Health Information

Medications for Heart Attack

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The more you know about your health, the better prepared you are to make informed healthcare decisions. Our health library gives you the information you need to take charge of your health.

The information provided here is meant to give you a general idea about each of the medication categories listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Emergency medical personnel may begin treating you with medications before you reach the hospital. At the hospital, additional drugs will be given and you will likely receive medications to take at home after you are discharged.

Prescription Medications

Opioids

  • Morphine
  • Dilaudid
  • Fentanyl

Nitrates

  • Nitroglycerin

Thrombolytic Agents

  • Tissue plasminogen activator (tPA)
  • Streptokinase
  • Reteplase
  • Tenecteplase
  • Lanoteplase

Antiarrhythmic

  • Sodium channel blockers
  • Beta blockers
  • Action potential-prolonging agents
  • Calcium channel blockers

ACE Inhibitors

  • Enalapril
  • Lisinopril
  • Quinapril

Angiotensin II Receptor Blockers

  • Candesartan
  • Irbesartan
  • Losartan
  • Valsartan

Antiplatelet Drugs

  • Ticlopidine
  • Clopidogrel
  • Prasugrel

Anticoagulants

  • Heparin
  • Warfarin
  • Bivalirudin

Statins

  • Atorvastatin
  • Pravastatin
  • Lovastatin
  • Simvastatin
  • Fluvastatin
  • Resuvastatin

Over-the-Counter Medications

  • Aspirin

Prescription Medications

Opioids

Common names include:

  • Morphine
  • Dilaudid
  • Fentanyl

Morphine is given to relieve chest pain.

Possible side effects include:

  • Constipation
  • Nausea and vomiting
  • Itching
  • Lightheadedness
  • 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

Common names include:

  • Tissue plasminogen activator (tPA)
  • Streptokinase
  • Reteplase
  • Tenecteplase
  • Lanoteplase

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

Possible side effects include:

  • Stroke
  • Hemorrhage
Antiarrhythmic

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 via an IV. 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.

Sodium Channel Blockers

Sodium channel blockers are a type of antiarrhythmic drugs. Examples of these medications include:

  • Procainamide
  • Quinidine
  • Disopyramide
  • Lidocaine
  • Flecainide
  • Tocainide
  • Amiodarone
  • Mexiletine
  • Propafenon
  • Moricizine
Beta Blockers

Common names include:

  • Acebutolol
  • Atenolol
  • Betaxolol
  • Metoprolol
  • Nadolol
  • Pindolol
  • Propranolol
  • Timolol
  • Carvedilol
  • Nebivolol

Beta blockers are another type of antiarrhythmic drugs. 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
Action Potential-Prolonging Agents

Action potential-prolonging agents are another type of antiarrhythmic drugs. Examples of these medications include:

  • Bretylium
  • Sotalol
  • Dofetilide
Calcium Channel Blockers

Common names include:

  • Amlodipine
  • Felodipine
  • Isradipine
  • Nicardipine
  • Nifedipine
  • Verapamil
  • Diltiazem

Another type of antiarrhythmic drugs, 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.

Possible side effects include:

  • Low blood pressure
  • Lightheadedness
  • Constipation
ACE Inhibitors

Common names include:

  • Enalapril
  • Lisinopril
  • Quinapril

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

Possible side effects include:

  • Persistent dry, unproductive cough
  • Low blood pressure
  • Headache
  • Lightheadedness
  • Swelling
  • Skin rashes
Angiotensin II Receptor Blockers

Common names include:

  • Candesartan
  • Irbesartan
  • Losartan
  • Valsartan

Possible side effects include:

  • Headache
  • Lightheadedness
  • Nasal congestion
  • Back and leg pain
  • Diarrhea
Antiplatelet Drugs

Common names include:

  • Ticlopidine
  • Clopidogrel
  • Prasugrel

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

Common names include:

  • Heparin
  • Warfarin
  • Bivalirudin

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

Possible side effects include:

Statins

Common names include:

  • Atorvastatin
  • Pravastatin
  • Lovastatin
  • Simvastatin
  • Fluvastatin
  • Resuvastatin

Statins are drugs that help to lower blood cholesterol levels. They may be prescribed along with a low cholesterol diet if you have high cholesterol. Atorvastatin may reduce the risk of repeat stroke or heart attack.

Possible side effects include:

  • Headache
  • Muscle pain
  • Liver damage (rare)

Over-the-Counter Medications

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
  • Gastrointestinal bleeding and stroke

Special Considerations

If you are taking medications, follow these general guidelines:

  • Take your medication as directed. Do not change the amount or the schedule.
  • Do not stop taking them without talking to your doctor.
  • Do not share them.
  • Know what the results and side effects. Report them to your doctor.
  • Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medication and herb or dietary supplements.
  • Plan ahead for refills so you don’t run out.

Revision Information

  • Acute coronary syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 31, 2014. Accessed April 10, 2014.

  • Cardiac medications. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartAttack/PreventionTreatmentofHeartAttack/Cardiac-Medications%5FUCM%5F303937%5FArticle.jsp. Updated February 26, 2014. Accessed April 10, 2014.

  • How is a heart attack treated? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/heartattack/treatment.html. Updated December 17, 2013. Accessed April 10, 2014.

  • ST-elevation myocardial infarction (STEMI). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 7, 2012. Accessed August 8, 2012.

  • 9/19/2006 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Amarenco P, Bogousslavsky J, Callahan A, Goldstein LB, Hennerici M, Rudolph AE, et al. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med. 2006;355(6):549-559.

  • 3/5/2012 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: FDA announces safety changes in labeling for some cholesterol-lowering drugs. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm293623.htm. Updated March 2, 2012. Accessed April 10, 2014.