There are hundreds of different of medications that are prescribed for the heart patient. The number of medications and odd names are frequently bewildering for the patient and his/her family. The information that follows will help clarify some of this by organizing the medicines into classes. Each class contains information about the actions, reactions, and names of the common medications.

• Beta Blockers
• Calcium Channel Blockers
• Antiarrhythmic Medications
• Blood Thinners
• Diuretics

Uses
Available since the 1960's, Beta Blockers are used to treat Angina Pectoris (heart pains caused by lack of blood supply to the heart muscle), Hypertension (high blood pressure, usually BP greater than 140/85-90), various Heart Rhythm Disturbances (rapid heart problems such as atrial fibrillation, atrial tachycardias, and irregularities of the heart rhythm such as PVCs), Migraine Headaches, and certain Neurohormonal Imbalances.

Common Medications
The commonly prescribed drugs in this class are Inderal, Lopressor, Toprol, Atenolol, Tenormin, Corgard, Labetelol, Coreg, and others.

Side Effects
The most frequent side effects (which are quite uncommon) are unexpected wheezing and shortness of breath, excessively slow heart rates, and excessive lowering of the blood pressure. In rare cases the side effects may also include worsening of fluid retention or the development of congestive heart failure. All of these side effects are usually of short duration and are reversible once the medication is discontinued.

Uses
Available since the 1970's, Calcium Channel Blockers are used to treat a variety of cardiac conditions including: Hypertension, Angina Pectoris, Migraine Headache, and certain types of Rapid Heart Beat conditions. They are also used to treat Coronary Artery Spasms (caused by the contraction of the muscle within the artery wall resulting in temporary closure of the artery), muscle spasms in patients with Esophageal Spasm, and certain types of Strokes.

Common Medications
The common medications include Verapamil, Calan, Isoptin, Tiazac, Cardizem, Diltiazem, Norvasc, and Procardia.

Side Effects
Side effects are uncommon and include swelling of the feet and ankles, excessive lowering of the blood pressure, and (rarely) an excessively slow heart beat. These side effects usually go away within a few hours to a day or so and are not said to be permanent once the medication has "washed out" of the system.

Uses
The first medication found to be useful in treating disorders of the heartbeat was Digitalis leaf. It was first administered in the late 1800's to treat atrial fibrillation and congestive heart failure and is still used in a modified form today. There are currently multiple classes of antiarrythmic medications because the electrical/conduction system of the heart is terribly complex, and disturbances of the heart rhythm require complex manipulation.

Common Medications
The common medications in this class include:

• Various Digitalis preparations (Lanoxin, Digoxin, Lanoxicaps)
• Two types of Quinidine compounds (Quinaglute, Quinidine Sulfate )
• Two types of Pronestyl compounds (Procan SR, Pronestyl CR)
• Norpace CR and its generic twin (Disopyramide)
• Cardarone (also called amiodarone)
• Sotalol (Betapace)
• Certain Beta Blockers, certain Calcium Channel Blockers (Verapamil, Cardizem)
• Sometimes Rythmol and its generic twin (Propafenone)
• Rarely Tambocor

Side Effects
The antiarrhythmic medications do have some potentially serious side effects. Side effects include serious rapid heart rate conditions such as Ventricular Tachycardia and Ventricular Fibrillation (including sudden death), worsening of preexisting heart failure, weakening of the heart muscle, and development of a very slow heartbeat causing the need for a temporary pacemaker (until the medication is cleared from the body). Failure of the lungs, failure of the liver, and unusual skin pigmentation have been reported as side effects of the recent and very useful Cardarone.

Uses
This group of drugs is extremely useful in the treatment of Blood Clot Conditions.

Medications taken by mouth
The most common outpatient medication, Coumadin, is frequently used in the treatment of Heart Valve Conditions (for artificial valve prostheses, and leakage of a native heart valves), and the long term treatment of Thrombophlebitis (usually in the leg veins). Coumadin is also useful in treating and preventing Pulmonary Emboli, and the type of Arterial Blood Clots that cause Strokes and other arterial embolic events (blood clot traveling from the heart to a kidney or a leg causing the loss of that organ or extremity if the clot is not removed).

Aspirin is a very potent anticoagulant which has been found to lower the risk of heart attacks as well as improving the prognosis with a heart attack. Data has also shown a reduced stroke risk in patients who take prophylactic aspirin.

In the past 5 years or so another class of "thinners"(Plavix) has been found to be useful in angioplasty/coronary stent implantation to prevent closure of the stented artery. Plavix is also used for prevention of certain types of strokes.

Intravenous Medications
Heparin (and its recent cousin Lovenox) are very potent intravenous blood thinners. This type of thinner is generally used in an inpatient setting to quickly stop the development of an ongoing blood clot as seen in serious Unstable Angina, certain strokes, and in severe acute Thrombophlebitis and acute pulmonary emboli.

Available for the past decade, TPA/RPA type drugs are known as "Clot Busters". These medications are used in an inpatient setting where they rapidly dissolve a fresh clot in whatever location it resides-perhaps inside a heart artery causing a heart attack, or perhaps inside a brain artery causing a stroke. The clot is cleared rapidly once the Clot Buster is administered.

Intravenous antiplatelet agents, a relatively new class of drugs, are given in the catheterization laboratory during angioplasty and stent placement for serious Unstable Angina. These medications include Integrilin, Reopro, and several others.

Side Effects
The side effect of this category of drugs is the potential for bleeding. The powerful blood thinners such as TPA/ Heparin /Coumadin are more likely than Aspirin or Plavix to cause significant bleeding although serious bleeding from these drugs is infrequent.

Uses
This category of important medications have been around in one form or another since the 1930's when the first diuretic Mercuhydrin was introduced. Since then, several different types of diuretics have become available. All diuretics act by removing salt and water from the body through the action of the kidney. Diuretics are the mainstay in the treatment of Congestive Heart Failure, often used in treating Hypertension (High Blood Pressure), as well as in certain types of Renal Diseases, certain Liver Diseases, in certain types of Lung Conditions, as well as preventing and/or treating certain benign Edematous Conditions unrelated to the heart, lungs, or kidneys.

Common Medications
Diuretics are not identical in their potency and the following list will be in increasing order of strength- Maxzide/Dyazide/Hydrochlorothiazide (least powerful), Lasix/Demadex/Zaroxylin (most powerful).

For the greatest benefit from certain of the Diuretics, the intravenous route is necessary. Additionally, Potassium replacement is frequently prescribed along with the Diuretic because Diuretics cause major loss of potassium through the kidney.