Types of Medications for Heart Attack Prevention and Treatment
Medically reviewed by Femi Aremu, PharmDMedically reviewed by Femi Aremu, PharmDIf you are recovering from a heart attack, your healthcare provider may prescribe medication to lower the risk of it happening again. These treatments can serve several purposes, such as lowering blood pressure, preventing blood clots, and improving blood flow.Certain medications may also be given during the actual event. These may help relieve symptoms (such as chest pain), improve blood flow, or dissolve blood clots.Always call 911 if you or someone else is having a suspected heart attack. Prompt medical treatment can save a person's life.
When to Call 911If you or anyone else is having a heart attack, immediately call 911 first.The symptoms of a heart attack may include:Chest discomfort, such as uncomfortable pressure, squeezing, fullness, or pain in the center of the chest that lasts more than a few minutes or goes away and comes backDiscomfort in other upper body areas in one or both arms, the back, neck, jaw, or stomachPale, gray, or bluish skinFeelings of anxiety or impending doomShortness of breathCold sweatNausea or vomitingLightheadedness or dizzinessUnresponsiveness
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ACE Inhibitors and ARBsAngiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARB) drugs lower blood pressure to reduce the workload on the heart and blood vessels.Both these drugs are taken to improve the symptoms of heart disease. They are also helpful in treating people who have had a previous heart attack.Common ACE drugs include:Lotensin (benazepril)Vasotec (enalapril)Zestril (lisinopril)QuinaprilMoexiprilAltace (ramipril)Common ARBs include:Edarbi (azilsartan)Atacand (candesartan)Cozaar (losartan)Benicar (olmesartan)Avapro (irbesartan)Micardis (telmisartan) Diovan (valsartan)
Boxed Warning for PregnancyACE inhibitors and ARBs have a boxed warning due to the potential safety risks of taking them during pregnancy. According to their labels, these medications should not be taken during the second and third trimesters.
Antiplatelet DrugsAntiplatelet drugs are a type of blood-thinning medicine. They make platelets less sticky, preventing platelet clumping or aggregation and blood clot formation in the arteries.Aspirin is a common antiplatelet drug for preventing further heart attacks. It is typically only for people who have had a previous heart attack or stroke. Starting regular aspirin treatment in people over the age of 70 is also not recommended.Long-term aspirin use in people without a history of heart attack or stroke may lead to negative complications that outweigh its benefits. Because circumstances may vary from person to person, make sure you consult your provider before starting aspirin as a preventive therapy.P2Y12 receptor blockers are another group of antiplatelet medications. These include:Plavix (clopidogrel)Brilinta (ticagrelor)Effient (prasugrel)Kengreal (cangrelor)Ticlopidine
Warnings for Brilinta and EffientThe U.S. Food and Drug Administration (FDA) has issued several safety precautions regarding Brilinta and Effient, which can cause bleeding issues. People with a history of intracranial hemorrhage or with active bleeding, such as a peptic ulcer, should not take them.People undergoing urgent coronary artery bypass graft (CABG) surgery should also refrain from taking them. They should stop Brilinta and Effient at least seven days before their CABG surgery if possible.Effient is also not recommended for people older than 75 due to its increased risk of bleeding.
Beta-BlockersBeta-blockers are commonly prescribed after a heart attack to prevent the risk of future heart attack, chest pain, and irregular heartbeats.Beta-blockers lower blood pressure by inhibiting certain hormones, such as adrenaline. They slow the heart rate and force of contraction but increase oxygen supply by improving blood flow.The most commonly prescribed beta-blockers include:Lopressor (metoprolol)Tenormin (atenolol)Toprol XL (metoprolol)NadololInderal LA (propranolol)AcebutololBetaxololBetapace (sotalol)BisoprololZiac (bisoprolol/hydrochlorothiazide)AnticoagulantsBlood thinners, such as anticoagulants, prevent the formation of blood clots in the blood. However, they do not break existing blood clots; they stop them from increasing in size.Anticoagulants are taken to prevent a heart attack. These include:HeparinVitamin K antagonists such as Jantoven (warfarin)Eliquis (apixaban) Pradaxa (dabigatran)Savaysa (edoxaban)Xarelto (rivaroxaban)
Boxed WarningsStopping anticoagulants too soon can increase the risk of life-threatening blood clots. If you need to stop taking it, your healthcare provider may prescribe a different type of medication to prevent blood clot formation.Additionally, people who take anticoagulants are at a greater risk of an epidural or spinal hematoma while undergoing anesthesia or spinal puncture.
