When an effect, such as changes in blood pressure, pain or serum cholesterol is readily measured, the dose of a drug should be adjusted according to the response. Monitoring drug concentration is more useful when drugs are used to prevent an adverse outcome, for example, graft rejection or to avoid toxicity, as with aminoglycosides.
Full Answer
How will my medication treatment plan depend on my heart disease?
Your medication treatment plan will depend on how heart disease affects your cardiovascular system, meaning your heart and blood vessels. Not all heart disease is the same, so it’s not all treated the same way.
Why is it important for a heart patient to understand medications?
As a heart patient, it’s important for you to understand what each medication does and how to use them safely, often in combination. When used appropriately and according to the proper prescription, these medications extend both quantity and quality of life by preventing heart attacks and strokes.
Why would a doctor prescribe an anticoagulant for an irregular heartbeat?
They may also prescribe one if you have an abnormal heart rhythm, such as atrial fibrillation. Arrhythmias raise your risk of blood clots. Like anticoagulants, antiplatelet medications help prevent blood clots, but they do so in a different way.
How effective are drugs for heart failure treatment?
The good news is that standard drugs for heart-failure treatment are effective and new ones are under development.
How long does it take for heart medication to work?
For example, it might be two to four weeks before a cholesterol-lowering statin drug like atorvastatin (Lipitor) takes effect. It blocks an enzyme that the liver needs to make cholesterol. With less cholesterol circulating in the blood, the body is forced to better use and break down the remaining cholesterol.
How do cardiac drugs work?
Cardiac glycosides are believed to increase the force of cardiac muscle contraction by binding to and inhibiting the action of a membrane enzyme that extrudes sodium ions from the cell interior. These drugs also enhance the release of calcium from internal stores, resulting in a rise in intracellular calcium.
What are the stages of heart treatment?
Treatment methods for Stages A, B & C apply. Patient should be evaluated to determine if the following treatments are available options: heart transplant, ventricular assist devices, surgery options, research therapies, continuous infusion of intravenous heart pump drugs, and end-of-life (palliative or hospice) care.
How does heart failure medication work?
Doctors usually treat heart failure with a combination of medications. Depending on your symptoms, you might take one or more medications, including: Angiotensin-converting enzyme (ACE) inhibitors. These drugs relax blood vessels to lower blood pressure, improve blood flow and decrease the strain on the heart.
What medication speeds up heart rate?
Atropine IV/IM. Used to increase heart rate through vagolytic effects, causing increase in cardiac output.
Do blood thinners prevent heart attacks?
Blood thinners, or anticoagulants, can be a lifesaving medication for many people. They prevent blood from getting too thick and prevent clots from forming, which can reduce the risk of stroke or heart attack.
How do I know if my heart failure is getting worse?
Signs of Worsening Heart FailureShortness of breath.Feeling dizzy or lightheaded.Weight gain of three or more pounds in one day.Weight gain of five pounds in one week.Unusual swelling in the legs, feet, hands, or abdomen.A persistent cough or chest congestion (the cough may be dry or hacking)More items...
How long does it take ejection fraction to improve?
If after 3 to 6 months of therapy the EF has increased (taking into account the variability in repeated readings), the therapy may be deemed successful. If the EF has risen to a normal level or to at least more than 40 or 45%, the patients may be classified as having “improved” or even “recovered” EF.
How do you know if your heart is pumping enough blood?
When the heart doesn't have enough pumping power to force used blood back up from the lower extremities, fluid can collect in the ankles, legs, thighs, and abdomen. Excess fluid can also cause rapid weight gain. S = Shortness of breath.
Can heart failure improve?
For most people, heart failure is a long-term condition that can't be cured. But treatment can help keep the symptoms under control, possibly for many years.
Can EF improve with medication?
Angiotensin-converting enzyme inhibitors—also called ACE inhibitors—may be prescribed for people who have heart failure with reduced ejection fraction, which is also called dilated cardiomyopathy. These medications widen, or dilate, blood vessels to improve blood flow.
Can the heart repair itself after congestive heart failure?
The heart is unable to regenerate heart muscle after a heart attack and lost cardiac muscle is replaced by scar tissue.
