The information provided here is meant to give you a general idea about each of the medicine 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 medicines 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 medicines before you reach the hospital. At the hospital, additional drugs will be given and you will likely receive medicines to take at home after you are discharged.

Prescription Medications

Opioid Analgesics

  • Morphine
  • Dilaudid
  • Fentanyl

Nitrates

  • Nitroglycerin

Thrombolytic Agents

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

Antiarrhythmic

ACE Inhibitors

  • Enalapril (Vasotec)
  • Lisinopril (Zestril)
  • Quinapril (Accupril)

Angiotensin II Receptor Blockers

  • Candesartan (Atacand)
  • Irbesartan (Avapro)
  • Losartan (Cozaar)
  • Valsartan (Diovan)

Antiplatelet Drugs

  • Ticlopidine (Ticlid)
  • Clopidogrel (Plavix)
  • Prasugrel (Effient)

Anticoagulants

  • Heparin
  • Warfarin (Coumadin)
  • Bivalirudin (Angiomax)

Statins

  • Atorvastatin (Lipitor)
  • Pravastatin (Pravachol)
  • Lovastatin (Mevacor)
  • Simvastatin (Zocor)
  • Fluvastatin (Lescol)
  • Resuvastatin (Crestor)

Over-the-Counter Medications

Prescription Medications

Opioid Analgesics

Common names include:

  • Morphine
  • Dilaudid
  • Fentanyl

Morphine is given to relieve chest pain. Possible side effects include:

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 a needle placed in the arm (intravenously or 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:

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 medicine 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 medicines 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 medicines include:

  • Procainamide (Procan-SR, Pronestyl)
  • Quinidine (Cardioquin, Quinidex Extentabs)
  • Disopyramide (Norpace)
  • Lidocaine
  • Flecainide (Tambocor)
  • Tocainide (Tonocard)
  • Amiodarone (Cordarone)
  • Mexiletine (Mexil)
  • Propafenone (Rythmol)
  • Moricizine (Ethmozine)

Beta-Blockers

Common names include:

  • Acebutolol (Sectral)
  • Atenolol (Tenormin)
  • Betaxolol (Kerlone)
  • Metoprolol (Lopressor, Toprol)
  • Nadolol (Corgard)
  • Pindolol (Visken)
  • Propranolol (Inderal)
  • Timolol (Blocadren)
  • Carvedilol (Coreg)
  • Nebivolol (Bystolic)

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 medicines include:

  • Bretylium
  • Sotalol (Betapace)
  • Dofetilide (Tikosyn)

Calcium Channel Blockers

Common names include:

  • Amlodipine (Norvasc, Lotrel)
  • Felodipine (Plendil)
  • Isradipine (Dynacirc)
  • Nicardipine (Cardene)
  • Nifedipine (Adalat, Procardia)
  • Verapamil (Calan, Isoptin)
  • Diltiazem (Cardizem, Tiazac)

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:

ACE Inhibitors

Common names include:

  • Enalapril (Vasotec)
  • Lisinopril (Zestril)
  • Quinapril (Accupril)

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

Possible side effects include:

  • Low blood pressure
  • Headache
  • Dizziness
  • Cough
  • Swelling
  • Skin rashes

Angiotensin II Receptor Blockers

Common names include:

  • Candesartan (Atacand)
  • Irbesartan (Avapro)
  • Losartan (Cozaar)
  • Valsartan (Diovan)

Possible side effects include:

  • Headache
  • Dizziness
  • Lightheadedness
  • Nasal congestion
  • Back and leg pain
  • Diarrhea

Antiplatelet Drugs

Common names include:

  • Ticlopidine (Ticlid)
  • Clopidogrel (Plavix)
  • Prasugrel (Effient)

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 (Coumadin)
  • Bivalirudin (Angiomax)

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

Possible side effects include:

Statins

Common names include:

  • Atorvastatin (Lipitor)
  • Pravastatin (Pravachol)
  • Lovastatin (Mevacor)
  • Simvastatin (Zocor)
  • Fluvastatin (Lescol)
  • Resuvastatin (Crestor)

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 medicines, follow these general guidelines:

  • Take your medicine 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 medicine and herb or dietary supplements.
  • Plan ahead for refills so you don’t run out.