General Advice on Medication

Thrombolytics (Streptokinase/TPA) --- These drugs are meant to dissolve the clot which causes the "heart attack" but it can not repair any damage that has already been done. These drugs are more effective the sooner they're given. They need to be administered within hours of the first onset of chest pain. As a lot of things will be happening at the time of your admission, you may have forgotten whether this was given or not; so you should ask your doctor about the details of the drugs given to you. Usually you are given a card which states which drug has given to you. You should keep the card with you because it will be important for the other doctor who may treat you for any further attacks.

Analgesics - (Pain Killers) --- You may have been given a strong pain killing injection when you arrived at hospital. This injection will have made you drowsy and perhaps made you feel sick. If given morphine, you would have probably been given an ant emetic to counteract the nausea.

Aspirin --- Small doses of aspirin reduces the stickiness of the blood and so as a result the chances of having another heart attack or stroke reduce. The aspirin must be taken regularly, perhaps for the rest of the person’s life.

Beta-Blockers (e.g. Atenolol, Bisoprolol, Metoprolol) --- Beta-blockers help the recovery from a heart attack by reducing the work the heart has to do whilst it recovers. They are also used to treat angina and high blood pressure. As you will have seen, high blood pressure can increase the chances of having a further heart attack, so beta-blockers can provide a “double benefit” in recovery from a heart attack. Beta blockers are not suitable for those suffering from poor circulation or asthma.

ACE inhibitors (e.g. Ramipril, Lisinopril, Enalapril) -- Like beta blockers, ACE inhibitors also help to reduce the stress on the heart during the recovery process. ACE inhibitors work by a combination of dilating blood vessels (like nitrates) and increasing urine output. They are also used to treat high blood pressure, so (like beta blockers), provide double benefit.

Lipid-lowering agents (e.g. Simvastatin, Atorvastatin) -- Cholesterol increases the risk of a heart attack. This is particularly true when a person has already had a heart attack. If your cholesterol level is raised, the usual method of handling this is initially by diet. Some people, however, inherit a tendency to have high cholesterol levels, and can't keep them down no matter how well they control their diet. If diet alone fails to control cholesterol levels, it may be necessary to use one of a group of drugs known as “statins”. Most commonly used statins are simvastatin and pravastatin. These drugs can markedly reduce the chances of another heart attack, when used together with a sensible and healthy diet.

Nitrates (Includes GTN Spray) ---- Nitrates are mainly used to treat angina, and sometimes to treat heart attack. They dilate the blood vessels in the circulatory system which reduces the resistance to blood flow, and hence reduces the amount of work the heart has to do. They can be used to give immediate relief from an attack of angina, usually by using a spray applied under the tongue.
Imdur, Elantan, Isosorbide Mononitrate ------- If you suffer frequent attacks, you may be given tablets of Imdur, Elantan, Isosorbide or Mononitrate to provide a constant level of nitrate in the blood, topped up with the spray when necessary. You may experience a headache when first using nitrates, although this usually becomes less troublesome once treatment has continued for some time.

Some Common Drugs Explained