What is the purpose of diuretics?
Diuretics (Also known as water pills) Causes the body to rid itself of excess fluids and sodium through urination. Helps to relieve the heart’s workload. Decreases the buildup of fluid in the lungs and other parts of the body, such as the ankles and legs.
Can anticoagulants be used for heart failure?
Anticoagulants are not used to treat heart failure without the presence of atrial fibrillation. Cholesterol-lowering drugs (statins) Your doctor may prescribe this class of medication if you have high cholesterol or have had a heart attack. This class of drugs is not used to treat heart failure, but other conditions as indicated.
What is the best medicine for heart failure?
5. Beta-blockers — to treat heart attack and heart failure and sometimes used to lower blood pressure. Beta-blockers block the effects of adrenaline, which comes on in response to stressful situations. Beta-blockers are prescribed in the treatment of these four conditions: Angina.
What is the first line of treatment for AFIB?
“The first line drug for afib (depending on renal function) is novel oral anticoagulants ,” she says. 5. Beta-blockers — to treat heart attack and heart failure and sometimes used to lower blood pressure.
What is the best medicine for angina?
It’s also often used for patients with worsening angina. Dr. Cho says if you’ve had acute coronary syndrome, a better option might be Ticagrelor or Prasugrel, however. 4. Warfarin — to prevent blood clots. This drug is a stronger anti-clotting agent than aspirin and clopidogrel.
What are the big six medications?
Modern heart drug therapy includes the following “big six” medications: 1. Statins — to lower LDL cholesterol. Statins were first introduced in 1987 and doctors now have seven different medications from which to choose depending on a patient’s need. They lower the “bad” LDL cholesterol levels by 20 to 60% and also reduce inflammation.
How much aspirin should I take a day?
Aspirin can help to keep your arteries open because of its anti-clotting and anti-platelet effects. A standard dosage for heart patients is 81 mg a day, which is one baby aspirin. Aspirin makes sense for people who already have heart disease, but not necessarily for people who just have risk factors.
Why is it important to understand what each medication does?
As a heart patient, it’s important for you to understand what each medication does and how to use them safely, often in combination. When used appropriately and according to the proper prescription, these medications extend both quantity and quality of life by preventing heart attacks and strokes.
What are beta blockers?
Beta-blockers block the effects of adrenaline, which comes on in response to stressful situations. Beta-blockers are prescribed in the treatment of these four conditions: 1 Angina. 2 Heart attack. 3 Congestive heart failure. 4 Abnormal heart rhythms.
What does a doctor do if you have a heart failure?
The doctor may examine the veins in your neck and check for fluid buildup in your abdomen and legs.
How can doctors correct heart failure?
Doctors sometimes can correct heart failure by treating the underlying cause. For example, repairing a heart valve or controlling a fast heart rhythm may reverse heart failure. But for most people, treatment of heart failure involves a balance of the right medications and, sometimes, use of devices that help the heart beat and contract properly.
What is the purpose of an echocardiogram?
An echocardiogram can be used to measure ejection fraction, which shows how well the heart is pumping and helps classify heart failure and guides treatment. Stress test.
How to make your heart beat faster?
Stop smoking. Smoking damages your blood vessels, raises blood pressure, reduces the amount of oxygen in your blood and makes your heart beat faster.
What tests are done after a physical exam?
After the physical exam, your doctor may also order some of these tests: Blood tests. Blood tests are done to look for signs of diseases that can affect the heart. Chest X- ray. X-ray images can show the condition of the lungs and heart. Electrocardiogram (ECG).
How to diagnose heart failure?
To diagnose heart failure, your doctor will take a careful medical history, review your symptoms and perform a physical examination. Your doctor will also check for the presence of risk factors, such as high blood pressure, coronary artery disease or diabetes.
Is heart failure a chronic disease?
Heart failure is a chronic disease needing lifelong management. However, with treatment, signs and symptoms of heart failure can improve, and the heart sometimes becomes stronger. Treatment may help you live longer and reduce your chance of dying suddenly.
How to recover from a cardiac event?
