Drug profiles: maximizing therapeutic effectiveness

Major cardiac events are inevitably followed with a pharmacologic plan of therapy for cardiac patients. Careful assessment of the patient's drug regimen is an important aspect of cardiovascular nursing practice. Such assessment will reveal implications for education, compliance counseling, and side effect evaluation. A thorough drug history should include information about both prescription and nonprescription drug use. Assessment for adherence is improved by using supportive, open-ended questions. Assessment for side effects that affect quality of life is important, particularly in the area of sexual dysfunction. Sexual function should be assessed before beginning cardiovascular drug therapy and monitored for changes during treatment. Using principles of chronopharmacology, or therapy based on the time-dependent effects of drugs, nurses can schedule cardiovascular medications and evaluate patient responses in relation to circadian variability in vulnerability and symptoms. Assessment for ease of self-management of the drug regimen should be a particular focus with non-English-speaking patients and those with complex or costly drug regimens.