Medications for Heart Attack

Opioid Analgesics (Pain Medication)

• Morphine]]>
• ]]>Dilaudid]]>
• ]]>Fentanyl]]>

Morphine is given to relieve chest pain. Possible side effects include:

• Constipation
• Nausea and vomiting
• Itching
• Dizziness
• Sedation

Nitrates

• Nitroglycerin]]>

Nitrates help relieve chest pain by dilating the arteries, which allows more blood to flow to the heart muscle. Early in treatment nitroglycerin may be administered as a tablet placed under the tongue or infused through a vein. Long-term, nitroglycerin may be given on a regular basis through a patch, paste, or orally to control chronic chest pain.

Possible side effects include:

• Low blood pressure
• Headache

Thrombolytic Agents

• Tissue plasminogen activator (tPA)
• Streptokinase

A drug to dissolve or break up blood clots in the coronary artery may be given intravenously. Early treatment, within three hours of the heart attack, offers the best chance for good results. The patient’s medical history, age, and condition may prevent treatment with clot-busting drugs.

Possible side effects include:

• Stroke]]>
• Hemorrhage

Antiarrhythmic

Sodium Channel Blockers (Class I)

• Procainamide]]> (Procan-SR, Pronestyl)
• ]]>Quinidine]]> (Cardioquin, Quinidex Extentabs)
• ]]>Disopyramide]]> (Norpace)
• ]]>Lidocaine]]>
• ]]>Flecainide]]> (Tambocor)
• Tocainide (Tonocard)
• ]]>Amiodarone]]> (Cordarone)
• ]]>Mexiletine]]> (Mexil)
• ]]>Propafenone]]> (Rythmol)
• ]]>Moricizine]]> (Ethmozine)

Beta Adrenergic Blockers (Class II)—see below

Action Potential-Prolonging Agents (Class III)

• Bretylium
• ]]>Sotalol]]> (Betapace)
• ]]>Dofetilide]]> (Tikosyn)

Calcium Channel Blockers—see below

During a heart attack, damage to the heart muscle can increase the risk of abnormal heart rhythms. Unstable heart rhythms can prevent the heart from effectively pumping blood, and if serious, lead to sudden death. Antiarrhythmic drugs help the heart beat more normally, usually by suppressing abnormal beats or by regularizing the heart rate. There are a wide variety of drugs available to treat the various causes of abnormal rhythms. In emergencies, some of these drugs are given intravenously. Oral forms of medication are used to treat more chronic arrhythmias. The main issue with these drugs is that unless the underlying rhythm problem can be corrected, they must be taken indefinitely. Also, one of the more unpredictable side effects of some of these medications is the risk of making the arrhythmia worse. Talk to your doctor about the specific side effects or warning signs to watch for based on the drug you are taking.

Beta-Blockers

• Acebutolol]]> (Sectral)
• ]]>Atenolol]]> (Tenormin)
• ]]>Betaxolol]]> (Kerlone)
• ]]>Metoprolol]]> (Lopressor, Toprol)
• ]]>Nadolol]]> (Corgard)
• ]]>Pindolol]]> (Visken)
• ]]>Propranolol]]> (Inderal)
• ]]>Timolol]]> (Blocadren)
• ]]>Carvedilol]]> (Coreg)
• ]]>Nebivolol]]> (Bystolic)

Beta-blockers decrease demands on the heart and lower blood pressure. They may limit the amount of heart damage and help to prevent future heart attacks. They can also be used for their antiarrhythmic effects.

Possible side effects include:

• Low blood pressure
• Slow heart rate
• Fatigue
• Sexual dysfunction

ACE Inhibitors

• Enalapril]]> (Vasotec)
• ]]>Lisinopril]]> (Zestril)
• ]]>Quinapril]]> (Accupril)

ACE inhibitors lower blood pressure and help lower mortality in people who sustain significant damage to their heart muscle.

Possible side effects include:

• Low blood pressure
• Headache
• Dizziness
• Cough
• Swelling
• Skin rashes

Angiotensin II receptor Blockers

• Candesartan]]> (Atacand)
• ]]>Irbesartan]]> (Avapro)
• ]]>Losartan]]> (Cozaar)
• ]]>Valsartan]]> (Diovan

Possible side effects include:

• Headache
• Dizziness
• Lightheadedness
• Nasal congestion
• Back and leg pain
• Diarrhea

Antiplatelet Drugs

• Ticlopidine]]> (Ticlid)
• ]]>Clopidogrel]]> (Plavix)

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

Possible side effects include:

• Bleeding
• Diarrhea
• Stomach upset

Anticoagulants

• Heparin]]>
• ]]>Warfarin]]> (Coumadin)

Anticoagulants help to prevent the blood from clotting. It is often given to patients during heart procedures or after a clot-busting drug treatment.

Possible side effects include:

• Internal bleeding
• Stroke

Calcium Channel Blockers

• Amlodipine]]> (Norvasc, Lotrel)
• ]]>Felodipine]]> (Plendil)
• ]]>Isradipine]]> (Dynacirc)
• ]]>Nicardipine]]> (Cardene)
• ]]>Nifedipine]]> (Adalat, Procardia)
• ]]>Verapamil]]> (Calan, Isoptin)
• ]]>Diltiazem]]> (Cardizem, Tiazac)

Calcium channel blockers lower blood pressure and slow the heart rate. These may be given to patients who cannot take beta-blockers. They can also be used for their antiarrhythmic effects. Recent research indicates they are not helpful in the early treatment of heart attack, nor do they prevent future heart attacks.

Possible side effects include:

• Low blood pressure
• Dizziness
• ]]>Constipation]]>

Statins

• Atorvastatin]]> (Lipitor)
• ]]>Pravastatin]]> (Pravachol)
• ]]>Lovastatin]]> (Mevacor)
• ]]>Simvastatin]]> (Zocor)
• ]]>Fluvastatin]]> (Lescol)

Statins are drugs that help to lower blood cholesterol levels. They may be prescribed along with a low cholesterol diet in patients with elevated blood cholesterol levels. In a recent clinical trial of daily atorvastatin after recent stroke or "mini-stroke" (and no known coronary heart disease), atorvastatin reduced the risk of repeat stroke or heart attack. ]]>*]]>

Possible side effects include:

• Liver damage
• Muscle pain

Aspirin

Aspirin]]> may be given by emergency medical personnel and continued after admission to the hospital. Aspirin helps prevent clotting and reclosing of the artery. Aspirin should generally be taken with food to decrease stomach upset.

Possible side effects include:

• Stomach upset
• Bleeding and stroke
• Bronchospasm

Additional drugs may be given depending on your condition and response to treatment.