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Heart disease medications

• Several different types of drugs are given to people who have had heart attacks. They are given to treat your symptoms or reduce the chances of a second attack. Some drugs will do both!

• Some tablets need to be continued for a considerable length of time. So when you come to the end of one prescription, ask your doctor whether a repeat prescription is necessary.

• It can be confusing if you are taking a variety of tablets at different times of the day, so you'll be less likely to miss a dose if, each morning, you set out your tablets for the whole day.

• Drink sufficient amounts of water to flush down your tablets; never swallow them without water. Remember tablets have to dissolve inside your stomach before they can get to work.

• If you experience side-effects, make sure you report them to your doctor. Don't stop taking medication without letting your doctor know.

• Some tablets are more effective when taken on an empty stomach and others need to be taken after food. Still others may be totally unaffected by food, so ensure you read the label on the bottles.

• If you're on regular heart tablets, make sure you tell your pharmacist before you buy any form of medication over the counter. (This is really important as some medications can clash).

• As with all drugs, side effects sometimes occur. So if you have any questions about your medication, your pharmacist, and health care provider will be happy to help you, so please ask.

 

Some common drugs:

Thrombolytics (Streptokinase/TPA)

These drugs dissolve the clot that causes the "heart attack" but will not repair any damage that has already been done. Thrombolytics are more effective the sooner they're given and have to be administered within hours of the first onset of chest pain. You will be advised if you have had a thrombolytic drug administered. As a lot of things will have been happening at the time of your admission, you may have forgotten whether this was given (and if it was which one!) so ensure you have this information handy.

If you were given STREPTOKINASE, after your heart attack, you will be given a card saying so. Keep this card with you, as it will be important for the doctor who treats you for any further attack to know this. Streptokinase should not be given to a person more than once, although TPA can be given on as many occasions as necessary.

Not everyone is given a thrombolytic, particularly those with disorders of the blood clotting system, a recent stomach or duodenal ulcer, or who have undergone recent surgery. There is also little point in giving a thrombolytic more than 12 hours after the onset of symptoms.

Analgesics - (Pain Killers)

You may have been given a strong pain killing injection when you arrived at hospital (or your own doctor may have given you one before you set off to hospital). This injection will have made you drowsy and perhaps made you feel sick. If given morphine, you would have probably been given an ant emetic to counteract the nausea.

Aspirin

Small doses of aspirin have been found to reduce the stickiness of the blood and so reduce the likelihood of having another heart attack or stroke. The aspirin must be taken regularly, perhaps for the rest of the person’s life.

Beta-Blockers (e.g. Atenolol, Bisoprolol, Metoprolol)

Beta-blockers help the recovery from a heart attack by reducing the work the heart has to do whilst it recovers. They are also used to treat angina and high blood pressure. As you will have seen, high blood pressure can increase the chances of having a further heart attack, so beta-blockers can provide a “double benefit” in recovery from a heart attack. Beta blockers are not suitable for all people, particularly those suffering from poor circulation or asthma.

ACE inhibitors (e.g. Ramipril, Lisinopril, Enalapril, Captopril, Perindopril)

Like beta blockers, ACE inhibitors also help to reduce the stress on the heart whilst it recovers. ACE inhibitors work by a combination of dilating blood vessels (like nitrates) and increasing urine output. They are also used to treat high blood pressure, so (like beta blockers), provide more than one benefit.

Some patients, however, find ACE inhibitors can reduce their blood pressure a bit too much, and they become dizzy, particularly if they stand up suddenly. ACE inhibitors are also not suitable for patients with certain kidney disorders, and can sometimes cause a rash or dry cough. Provided you don't suffer from any of the side-effects described above, ACE inhibitors can greatly improve your chances of a successful recovery.

Lipid-lowering agents (e.g. Simvastatin, Pravastatin, Atorvastatin)

Raised blood levels of fatty substances (lipids), such as cholesterol, are known to be one of several factors that increase the risk of a heart attack. This is particularly true when a person has already had a heart attack.

If your cholesterol level is raised, the usual method of handling this is initially by diet, (the dietician will be able to advise you). Some people, however, inherit a tendency to have high cholesterol levels, and can't keep them down no matter how well they control their diet. If diet alone fails to control cholesterol levels, it may be necessary to use one of a group of drugs known as “statins”.

Statins most commonly used are simvastatin and pravastatin. These drugs can markedly reduce the chances of another heart attack, when used together with a sensible and healthy diet. Like all drugs, however, they can have side effects, and you should report immediately any unexplained muscle pain or weakness to your doctor. You will also have blood tests from time to time to check your liver is working properly.

Nitrates (Includes GTN Spray)

Nitrates are mainly used to treat angina, and sometimes to treat heart failure. They work by dilating blood vessels in the circulatory system. This reduces the resistance to blood flow, and hence reduces the amount of work the heart has to do. They can be used to give immediate relief from an attack of angina, usually by using a spray applied under the tongue.

If you suffer frequent attacks, you may be given tablets/capsules (e.g. Imdur, Elantan, Isosorbide Mononitrate) to provide a constant level of nitrate in the blood, topped up with the spray when necessary. You may experience a headache when first using nitrates, although this usually becomes less troublesome once treatment has continued for some time.

In the event of sudden severe chest pain or discomfort such as the reoccurrence of pain like your previous heart attack, you should dial for an emergency ambulance immediately.

DO NOT WASTE PRECIOUS TIME HOPING THE PAIN WILL GO AWAY!!!

Most patients, who leave hospital after a heart attack, can eventually lead a perfectly normal life. Statistics show after about two years, the risk of another heart attack is no greater than for anyone else.

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