NitratesNitrates are helpful in the management and treatment of angina (chest pain). Nitrates were first discovered in 1847 as a treatment for chest pain.They work by dilating the blood vessels and reducing stress on the heart by improving blood flow to the heart muscles. The heart does not need to work as hard and, therefore, does not need as much oxygen.The main types of nitrates include:Nitrostat (nitroglycerin): taken for angina pectoris (treatment/prevention), acute coronary syndrome, heart failure, hypertension (high blood pressure)Monoket (isosorbide mononitrate): taken for chronic angina pectoris (treatment)Isosorbide dinitrate: taken for chronic angina pectoris (treatment/prevention)Nitrates are commonly taken to prevent angina, limit the number of angina attacks, relieve the pain of a current attack, or treat the symptoms of heart failure.Short-acting sublingual (under the tongue) nitroglycerine is currently recommended for all people as the best first-line treatment for immediate relief of acute angina symptoms. Long-acting nitrates are essential second-line preventive drugs.StatinsStatins are a class of medicines that can help lower the low-density lipoprotein (LDL) cholesterol (also known as "bad" cholesterol) levels in the blood. Excess cholesterol can lead to plaque buildup in the arteries, causing heart diseases. Statins have a potent lipid-lowering effect that reduces cardiovascular risk and decreases mortality.They work to:Slow down LDL cholesterol production in the liver.Increase the liver's ability to remove LDL cholesterol in the blood.Reduce the formation of plaques in the arteries.Lower the triglyceride level.Studies have shown that statins lower the risk of heart attack in people with high LDL cholesterol. Statins effectively treat or reduce the risk of heart attack due to their anti-inflammatory, antithrombotic, and antioxidant effects.Some common statins include:Lipitor (atorvastatin)Lescol XL (fluvastatin)LovastatinAltoprev (lovastatin ER)Livalo (pitavastatin)PravastatinCrestor (rosuvastatin)Zocor (simvastatin)They are also available as combination products, including Vytorin (simvastatin/ezetimibe).ThrombolyticsThrombolytic drugs, also known as clot busters, are taken for the emergency treatment of heart attacks. They work by dissolving a blood clot to improve blood flow to the heart and prevent ischemic (damage to the part of the body due to insufficient blood and oxygen supply) to the heart muscle. They can also stop a potentially deadly heart attack.The American College of Cardiology and the American Heart Association suggest that, ideally, a person should receive a thrombolytic drug within 30 minutes of reaching the hospital.Thrombolytic drugs are only taken for a specific type of heart attack called an ST elevation myocardial infarction (STEMI), where particular changes will appear on an electrocardiogram (ECG).The most common thrombolytic drugs are tissue plasminogen activators (tPAs). Examples of thrombolytic drugs include Activase (alteplase) and Retavase (reteplase).
What Is a Myocardial Infarction?A myocardial infarction is the medical term for a heart attack. Heart attacks happen when the blood flow to the heart is blocked, which stops the heart from receiving the oxygen it needs.Importantly, heart attacks, or myocardial infarctions, are not the same as cardiac arrests, which occur when the heart stops suddenly. However, heart attacks can cause cardiac arrests.
Other MedicationsAlong with these drugs, several other classes of drugs can treat the symptoms of heart attack and other cardiovascular problems. These may include:Calcium channel blockers such as Norvasc (amlodipine), Cardizem (diltiazem), and othersDigitalis preparations, such as Lanoxin (digoxin)Diuretics, such as Lasix (furosemide), Aldactone (spironolactone), and othersSummaryHeart attacks can have major complications and even a deadly outcome if left untreated. Taking medication prevents and treats heart attacks from occurring if you are at a high risk of having them.Your healthcare provider will prescribe the suitable medicine or a combination of medicines to control your symptoms. However, improving your lifestyle and activities is also important to prevent heart disease and limit your risk of future events. Read the original article on Verywell Health.
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