Question

The physician order Beta-blockers, Statins, ACE inhibitors, Antiplatelet therapy as standard secondary prevention treatment following acute myocardial infarction in this patient?For each of the classifications give an example of drug name, indication, action, adverse effect, and how can you minimize the adverse effect?

Answer 1

Beta blockers

Drug name :Atenolol

Indication:

• Hypertension
• Anginal pain
• In myocardial infarction

Action:

This drug works by blocking the beta 1 adrenergic receptor.As a resukt the rekease of epinephrine is blocked. Thereby decreasing the heart rate and blood pressure

Adverse effects:

• Nausea
• Dizziness, confusion,light headedeness
• Hypotension
• Rash

Nursing interventions:

• Provide small and frequent feeds wth preferred foods
• Encourage to stand up slowly when changing position from supine to prevent dizziness
• Avoid smoking
• Warm dressing
• No OTC drugs

Statins

Drug name: Atorvastin( Lipitor)

Indication:

• to treat hyperlipidemia

Action:

It reduces or prevebts the action of HMG COA reductace receptor in the body .If this is stopped the mevolanate needed for cholesterol synthesis is stopped as a result the production of cholesterol is blocked. Hence control the high cholesterol levels.

Adverse effects:

• GIT: nausea, diarrhoea
• Musculoskeletal:pain , myalgias
• Urinary tract:UTI
• CNS: insomnia

How to minimise adverse effects

• Provide calm and quite environment to sleep
• Simple mild exercise to boost musculoskeletal function
• Infection control practice
• Perennial hygiene
• Low fat dietary habits

ACE inhibitors

Drug name:Enalpril

Indication

• Hypertension
• Cardiac failure

Action

It stops the angiotensin converting enzyme to angiotensin 2.As a result the blood vessels are dilated and the blood pressure is reduced

Adverse effect

• GIT:nausea, diarrhoea
• CNS: dizziness, headache
• Respiratory:Dry cough
• Integumentary:rash

How to manage adverse effects

• Take like warm water
• Fibre rich diet
• Relaxation techniques
• Avoid triggers for headache
• Skin care

Antiplatelet therapy

Drug name: clopidogrel

Indication

• Heart attack
• Stroke
• Pain in chest

Action

It stops the binding of the ADP with the platelet receptor.This will prevent platelet aggregation . Thereby preventing blood clots .

Adverse effects

• GIT: nausea, diarrhoea, indigestion ,pain, constipation
• CNS: dizziness
• CVS:risk of bleeding
• Respiratory:epistaxis

How to manage adverse effects

• Adequate exercise
• No unnecessary invasoce procedure
• Proper diet
• No OTC drug
• No alcohol, smoking