Keep in mind that the recovery after a cardiac event is variable; some people sail through each stage, while others may have a tough time getting back to normal. Work closely with your doctor to understand your progress and prognosis after a cardiac event. 1.
What is the best way to help a person with cardiac rehabilitation?
Prescribe an appropriate assistive device, like a cane or a walker, to ensure that you are able to move around safely. Work with you and your family to provide education about your condition and the expected benefits and risks associated with a cardiac rehabilitation program.
What is the role of a physical therapist in cardiac rehabilitation?
Physical therapists work as members of the cardiac rehabilitation team, helping to evaluate cardiac function, assess impairments that may limit your mobility, and prescribe progressive exercise and physical activity to help you return to your normal lifestyle after a cardiac event. There are four phases of cardiac rehabilitation.
How to improve cardiac fitness?
Work with doctors, nurses and other therapists to ensure that appropriate discharge planning occurs. Prescribe safe exercises to help you improve your mobility, and to improve cardiac fitness.
How many phases of cardiac rehab are there?
There are four phases of cardiac rehabilitation. The first phase occurs in the hospital after your cardiac event, and the other three phases occur in a cardiac rehab center or at home, once you've left the hospital. Keep in mind that the recovery after a cardiac event is variable; some people sail through each stage, ...
What is cardiac rehabilitation?
Cardiac rehabilitation refers to a structured program of exercise and education designed to help you return to optimal fitness and function following an event like a heart attack. 1 It's usually provided by a team of specialists in various settings; these healthcare professionals work together to help you improve your ...
When do you go into phase 2 rehab?
Once significant healing has taken place, you may be discharged home to begin phase two cardiac rehab.
When should a drug be monitored?
When an effect, such as changes in blood pressure, pain or serum cholesterol is readily measured, the dose of a drug should be adjusted according to the response. Monitoring drug concentration is more useful when drugs are used to prevent an adverse outcome, for example, graft rejection or to avoid toxicity, as with aminoglycosides. A drug should satisfy certain criteria to be suitable for therapeutic drug monitoring. Examples include:
Why is timing important in drug testing?
The timing of the collection of the sample is important as the drug concentration changes during the dosing interval. The least variable point in the dosing interval is just before the next dose is due. This pre-dose or trough concentration is what is usually measured. For drugs with long half-lives such as phenobarbitone and amiodarone, samples can be collected at any point in the dosage interval. 1-3
Why is therapeutic drug monitoring important?
Therapeutic drug monitoring of concentrations of drugs in body fluids, usually plasma, can be used during treatment and for diagnostic purposes. The selection of drugs for therapeutic drug monitoring is important as the concentrations of many drugs are not clearly related to their effects. For selected drugs therapeutic drug monitoring aims to enhance drug efficacy, reduce toxicity or assist with diagnosis. Despite its apparent advantages, it has inherent limitations. Some large hospitals have services which provide support with drug monitoring and interpretation of results.
How long should a plasma sample be steady state?
Timing of the plasma sample ('when to do it') Unless therapeutic drug monitoring is being used to forecast a dose or there are concerns about toxicity, samples should be taken at steady state (4-5 half-lives after starting therapy 1-3. At steady state, plasma concentration is usually proportional to receptor concentration.
How long should digoxin be monitored?
Correct sample timing should also take into account absorption and distribution. For example, digoxin monitoring should not be performed within six hours of a dose, because it will still be undergoing distribution and so plasma concentrations will be erroneously high. 1-3.
What is the purpose of monitoring therapeutic drugs?
The monitoring of therapeutic drugs involves measuring drug concentrations in plasma, serum or blood. This information is used to individualise dosage so that drug concentrations can be maintained within a target range. 1
What are the limitations of drug monitoring?
Apart from the limited number of drugs amenable to therapeutic drug monitoring, there are also inherent limitations, including the scientific accuracy of the drug assays, laboratory variability in reporting, limited accessibility in rural Australia and the validity of suggested target ranges 1 , 3
How to keep heart medications on plane?
Keep heart medications with you when traveling. Don't pack them in luggage that you don't plan to keep with you at all times; luggage that is checked can be lost or delayed in getting to you.
How many pharmacists do you need to fill prescriptions?
