Medical Therapeutic - CardioVascular Assessment         CORONARY VASODILATORS Used for angina - Nitrate or Nitro IV. Nitrobid,Nitrostat - S.L. Nitroglycerin Topical... Nitrol..Nifcrodur,Nitrobid - Oral  Nitrobid S/E - flushed face - headache vertigo and faintness (syncope) - postural hypotension ANTICOAGULANTS Heparin (antagonist  porotamine  sulfate) - (IV or S/C  Tx  Thrombi and Emboli Dose  /PTT - Do not aspirate - Do not rub area before or after injection PROTHROMBIN KEEP AT 18 -30 SECONDS    normal 12-14 sec usually 2 -21/2 patient's first count    avoid cabbage, cauliflower. spinach, leafy veggies ( Vit K)    S/E .. Hematuria, nose bleeds, bruises, ecchymosis, bleeding     gums. ANTIARRHYTHMICS    Ouinidine - Atrial Fibrillation    S/E cinchonism (quinidine poison)    tinnitus, vertigo, visual disturbances, ventricular    fibrillation,thrombocytopenia DEATH PRONESTYL PVC's (Premature ventricular contraction)    S/E GI symptoms -  Agranulocytosis NOR PACE (normal pace)    premature ventricular contraction (PVC'S)    S/E CNS low,GI symptoms,low BP,edema,weight up,    SOB, GU, low (urinary retention) -  LIDOCAINE Ventricular tachycardia    S/E paresthesias -  slurred speech, numbness drunk, D.T.'S (delirium tremens)    blurred vision -   seizures -  coma EPINEPHRINE (Adrenalin) speed up the heart    alpha effect ...... constriction -  beta effect ...... relax -  INDERAL .( beta blockers) Angina    all low rate, conduction, contractility -  S/E brochoconstriction, low BP    also used for: -  Hhypertension    Migraine (cerebral blood vessel constriction) - Take BP and pulse before   Not given if history of CHF (congestive heart -  failure, or asthma    use with caution to diabetics. ATROPINE SULFATE  Anticholinergic - bradychardia CHF - S/E inability to void, especially with prostate enlargement Dry mouth and skin flushing, dilatation pupils/blurred vision, low bronchial secretions/low bowel motility, fluid - retention. HEART VALVES STENOSIS PREDISPOSED -  Hx CHF -  Rheumatic heart disease Strep throat -  Mitral valve -  Arteriosclerosis - S&S Low cardiac output.. tired and lethargic, dizziness   and  syncope/angina. Rx : Surgical repair (valvotomy) or replacement Complications : atrial fibrillation, thrombi, heart failure, subacute bacterial endocarditis. INFLAMMATORY DISEASES OF HEART  Bacterial endocarditis - Pericarditis  Myicarditis -  Rheumatic fever - systemic disease may include all above  Rheumatic Heart disease - follows Rheumatic fever and   includes valve damage  S & S - Fever,chills,diaphoresis,lassitude,anorexia,tachycardia,chest  pain,dyspnea.