:

  • Lasting dry, unproductive cough
  • Low blood pressure
  • Headache
  • Lightheadedness
  • Swelling
  • Skin rashes
ARBs

Common names:

  • Candesartan
  • Irbesartan
  • Losartan
  • Valsartan

Possible problems are:

  • Headache
  • Lightheadedness
  • Nasal congestion
  • Back and leg pain
  • Diarrhea
Antiplatelet Drugs

Common names:

  • Ticlopidine
  • Clopidogrel
  • Prasugrel

These drugs help keep the blood from clotting. They may be given when aspirin cannot be used. They may also be given with aspirin to people who have had an angioplasty.

Possible problems are:

  • Bleeding
  • Diarrhea
  • Stomach upset
Anticoagulants

Common names:

  • Heparin
  • Warfarin
  • Bivalirudin

Anticoagulants help to keep the blood from clotting. It is often given to people during heart procedures or after other clot-busting drug treatment.

Possible problems are:

  • Internal bleeding
  • Stroke
Statins

Common names:

  • Atorvastatin
  • Pravastatin
  • Lovastatin
  • Simvastatin
  • Fluvastatin
  • Rosuvastatin

Statins lower cholesterol levels in the blood. Atorvastatin may reduce the risk of repeat stroke or heart attack. These drugs may be used with other methods to treat high cholesterol such as changes in how you eat.

Possible problems are:

  • Headache
  • Muscle pain
  • Liver damage—rare

Over-the-Counter Medications

Aspirin

Aspirin helps prevent clotting and reclosing of the artery. Aspirin may become part of long-term treatment.

Possible problems are:

  • Stomach upset
  • Gastrointestinal bleeding and stroke

Special Considerations

If you are taking medicine:

  • Take medicine as directed. Do not change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medicine.
  • Do not share your prescription medicine.
  • Medicine can be dangerous when mixed. Talk to your doctor or pharmacist if you are taking more than one medicine. This includes over-the-counter products and supplements.
  • Plan for refills as needed.

References

Acute coronary syndromes. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T116779/Acute-coronary-syndromes . Updated March 15, 2019. Accessed March 27, 2019.

Acute myocardial infarction (MI). Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/cardiovascular-disorders/coronary-artery-disease/acute-myocardial-infarction-mi. Updated December 2018. Accessed March 27, 2019.

Cardiac medications. American Heart Association website. Available at: https://www.heart.org/en/health-topics/heart-attack/treatment-of-a-heart-attack/cardiac-medications. Accessed March 27, 2019.

Hypertension medication selection and management. EBSCO DynaMed Plus website. Available at:  https://www.dynamed.com/topics/dmp~AN~T114476/Hypertension-medication-selection-and-management . Updated November 16, 2018. Accessed March 27, 2019.

ST-elevation myocardial infarction (STEMI). EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T115392/ST-elevation-myocardial-infarction-STEMI . Updated July 10, 2018. Accessed March 27, 2019.

Statins. EBSCO DynaMed Plus website. Available at:  https://www.dynamed.com/topics/dmp~AN~T116844/Statins . Updated April 5, 2018. Accessed March 27, 2019.

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