Drugs Used in Disorders of the Heart
Robin Brain
August 30, 2008
Role of Vitamins in Atherosclerosis Prevention: Raised levels of Homocysteine (an amino acid) accelerate the process of atherosclerosis. This can be slowed by the use of folic acid (5 mg! day), methylcobalamin (an active form of Vitamin B12) and pyridoxine (Vitamin 86).
Other Vitamins A,C, and E have antioxidant properties and thus remove the free radicals from tissues (free radical are injurious and allow atherosclerosis to progress). Therefore, 'healthy heart nutrients' supplementation may be needed (along with lipid lowering drugs) to tackle the complex process of atherosclerosis.
Drugs Used in Angina Pectoris
There are three distinct aims of the treatment of angina pectoris 1) treatment of an acute attack or prevention of an attack shortly before undergoing physical exertion; 2) chronic prophylaxis (long-term prevention) of a future attacks, and 3) changing life style of patient (nondrug treatment).
Drugs for Long-Term Prevention
There are five groups of drugs used to prevent angina pectoris. These are: 1) Beta blockers 2) Calcium entry blockers, 3) Nitrates, 4) Potassium channel openers, and 5) Heart muscle cell protectors.
Beta Blockers (Atenolol 50-100 mg, Metoprolol 100-200 mg, Celiprolol 200-400 mg, Carvedilol 6.25-25 mg, Propranolol 80-160 mg).
These drugs reduce work of the heart so oxygen need is reduced, particularly during exercise thus increasing the exercise capacity. Continuous use lowers the risk of sudden death due to attacks. In unstable angina, beta blockers are not preferred because some of them (propranolol) may increase the narrowing of coronaries.
Adverse Effects: Tiredness, fatigue, slow pulse, leg pains, cold hands and feet, dreams or loss of sleep, worsening of asthma, congestive heart failure (poor pumping of blood) and poor control of diabetes may occur by these drugs. Propranolol like non selective betablockers are more likely to produce such adverse effects.
Precautions
Unlike nitroglycerine, these drugs should be stopped abruptly as this can lead to a heart attack.
Do not take verapamil or diltiazem along with these drugs (discussed later).
The safety of these drugs has not been established in pregnancy.
Elderly patients may start with a smaller dose.
Other Vitamins A,C, and E have antioxidant properties and thus remove the free radicals from tissues (free radical are injurious and allow atherosclerosis to progress). Therefore, 'healthy heart nutrients' supplementation may be needed (along with lipid lowering drugs) to tackle the complex process of atherosclerosis.
Drugs Used in Angina Pectoris
There are three distinct aims of the treatment of angina pectoris 1) treatment of an acute attack or prevention of an attack shortly before undergoing physical exertion; 2) chronic prophylaxis (long-term prevention) of a future attacks, and 3) changing life style of patient (nondrug treatment).
Drugs for Long-Term Prevention
There are five groups of drugs used to prevent angina pectoris. These are: 1) Beta blockers 2) Calcium entry blockers, 3) Nitrates, 4) Potassium channel openers, and 5) Heart muscle cell protectors.
Beta Blockers (Atenolol 50-100 mg, Metoprolol 100-200 mg, Celiprolol 200-400 mg, Carvedilol 6.25-25 mg, Propranolol 80-160 mg).
These drugs reduce work of the heart so oxygen need is reduced, particularly during exercise thus increasing the exercise capacity. Continuous use lowers the risk of sudden death due to attacks. In unstable angina, beta blockers are not preferred because some of them (propranolol) may increase the narrowing of coronaries.
Adverse Effects: Tiredness, fatigue, slow pulse, leg pains, cold hands and feet, dreams or loss of sleep, worsening of asthma, congestive heart failure (poor pumping of blood) and poor control of diabetes may occur by these drugs. Propranolol like non selective betablockers are more likely to produce such adverse effects.
Precautions
Unlike nitroglycerine, these drugs should be stopped abruptly as this can lead to a heart attack.
Do not take verapamil or diltiazem along with these drugs (discussed later).
The safety of these drugs has not been established in pregnancy.
Elderly patients may start with a smaller dose.
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