Question

1. Some cardiac drugs have effects on exercise.  Which drugs specifically affect exercise and how?  If you worked in cardiac rehab how would you deal with these effects (answer for each type of drug that affects exercise)?

Answer 1

1 - BETA BLOCKERS

Beta-blockers slow your heart rate, which can prevent the increase in heart rate that typically occurs with exercise. This means that it might not be possible for you to reach your target heart rate.No matter how hard you exercise when taking a beta-blocker, you may never reach your target heart rate. Keep in mind that being unable to reach your previous target heart rate doesn't mean you're not getting the cardiovascular benefits of exercise.

There's no precise way to predict the effect of beta-blockers on your heart rate. An exercise stress test, which checks blood flow through your heart while you exercise, can measure how hard your heart pumps while you're taking beta-blockers. Your doctor can use this information to determine your target heart rate.

If you don't have an exercise stress test, you can use a perceived exertion scale, such as the Borg Rating of Perceived Exertion Scale, which relies on your judgment of how hard you're working based on effort, breathlessness, and fatigue. Ask your doctor for help finding and using an exertion scale.

For most workouts, your best bet is to aim for physical activity that feels somewhat hard, it takes effort but you can continue to exercise. If you can't talk while you're exercising, you're probably overdoing it.

2 - OTHER BLOOD PRESSURE - LOWERING DRUGS

One of the many reasons exercise is good for your health is because it helps lower your blood pressure, even after your workout is complete. This post-workout blood pressure drop is expected but can be made worse if you’re also taking medications designed to lower blood pressure (like beta-blockers, diuretics, ACE inhibitors, and others).

That means you’ll want to talk to your doctor about how to safely monitor your exercise intensity to make sure your heart rate and blood pressure don’t drop too low. Here are a few additional suggestions:

3 - STATINS

Simvastatin and rosuvastatin (Crestor) belong to a group of medications called statins, some of the most commonly prescribed prescription drugs in the world. Statins help lower cholesterol but can also cause muscle cramps or muscle pain as a side effect.

These muscle cramps are likely to go away after a few weeks of taking the medication consistently. Until then, it may be best to stick to exercises that don’t strain your muscles too much (e.g., cardio, as opposed to resistance training). If muscle pain lasts, your doctor may suggest switching to a different statin.

Hoe I deal with these effects

• I will make sure that my patient stays hydrated at the time of exercising.
• I will advise him that, be careful when going from lying down to sitting or sitting to standing.
• I will instruct him that if he feels dizzy, or light-headed, sit down and take a break or call it quits for the day.