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 It
is not uncommon to be taking medication following a heart attack. Your physician
carefully chose the type of medication and dosage you need based upon your present
condition. It is important to recognize that not everyone will be taking the
same medications. Your blood pressure, heart rhythm and the extent of damage
to the heart muscle, will influence your doctor's decision. The following is
a brief outline of the drugs most commonly used and their role in treating heart
disease.
ECASA decreases the normal stickiness of your blood. In doing so, the risk of a blood clot forming in an injured/narrowed coronary artery will be reduced.
Beta Blockers reduce the heart's need for oxygen by decreasing the heart rate
and blood pressure at rest and during exercise. If you use this type of medication,
you may be aware of an increase in your physical capabilities before angina
occurs. In fact, your physician may suggest taking a beta-blocker to reduce
the chance of recurrent heart attack. Atenolol (Tenormin), Labetalol (Trandate),
Nadolol (Corgard), Timolol (Blocadren), Propranolol (Inderal), Pindolol (Visken),
Bisoprolol (Monocor), Carvedilol (Coreg) and Metoprolol (Betaloc, Lopressor)
are a few of the drugs in this category.
Nitrates (Nitroglycerin, Isordil, Nitro Spray) open up blood vessels thereby increasing the supply of blood and oxygen to the heart. When angina occurs, a nitroglycerin tablet or spray under the tongue usually quickly relieves discomfort. In addition some nitrates can be used to prevent anginal attacks if you know that performing a certain activity (ie. gardening, walking up a long flight of stairs) sometimes causes angina pain to occur. Longer acting nitrates (Nitrong SR, Isordil or Nitro Paste) may be needed by those individuals who experience angina more frequently throughout the day.
The Calcium Channel Blockers such as Verapamil (Isoptin), Nifedipine (Adalat), Diltiazem (Cardizem) and Amlodipine (Norvasc) may be used in the treatment of angina, disturbances in heart rhythm, or where spasm (temporary reduction of blood and oxygen supply to the heart muscle) of the coronary arteries is suspected. These drugs relax blood vessels and increase the supply of blood and oxygen to the heart.
Digoxin (Lanoxin) is used to improve the heart's pumping ability thus increasing the strength and efficiency of the heart. Digoxin is also used to control heart rate and rhythm.
Diuretics are used to reduce excess fluid in the body by causing increased
urine formation in the kidneys. By reducing fluid retention, the work of the
heart is decreased and blood pressure drops. A common medication used is Furosemide
(Lasix). Other diuretic medications, such as Hydrochlorothiazide (Hydrodiuril)
act in a different way; by reducing the resistance to blood flow they lower
blood pressure, which in turn reduces the work of the heart. Some diuretics
may increase potassium loss from your body. Since potassium is important in
many body functions, a supplement such as Slow K may be required.
These drugs, such as Quinidine (Biquin Durules), Amiodarone (Cordarone), Procainamide (Procan-SR, Pronestyl) restore irregular heart beats to a normal rhythm and help to slow an overactive heart. This allows the heart to work more efficiently.
ACE-Inhibitors such as Captopril (Capoten), Lisinopril (Prinivil), Enalapril
(Vasotec), Fosinopril (Monopril), Ramipril (Altace) and Quinapril (Accupril)
block the formation of a substance in the body that causes blood vessels to
narrow and tighten. These drugs, therefore, relax blood vessels and lower blood
pressure. They also slow down weakening of the heart muscle after a heart attack
to improve the heart’s pumping action.
Similar to ACE-inhibitors, these medications include Losartan (Cozaar), Valsartan
(Diovan), Irbesartan (Avapro), Candesartan (Atacand), and Telmisartan (Micardis).
They also increase the size of blood vessels, thus decreasing blood pressure
and easing the workload of the heart. These medications are usually prescribed
to patients that cannot take ACE-inhibitors for some reason, such as cough as
a side effect.
Statins help to improve blood cholesterol levels. These drugs help to reduce the development of further heart problems by preventing the clogging of blood vessels due to cholesterol buildup. Lovastatin (Mevacor), Simvastatin (Zocor), Fluvastatin (Lescol), Pravastatin (Pravachol), Atorvastatin (Lipitor) are some of the drugs in this category.
Contact your doctor or pharmacist before taking any non prescription drugs, nutritional supplements or herbal remedies to see if they are appropriate for you (eg. Ginseng can alter the effects of certain medications). Grapefruit juice (fresh and frozen) has also been shown to enhance the effects of certain heart medications which may result in serious increases in the incidence of adverse drug effects. Such drugs include Calcium Channel Blockers (eg. Amlodipine, [Norvasc], felodipine [Plendil] and HMG CoA Reductase Inhibitors (eg. Simvastatin [Zocor], Atorvastatin [Lipitor]. Therefore, it is best to avoid grapefruit juice if you are taking any of these heart medications. Other citrus juices (eg. orange juice) do not appear to be a problem.
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