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Understanding Your Medications |
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Written by Administrator
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Monday, 25 January 2010 22:36 |
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Taking your medications every day is essential in treating your heart failure. Common kinds of medicines prescribed for treating heart failure include:
ACE inhibitors (Angiotensin-converting enzyme inhibitors)
* Accupril (quinapril)
* Altace (ramipril)
* Capoten (captopril)
* Lotensin (benazepril)
* Monopril (fosinopril)
* Prinivil/Zestril (lisinopril)
* Vasotec (enalapril)
ACE inhibitors make it easier for the heart to pump. They have been shown to help patients live longer and feel better. They prevent the further deterioration of heart function. This will usually be the first medication your doctor will prescribe for heart failure. It may take several days to weeks before you feel these effects.
Side Effects: Report any side effects right away. The most common side effects of ACE inhibitors are:
* Cough
* Dizziness
* Skin rash
We may monitor your potassium level and kidney function more often while you are taking ACE inhibitors.
If you experience any of these symptoms your doctor may be able to change the dose or type of ACE inhibitor. A very low percentage of patients cannot tolerate ACE inhibitors at all. Please do not stop taking your ACE inhibitor without your doctor’s advice.
Angiotensin Receptor Blockers (ARBs)
* Atacand (candesartan)
* Avapro (irbesartin)
* Cozaar (losartan)
* Diovan (valsartan)
ARBs function in a similar manner to ACE inhibitors by affecting blood pressure in a way that makes it easier for the heart to pump blood. They are most often used in patients that cannot take ACE inhibitors. They are not a substitute for ACE inhibitors and do not prolong life the way ACE inhibitors do.
Beta-blockers
This class of drugs has shown dramatic improvements in patients with heart failure. The drugs decrease the toxic effects of heart failure. They seem to work best in women, but men also have substantial benefit.
The difficulty in using beta-blockers is the early start up. Because these drugs will worsen the contraction of a weak heart, some patients will feel more tired and short of breath. This does not mean you have to stop beta-blockers. It just means you need to let your doctor know.
These drugs take time to work. In fact, the maximal beneficial effects can take six to eight months to occur.
Types of beta-blockers: There are many types of beta-blockers, but for heart failure, we recommend only two. Coreg (carvedilol) and Toprol XL (metoprolol succinate long acting). The dose to start is very low and increased every two weeks to the maximum tolerated dose.
Side Effects: Beta-blockers can cause dizziness, nausea, vomiting, impaired peripheral circulation resulting in cold hands and feet, and sleep disturbances. It is very important to take your pills every day, unless your doctor tells you otherwise. Beta-blockers should be taken with food. When your heart adjusts, you should feel better. Keep track of how you feel — and tell your doctor if anything bothers you. You may feel the same, or worse for three to 10 weeks. After that most people feel better. Do not stop taking beta-blockers suddenly. If your doctor wants you to quit, he or she will gradually reduce your dose.
Amiodarone
Amiodarone is a heart rhythm stabilizing drug (antiarrhythmic). It is the safest drug of its type to use, if needed, in patients with heart failure. You will need regular lab work to monitor its effect.
Diuretics
Commonly known as a “fluid pill”. Diuretics make you urinate more often. This gets rid of the extra fluid your body holds on to because of your heart failure. Your heart does not have to work as hard if it has less volume in the circulation system. Diuretics will decrease the swelling in your ankles, feet, legs and abdomen. You will also notice you will become more short of breath if you skip a dose.
Common diuretics are:
* Lasix (furosemide)
* Demadex (torsemide)
* Bumex (bumetanide)
* HydroDiuril (hydrochlorothiazide)
* Edecrin (ethacrynic acid)
* Zaroxolyn (metolazone)
Side Effects: To avoid potassium loss, eat potassium rich foods (citrus, bananas, raisins) and take your potassium supplement as prescribed. We will monitor your potassium level with blood work.
Other side effects include:
* Leg cramps
* Incontinence
* Dizziness/lightheadedness
* Gout
* Skin rash
Please call us if you gain two pounds in one day or more than five pounds in one week. We may tell you to increase your diuretics.
Potassium-sparing diuretics
Aldactone is a diuretic that will hold on to potassium. This drug has also been shown to improve survival in heart failure patients. Care must be taken to insure you monitor your potassium level closely. The most common side effect is painful enlargement of the breasts in men.
Digoxin/digitalis (Lanoxin) makes the heart pump stronger and more efficiently. Digoxin is usually well tolerated. Signs that there is too much digoxin in your body are:
* Nausea
* Loss of appetite
* Mental confusion
* Blurred or yellow–colored vision
* Palpitations or slow heart rate
Call your doctors if you experience any of these symptoms.
Anti-Platelet Agents
* Aspirin (ASA)
* Plavix (clopidogrel)
Anti-Platelet Agents make your blood less likely to clot. They prevent new heart attacks, strokes and leg blockages.
Side Effects: The most common side effects of anti-platelet agents are stomach bleeding, belly pain, and diarrhea. Report any side effects right away.
Anticoagulants
Coumadin is an oral blood thinner. Sometimes patients are given this drug to help prevent a stroke. All patients with heart failure and atrial fibrillation should be on Coumadin unless there is a specific reason to not use this drug.
Link:
http://www.texasheart.org/PatientCare/Centers/HLTransplant/Recovery.cfm
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