Use one pharmacist to fill your prescriptions. That way, you can make sure you don't get medications that counteract each other.
How does aldosterone help with heart problems?
They protect your heart by blocking a chemical in your body called aldosterone that causes salt and fluid buildup.
How does inotropic therapy help the heart?
Inotropic therapy: This helps make an injured or weakened heart pump harder to send blood through the body. Administered through IV, it helps strengthen the heart muscle's contractions. It also relaxes constricted blood vessels so blood can flow more smoothly. Inotropic therapy may also speed up your heart's rhythm.
What are the effects of beta blockers?
Beta-blockers: They block the effects of adrenaline ( epinephrine ). This helps your heart work better. These meds also drop production of harmful substances your body makes in response to heart failure. And they cause your heart to beat slower and with less force. Those both lower your blood pressure.
What is the purpose of angiotensin II receptor blocker?
Angiotensin II receptor blockers (ARBs): These are used to lower blood pressure for people with heart failure. They help keep your blood vessels as wide as possible so blood can flow through your body more easily. They also lessen salt and fluid buildup in your body.
What is the purpose of digoxin?
Digoxin: It helps an injured or weakened heart to send blood through the body and work more efficiently. It strengthens the force of the heart muscle's contractions. It may improve blood circulation.
What is the problem with the success of drugs for heart failure treatment?
A potential problem with the success of drugs for heart-failure treatment is that it means the number of drugs that people are taking has increased. When new drugs are developed, they are typically not compared in head-to-head studies with old drugs.
What is the best treatment for heart failure?
Beta-blockers are another prominent heart-failure treatment. In addition to lowering blood pressure and decreasing heart rate, these drugs also lessen the effects of the hormones that result from heart failure. Beta-blockers are tremendously useful drugs, resulting in almost a 50% reduction in the risk of death in people with heart failure.
What is the second line of heart failure treatment?
While they look like they may be effective, for now they should be considered as second line treatment for heart failure.". Aldosterone Blockers. Some of the most significant breakthroughs in drugs for heart-failure treatment have come from the aldosterone blockers, such as Aldactone ( spironolactone ), and more recently, Inspra.
How much has the rate of death dropped in heart failure?
If you look at the heart-failure trials over the last 15 years, combining ACE inhibitors, and beta-blockers with devices used in heart-failure treatment, the rate of death has dropped 68% , says Bristow. "That's spectacular progress.".
Why does a failing heart cause a weakened heart?
One is the body's release of hormones that constrict the blood vessels, making it harder for the weakened heart to pump blood.
Is Inspra a heart failure drug?
More study of Inspra is needed since this drug has largely been studied in people who had suffered from a recent heart attack and not heart failure. But the results are exciting for people with heart failure, according to Konstam. "In the last 10 years of drug therapy, there have been three big stories," he says.
Does ACE cause heart failure?
The success of ACE inhibitors in reducing sickness and death from heart failure demonstrated the significant role that hormones play in worsening heart failure and changed the focus of heart-failure treatment. Some of the body's natural responses to a failing heart actually cause the condition to worsen.
How to treat heart disease?
To treat your heart disease, your doctor will probably recommend that you make important lifestyle changes, such as starting an exercise program. They’ll also likely prescribe medications. Many types of medications are available and they help treat heart disease in different ways .
How do anticoagulants work?
Anticoagulants work by preventing blood clots from forming. Some do this by preventing your body from making substances called clotting factors. Others keep the clotting factors from working or prevent other chemicals from forming so that clots can’t develop. Anticoagulants don’t break up existing blood clots, however.
Why do doctors prescribe beta blockers?
Your doctor may prescribe a beta-blocker to help prevent a first heart attack as well as repeat heart attacks. They may also prescribe one if you have high blood pressure, heart failure, chest pain, or an arrhythmia. Examples of beta-blockers include:
Why do doctors prescribe anticoagulants?
Anticoagulants. Your doctor may prescribe an anticoagulant to prevent heart attack, stroke, or other serious health problems. With heart disease, one of the main problems is plaque. A buildup of plaque in a blood vessel can lead to a blood clot, which can cause serious problems when it breaks free of the plaque.
