Medication after a heart attack
After a heart attack, it is necessary to start a drug therapy to prevent a new heart attack.The basic drugs used for treatment are so-called platelet aggregation inhibitors, which inhibit the clumping of blood platelets (thrombocytes) and thus prevent a new blood clot from triggering another heart attack. Well-known representatives of this group of drugs include acetylsalicylic acid (ASA), clopidogrel, prasugrel, ticagrelor, abciximab and tirofiban. Side effects of these drugs are an increased risk of bleeding in the gastrointestinal tract if taken continuously and heavy bleeding is possible with even minor injuries.
Another group of medications, the so-called anticoagulants, are also used in the treatment of a heart attack, especially if the left ventricle is affected or atrial fibrillation has remained. Anticoagulants such as phenprocoumon (Marcumar®), warfarin, dabigatran or rivaroxaban reduce the blood‘s ability to clot. When treated with anticoagulants, regular blood checks must be performed to ensure that the blood clotting factors are at an ideal level.
Side effects include bleeding from the nose and gums, and there is a risk of osteoporosis (bone loss) if taken continuously. Drugs that lower blood pressure are also used in the treatment of heart attacks. These include beta blockers, ACE inhibitors and angiotensin receptor blockers.
Beta blockers are used to prevent a new heart attack or the occurrence of ventricular fibrillation. Beta-blockers such as atenolol, bisoprolol, metoprolol or propanolol slow down the pulse, which means that the heart uses less oxygen and blood pressure drops. Beta-blockers can also cause undesirable side effects, such as a disturbance of the excitation conduction of the heart, the heart conduction can be critically lowered and beta-blockers may have a constricting effect on the bronchial tubes.
For this reason, people with severe heart failure or allergic bronchial asthma should not be treated with beta blockers. ACE inhibitors also lower blood pressure and have a positive effect on the growth of vascular wall and heart muscle cells after a heart attack. If diabetes mellitus or cardiac insufficiency exists in addition to a heart attack, ACE inhibitors such as captopril, enalapril or ramipril are among the drugs of first choice.
The most common side effect of ACE inhibitors is a nagging cough, which in some cases leads to discontinuation of the drug or a switch to angiotensin receptor blockers (very similar effect to ACE inhibitors). Statins also play a role in the therapy of myocardial infarction. Statins inhibit the production of cholesterol in the liver and thus reduce the concentration of excess cholesterol in the body, which is deposited on the walls of blood vessels and closes them.
This mechanism is considered the main cause of heart attacks. Side effects of statins include gastrointestinal complaints, liver damage and muscle pain, as well as psychological side effects (such as aggressiveness, memory loss and lack of concentration), which is why careful medical supervision is necessary when taking statins. The following topics may also be of interest to you: Medications for high blood pressure
