Drug Information

The 5 main types of medication used in the treatment of Cardiac Disease

1. Aspirin
2. ACE Inhibitors
3. Beta Blockers
4. Statins
5. Nitrates (GTN)

Aspirin

It is a cheap and very effective drug that has been proven to reduce deaths from heart attacks and strokes. Once started on aspirin you are likely to be on it for life unless problems develop.

Action
Aspirin has two actions, the main one being the reduction of the stickiness of platelet cells, which clump together to form clots. The other function is to interfere with the reaction of blood vessels to minor damage, further reducing the likelihood of clot formation.

Use
Daily, usually in the morning dissolved in a little water and taken with food.

Possible Side Effects
Rarely can cause stomach problems.
Occasionally may cause wheezing in the asthmatic person.

Ace Inhibitors (Angiotensin Converting Enzyme Inhibitors)

They lessen blood vessel constriction.
(Reducing blood pressure)
They reduce salt and water retention by a chemical pathway.
(Reducing blood pressure and overloading the heart)
Reduce the risk of developing heart failure.
(Actively prevents heart failure)

Possible Side Effects
Can cause a sudden drop in Blood Pressure, especially when they are first used, or with a diuretic.
Can affect the function of the kidneys, so will have regular blood checks.
Dry cough.

Beta Blockers

Blocks the action of hormones (notably) ADRENALINE.
Adrenaline increases the heart rate and causes a rise in Blood Pressure.
Beta Blockers prevent the heart beating quickly and as forcefully especially when exercising or with emotion. So reducing blood pressure and heart rate.
They prevent attacks of angina.
Because they reduce the heart beating quickly. The heart becomes a more efficient pump.

Beta Blockers names mostly end in an ....olol.

Possible Side Affects
May slow the heart rate too much and lower the blood pressure too much.
May cause a wheeze, especially in patients with asthma.
May cause cold hands and feet.
Some men suffer from a degree of impotency.

NEVER STOP BETA BLOCKERS SUDDENLY

Nitrates

These are used to relieve Angina.
Heart pain caused by the heart muscle being deprived of Oxygenated blood (ANGINA).
They work by dilating, or widening the Coronary Arteries.
This allows more Oxygenated blood to heart muscle (Myocardium).
They also allow more blood to be retained in the body away from the heart, lessening its load.

GTN tablets or spray (Glyceryl Trinitrate)

These are quick acting nitrates. They provide relief from Angina within minutes.

Remember if using the tablets, once the seal is broken they loose their effectiveness after 8 weeks.

The spray will last for several years.

Long Acting Nitrates

Isosorbride Nitrates

These act in the same way as the short acting nitrates, but they are released into the blood stream over a period of hours.

One big problem. TOLERANCE
If the body receives a dose throughout a 24 hour period, they become less effective.

It is important to have a nitrate-free period during the 24 hour period.
So remember to remove patches and ointment at night.

If you take the slow release tablets and you are on them twice a day. Take them morning and lunch time.

Cholesterol Lowering Drugs

Statins

The overall aim of diet and drug treatment for high cholesterol is to lower the amount of cholesterol in the blood, especially Low Density Lipoprotein Cholesterol.
20 to 30 % reduction in LDH can be achieved by diet and drug combination.

Statins inhibit the production by the liver of LDH.

ALL STATINS SHOULD BE TAKEN AT NIGHT

Common Statins are:

Other drugs that can be used, should a Statin not be suitable are Fibrates.

Possible Side Affects
Muscle pains.
Diarrhoea or constipation.
Flatulence.

DO NOT USE BENACOL WHEN TAKING STATINS

Other Common Cardiac Drugs

Diuretics
Increase the output of urine and salt.

Digoxin
Slows and strengthens the heart beat.

Anticoagulants
Prevent clots forming. Heparin & Warfarin.

Anti-arrhythmic drugs
Used to control an irregular heart rhythm. Amiodarone, Flecanide and Verapimil.

Calcium Channel Blockers
Reduces the amount of calcium entering the muscle cells of arteries (especially Coronary Arteries). This causes them to relax. Nifedipine, Diltiazem and Amlodipine.

Cardiac Care Team - Author: Maggie Jones

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