How does calcium channel blocker work?
Calcium channel blockers work by regulating the amount of calcium that enters muscle cells in your heart and blood vessels. This makes your heart beat less forcefully and helps blood vessels relax. Your doctor may prescribe a calcium channel blocker if you have high blood pressure, chest pain, or a heart arrhythmia.
How does beta blocker work?
In general, beta-blockers work by blocking the actions of certain chemicals that stimulate your heart, such as epinephrine (adrenaline). This allows the heart to beat more slowly and less forcefully.
Does ACE inhibitor help with high blood pressure?
Lower angiotensin levels, then, help widen your blood vessels and let your blood flow more easily. This reduces your blood pressure. Your doctor may prescribe an ACE inhibitor if you have high blood pressure or heart failure. They may also prescribe one after you’ve had a heart attack.
Diagnosis
Treatment
- Treatment for coronary artery disease usually involves lifestyle changes and, if necessary, drugs and certain medical procedures.
Clinical Trials
- Explore Mayo Clinic studiestesting new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Lifestyle and Home Remedies
- Lifestyle changes can help you prevent or slow the progression of coronary artery disease. 1. Stop smoking.Smoking is a major risk factor for coronary artery disease. Nicotine constricts blood vessels and forces your heart to work harder, and carbon monoxide reduces oxygen in your blood and damages the lining of your blood vessels. If you smoke, qu...
Alternative Medicine
- Omega-3 fatty acids are a type of unsaturated fatty acid that's thought to reduce inflammation throughout the body, a contributing factor to coronary artery disease. However, some studies haven't found a benefit. More research is needed. 1. Fish and fish oil.Fish and fish oil are the most effective sources of omega-3 fatty acids. Fatty fish — such as salmon, herring and light canned t…
Preparing For Your Appointment
- If you know you have symptoms of or risk factors for coronary artery disease, you're likely to see your primary care doctor. Eventually, you may be referred to a heart specialist (cardiologist). Here's some information to help you get ready for your appointment and to know what to expect from your doctor.
Treatment
Benefits
- Aspirin has been around for a long time and was first discovered to have cardiovascular benefits in the 1960s. Aspirin can help to keep arteries open because of its anti-clotting and anti-platelet effects. A standard dosage for heart patients is 81 mg a day, which is one baby aspirin. Aspirin makes sense for people who already have heart disease, b...
Medical uses
- This drug is considered a super-aspirin because of its effectiveness in preventing platelet clumping and it is often used in combination with aspirin. For some patients there is an increased risk of bleeding and doctors will weigh the benefits versus the risks of this drug. However, for patients with stents, the combination of aspirin and clopidogrel is essential to preventing clottin…
Pharmacology
- This drug is a stronger anti-clotting agent than aspirin and clopidogrel. It works as an anticoagulant or blood thinner. Warfarin is widely used to prevent the formation of clots for patients with atrial fibrillation, those with artificial heart valves and those who have formed blood clots in veins of the legs. Because it interacts with other medications and diet, it requires close …
Mechanism of action
- ACE (angiotensin-converting enzyme) inhibitors prevent the body from producing the artery-constricting hormone angiotensin. Arteries relax with ACE inhibitors and this lowers blood pressure. They are prescribed for patients with congestive heart failure, a recent heart attack, and those with hypertension.
Prevention
- Collectively, these drugs are saving lives by preventing heart attacks and strokes. Chances are you will take one or more these medications if you are at risk for or have coronary heart disease. Be sure to know your medications and follow your doctors instructions. You will want to work with him or her to get the safe and effective combination for you.
Sources
- The information in this article is summarized from the book Heart 411 by Marc Gillinov, MD, and Steven Nissen, MD, of Cleveland Clinics Heart & Vascular Institute.
Diagnosis
Treatment
Clinical Trials
Lifestyle and Home Remedies
Coping and Support
- Proper heart failure treatment can sometimes improve symptoms and help you live longer. You and your doctor can work together to help make you most comfortable. Pay attention to your body and how you feel, and tell your doctor when you're feeling better or worse. This way, your doctor will know what treatment works best for you. These steps may hel...
Preparing For Your Appointment