Heart failure is such a broad term when it comes to how we treat it. Sometimes our patients need only one drug to treat their symptoms, other times they require multiple medications from different drug classes. As we all know cardiac medications come in many different classes and all have a specific symptom they target, which makes them amazing! Sometimes we come across patients who have comorbidities, which require us to rethink our treatment plans in case we have any medication contraindications. According to Metra and Teerlink (2017), “The prevalence of comorbidities in patients with heart failure and their effects on prognosis are increasing, particularly in patients with heart failure with preserved ejection fraction.”
Lisinopril, also known as Prinivil, is classified as an angiotensin-converting enzyme inhibitor (ACE). I have given this medication many times in my nursing career. These types of medications slow down the activity of enzymes, which in turn slows down vasoconstriction, the result of that being your blood vessels enlarge and your blood pressure reduces. One of the most common side effects of ACE inhibitors is a persistent dry cough. I will NEVER forget this because it was one of my NCLEX questions and I knew I had it! This class of medication may increase blood levels of potassium, so the use of potassium supplements is not recommended. ACE inhibitors are labelled a category C for pregnancy. It was found that mothers who took ACE inhibitors during the 1st trimester of pregnancy had an increased risk of major congenital defects.
Carvedilol, also known as Coreg, is classified as a beta blocker. These are my personal favorite because they end in “lol” and that just makes me smile! It was also a fun way to remember them while in nursing school. Beta Blockers work by blocking epinephrine, which allows your heart to beat more slowly, which leads to reducing blood pressure. Possible side effects could be fatigue and weight gain, although most people report no issues. This class of medication is not typically used in patients with asthma because it has been known to trigger asthma attacks. In addition, it can mask the symptoms of low blood sugar levels in patients with diabetes.
Metra, M., & Teerlink, J. (2017). Heart failure. The Lancet, 390(10106), 1981–1995. https://doi.org/10.1016/S0140-6736(17)31071-1
Anonymous. (2006). ACE inhibitors and pregnancy. WHO Drug Information, 20(2), 71. Retrieved from http://search.proquest.com/docview/215678887/
Heart Disease and Beta-Blocker Therapy. (n.d.). Retrieved December 6, 2018, from https://www.webmd.com/heart-disease/guide/beta-blocker-therapy#