Heart Disease Medications
When you are diagnosed with heart disease the list of heart disease medications can be as overwhelming as the diagnosis itself. To begin with, there are several different types of drug categories, or classes. Each drug class has a number of different medications. If you can make sense of what each drug class is for, it will be easier to determine with your physician what heart disease medications are right for you.
The first drug class we will cover is the ACE inhibitor. An ACE or Angiotensin Converting Enzyme Inhibitor is used to lower your blood pressure. Angiotensin Converting Enzymes in the blood cause narrowing of the blood vessels, causing blood pressure to rise. An ACE inhibitor interrupts that chemical process which then dilates the blood vessels, thereby lowering the blood pressure. These heart disease medications, such as Altace or generic know Ramipril, Mavik or its generic counterpart Trandolapril and Zestril or Prinivil or generic named Lisinopril, all work by lowering the blood pressure making it easier for the heart to pump blood throughout the body. Easing the load on a diseased heart can make a tremendous difference in treating heart disease.
ARB or Angiotensin II Reception Blockers work essentially the same way as an ACE inhibitor. These heart disease medications block the Angiotensin II’s ability to narrow the blood vessels, keeping them dilated. They are prescribed to lower blood pressure to make it easier of the heart to function properly. Candesartan cilexetil or it brand name Atacand, Irbesartan or the brand name Avapro, and Losartan or its brand name equivalent Cozaar are all examples of ARBs and are generally prescribed when ACE inhibitors are not well tolerated by the patient.
Treatment with acetylsalicylic acid (ASA) or aspirin in low doses has been shown to reduce the risks of heart attacks. Heart attacks are usually caused by clots that form a blockage in the arteries of the heart. ASA makes platelets, making it harder for the blood to clots. A small dose of no more than 81 mg a day, about what you would find in one baby asprin, has been recommended as part of a regular daily regimin for those at risk of a heart attack.
Digoxin is created from the leaves of the plant digitalis lanata. Digoxin and the brand named Lanoxin have a couple of beneficial properties as heart disease medications. First they make the heart contractions stronger by inhibiting an enzyme that increases calcium into the heart. Increased calcium levels make the contractions of the heart stronger. Digoxin also interferes with the conduction of electricity between the heart’s ventricles and atria which is useful in treating many disorders associated with rapid heartbeat.
One of the greatest contributors to heart disease is high cholesterol, so many heart disease medications are statins. Statins work by blocking the enzyme responsible for cholesterol production by the liver. This lowers the cholesterol and triglyceride levels in the blood, helping to prevent strokes and heart attacks. Also referred to as enzyme blockers, there are several statins widely prescribed as a treatment for heart disease. Lipitor (Atorvastatin), Lescol (fluvastatin), Crestor (Rosuvastatin), Zocor (Simavastatin), Mevacor (Lovastatin), Pravachol (Pravastatin) and Livalo (Pitavastatin) are all statins that have been approved for usage in the United States.
Beta Blockers are another drug class of heart disease medications. Beta Blockers, or beta-adrenergic blocking agents, work by blocking the effects of epinephrine and norepinephrine, slowing down the heart rate and dilating vessels to lower blood pressure. There are different types of beta blockers as well. Selective beta blockers like Lopressor, Toprol XL or Metoprolol block mainly B1 receptors. This will slow the heart rate, but have little effect on vessels and no effect on air passages. Non-selective beta blockers, such as Inderal or Propranolol, on the other hand, block B1 and B2 receptors which will affect the heart rate, blood vessels and air passages. Drugs like Normodyne, Trandate (generically called Labetalol) and Coreg (Carvedilol) also block alpha-1 receptors which will boost the dilating effect on the blood vessels. Then there are some beta blockers that have ISA. Intrinsic sympathomimetic activity in beta blockers such as Visken (Pindolol) actually replicate the norepinephrine and epinephrine effects so there is less on a decrease in heart rate than with beat blockers that do not have ISA’s.
Calcium Channel Blockers work by dilating the arteries of the heart making it easier for the heart to pump blood. When it is easier for the heart to pump, it requires less oxygen. CCBs are also helpful in lowering blood pressure and slowing heart rates. Of calcium channel blockers, some like Isoptin, Calan (Verapamil) and Cardizem (Diltiazem) are most effective in reducing the heart rate, so these are generally used in conditions where the heart is beating too fast. In cases of heart failure or bradycardia (slow heart rate), Norvasc (Amlodipine) are calcium channel blockers without much effect on the heart rate, so they are safer to use with these patients.
Nitroglycerin, and all of its brand name counterparts such as Nitrostat, Nitro-Dur, Minitran to name a few, all belong to the drug class of nitrates. Nitrates are believed to dilate the arteries and veins in the body, correcting any imbalance in the flow or oxygen or blood to the heart. The widening of arteries and veins makes it easier for the heart to work which requires less blood and oxygen. In addition to that, Nitroglycerin also dilates blood vessels ensuring that oxygen is getting to all of the areas of heart tissue that need it the most.
Platelets are the remains of cells that circulate in the blood stream, initiating the formation of clots by clumping together. Antiplatelet drugs prevent this process from happening. Aspirin, which we have already discussed, is one type of antiplatelet agent. Additionally there are thienopyridines and glycoprotein IIb/IIIa inhibitors. Platelets naturally produce adenosine diphosphate (ADP). ADP sticks to the surface of the platelets, which promotes the clotting of the platelets. Thienopyridines block ADP from attaching to the platelet, therefore preventing the platelets from clotting. Plavix (Clopidogrel) and Ticlid (Ticlopidine) are both examples of thienopyridines. Drugs like Reopro (Abciximab) and Integrilin (Eptifibatide) are glycoprotein IIb/IIIa inhibitors. These drugs are administered intravenously and prevent blocking a different receptor for glycoprotein IIb/IIIa, which also prevents clumping.
Antiarrhythmic medications are used to correct irregularities or disturbances in the hearts rhythm. There is Quinidine, which goes by the brand names Quinidine Gluconate or Quinidine Sulfate, Procainamide or Pronestyl, and Disopyramide or Norpace all of which are classified as Class 1 Antiarrhythmic. These drugs interfere with sodium’s ability to pass into cells. This decreases the electrical stimulation of muscle cells. Class 2 antiarrhythmics are anti-sympathetic agents; all of these agents are beta blockers. Class 3 agents work by affecting the influx of potassium. Class 4 agents include verapamil and diltiazem. These are considered to be slow calcium channel blockers, decreasing conduction through the AV node. Digoxin and adenosine are classified as Class 5 antiarrhythmic agents.
A diagnosis of heart disease can be frightening. Gaining an understanding of the drug classes and all of the heart disease medications can help you to feel more in control while facing the changes that come with living with heart disease.
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