Heart Patients and Medication
The body is a unique piece of apparatus. To survive, however, it needs a continual feed of energy and nutrients and the route for this is the body pump (Heart) and its network of Roads and tunnels (Arteries, Veins and capillaries) and a control source/nerve centre (Brain).
Anything that affects the efficient working of this network results in disease and disability from a lack of energy and the invigoration /regeneration of tissues. In a ‘Normal’ functioning body the food and drink consumed is broken down to chemical basics by the gastro intestinal system, the active parts of which are absorbed into the blood carrier pathway and the waste is eliminated by the bowels or kidneys. Absorbed constituents are then run through the liver for further purification and the useful ingredients are then transported to the various needy tissues for regular function, growth and repair. The end destinations can be from the all governing Brain tissue, the essential pump mechanism of the Heart and lungs, the Poison controlling liver and to the peripheral circulation for skin maintenance and heat control of the body system.
The circulation road map of the body, thus, is of premier importance. In cardiac patients, the focus of attention is to make adjustments in order to retain the system in its original ‘A1’ condition or at least get as close to it as possible.
The malfunctions can range from – Angina (chest pain), Hypertension (Raised Blood Pressure), Heart Failure (Enlargement of heart chambers or inappropriate electrical conduction), Valve dysfunction (Blood leakage or ineffective transport thereof), the narrowing of blood vessels (due to the formation of cholesterol plaques) leading to ineffective surface temperature control, ineffective organ function resulting in angina, cold extremities, mal nourishment and general malaise.
One way to counter this, long term and effectively, is to introduce drugs that will correct and enhance performance to regain the normal function again. There are many drugs used to help attain this goal but mostly they fall into the following categories:
Drugs that open up blood vessels – these work in a variety of mechanisms but in the end reach the same conclusion to help the easy passage of blood and its content of energy, nutrients and removal of waste. These drugs include the under the tongue sprays ( nitrolingual, GTN), sublingual and oral nitrate tablets (GTN, Suscard, Isosorbide mono- and Dinitrate) , Calcium Channel blockers (Nifedipine, Amlodipine,Lercardipine, Verapamil, Diltiazem) , Angiotensin Converting Enzyme (ACE) inhibitors(Lisinopril, Ramipril, Captopril, Enalapril, Quinapril, Perindipril), Potassium channel blockers ( Nicorandil), Alpha Blockers (Doxazosin)
Drugs that slow down the Heart – an action by which the strain on the pump is reduced and the pressure of resulting blood flow reduced too. Examples are the Beta Blockers(Atenolol, Sotalol, Propranolol, Bisoprolol) ( Care with Asthmatics), some Calcium and Potassium channel blockers (see above).
Drugs that increase the force of contraction of heart muscle – Cardiac Glycosides (Digoxin), ACE inhibitors (Lisinopril, Ramipril, Captopril, Enalapril, Quinapril, Perindipril), Angiotensin II Receptor Antagonists (ARB) (Losarten, Candesarten, Irbesarten, Telmisarten, Valsarten)
Drugs that reduce blood volume – By reducing the volume of blood the pressure goes down just as opening a tap full results in splashing everywhere but opening only half goes straight into the receptacle, These are Diuretics – two types and can be given singlely or combined for additive effect ( Bendroflumethiazide, Hydrochlorothiazide, Furosemide, Bumetanide,Furosemide/Amiloride).
Drugs that dilate peripheral vessels – to allow better circulation and eliminate coldness in the extremities – (Naftidrofuryl, Oxerutins)
Drugs that act centrally from the brain – affecting heart function and blood vessel contractility (Methyldopa, Clonidine,Moxonidine ,Dopamine,Ephedrine, Phenylephrine).
Atherosclerosis – plaque formation in blood vessels causing a narrowing of the arteries – statins ( Simvastatin, Atorvastatin, Rosuvastatin, Pravastatin, Bezafibrate).
Antiplatelet function – Results in the ‘thinning of blood’ allowing free passage through the blood vessels (Aspirin, Dipyridamole, Clopidogrel).
I have tried to effect explanations in layman’s terms and the conditions and drugs listed are common ones. There are many more that can, and are being prescribed by the clinicians subject to their trust and experience.
For any prescribed drugs it is essential to report any adverse reactions to the Doctor, Pharmacist or Nurse to stop any unwanted reactions and to choose another equivalent safer preparation. Equally care must be exercised not to stop or commence any drug regimen without the express permission and knowledge of your managing clinician.
Most important do not take ‘A friend’s tablet’ because it worked for them. Not all drugs affect two people in the same way, hence the variety and duplication of available drugs. Think in terms of your choice of toothpaste, all variants promise the same end result of a dazzling white smile, but you know which you like or perform for you best.
Keep taking the tablets, live long and healthy.