The correct actions during an attack of myocardial infarction, as well as adequate treatment after it, significantly increase the patient's chances of recovery. Every person diagnosed with coronary heart disease should know the rules of behavior in a similar situation. Timely help of medical workers, as well as inpatient treatment, is important here. In the hospital, the doctor will prescribe a number of drugs for the treatment of myocardial infarction. They will have a complex effect on the patient. The features of the treatment of heart attack will be discussed later.
Pathology Description
The attack is caused by certain heart diseases. The result is an acute shortage of blood supply. Local tissue necrosis develops in the heart muscle.
The onset of the attack is usually sudden. It is accompanied by prolonged pain (at least 40 minutes) behind the chest. When taking a dose of nitroglycerin, discomfort does not stop. In this case, the person urgently needs to provide medical care. Moreover, others must perform a series of actions before the arrival of an ambulance. The main symptoms of the attack, in addition to pain, are weakness, severe anxiety, nausea, and cold, clammy sweat. Rare symptoms are abdominal pain, shortness of breath, suffocation.
After the ambulance is called up, you need to perform several necessary tricks. A person is laid on his back so that he is comfortable. It is necessary that the patient's body be in a half-sitting position. Often lying on the back exactly to a person in this state is painful. The room has windows open. You need to remove a tie, belt and other tightening objects. The patient should sit still, you can’t panic.
To date, there are enough drugs for the treatment and prevention of myocardial infarction used in clinics. Some of them should always be in the patient's medicine cabinet for emergency cases.
First Aid Medicines
A person is given a nitroglycerin tablet under the tongue and sedative (for example, corvalol, motherwort tincture, etc.). Need to measure the pressure. If it does not exceed 130/90 mm RT. Art., nitroglycerin is given to the patient every 5 minutes. Before the arrival of an ambulance, you can give a person no more than 3 tablets. If after the first pill there is severe throbbing pain, the dose is reduced to ½ unit. When using a spray, its single dose is 0.4 mg.
If, after the first dose of nitroglycerin, blood pressure drops sharply, the drug is no longer taken.
It is necessary to give a tablet of aspirin in powdered form. The drug dilutes the blood. If the pulse does not exceed 70 beats per minute, the patient can be given a beta-blocker (for example, the drug "Atenol" in a dosage of 25-50 mg). Mustard is applied to the area of localization of pain. It must be ensured that there is no burn.
Complications
It is important to use suitable medications for treatment during first aid. After myocardial infarction, there is very little time for medical care. Therefore, people with a predisposition to develop an attack should know the exact actions in such a situation. If the patient suffers from bronchial asthma, beta-blockers are not accepted (while an ambulance is traveling). Also, a person should not have blood diseases. Otherwise, aspirin is contraindicated. All actions that can be taken during first aid should be consulted with your doctor.
In some cases, complications may occur. Before the doctor arrives, the person may pass out or the heart stops. If the patient lost consciousness, it must be put on the floor. A roller is placed under the shoulders. The head should be thrown back. It is advisable to get dentures from the patient's mouth, if any. When vomiting occurs, the person’s head is turned to one side.
If, during the provision of first aid, the patient's heart stopped, artificial respiration should be performed. This procedure is combined with indirect heart massage. The amount of pressure on the heart region is 75-80 times per minute. The frequency of inhalation of air in the mouth or nose should be 2 times every 30 strokes of the chest.
Inpatient treatment
After the ambulance arrives, doctors carry out a number of effects on the patient's body. Then he is taken to a hospital where treatment of myocardial infarction is carried out in a hospital. Drugs are the main component of the patient rehabilitation technique. Delivery of the patient to a medical facility should be carried out within 30 minutes. If, due to certain circumstances, this is not possible, ambulance officers administer thrombolytics to restore coronary blood flow. These drugs include Purorolase, Alteplase and similar formulations.
The patient is taken out of the house on a stretcher. While an ambulance takes him to the hospital, the patient is ventilated with moistened oxygen. This reduces the burden on the heart, avoiding complications.
First of all, drugs are introduced to suppress the patient's excited state. To do this, use a composition such as Talomonal or a mixture of Fentanyl and Droperidol.
Next, an attack of acute pain is stopped. This procedure is performed by the ambulance team, as well as the medical staff of the hospital. Analgin or narcotic drugs such as morphine and the like may be used. These drugs are combined with Atropine and antihistamines, such as diphenhydramine. To accelerate the effect, drugs are administered intravenously. In addition, sedatives "Relanium", "Seduxen" are prescribed.
Different groups of drugs for the treatment of myocardial infarction in a hospital are prescribed after a deep examination of the patient. An electrocardiogram is performed. For some, prolonged hospitalization is recommended to reduce the lesion. In this case, thrombolytic therapy may be required to normalize coronary blood flow.
Statins
As a rule, the groups of drugs prescribed in the hospital for the treatment of myocardial infarction are selected according to the individual condition of the patient. They have a complex effect on the body, allowing you to overcome an attack. Properly selected funds do not allow its development in the future. The main groups of drugs that are used in the treatment of the disease are as follows:
- statins
- ACE inhibitors, ARBs;
- beta blockers;
- nitro drugs;
- anticoagulants, antiplatelet agents.
In addition to drug treatment, maintenance therapy is prescribed. Stop taking drugs without the permission of a doctor is prohibited. Even if the patient feels well, such unauthorized actions are unacceptable.
Today, many medications have been developed to maintain the body that modern pharmacology offers. Preparations for the treatment of myocardial infarction are divided into groups, of which statins are mandatory. They control the level of cholesterol in the body. The metabolism of this substance is accelerated when taking statins. This process occurs in the liver.
The presented group of medicines does not allow cholesterol in excess to enter the bloodstream. It ceases to settle on the walls of blood vessels. This allows you to maintain a sufficient level of blood supply in the heart muscle. Without taking statins, it will not be possible to restore its proper functioning. Statins include:
- Simgal.
- "Simvastatin."
- "Simol."
- Zokor.
- "Vasilip".
The dosage is prescribed by the doctor depending on the weight of the patient. It can vary between 10-80 mg. In addition to the listed drugs to normalize metabolic processes, the doctor can prescribe medications created on the basis of lovastatin, pravastatin, fluvastatin. The most popular are rosuvastatin-based drugs. These include Tevastor, Krestor, Livazo and others.
Beta blockers
Considering which drugs for the treatment of myocardial infarction are used by modern medicine, you should pay attention to such a group of medicines as beta-blockers. They do not allow receptors to respond, which are responsible for increasing blood pressure on the walls of blood vessels. Otherwise, the frequency of myocardial contraction increases, the load on the muscle increases.
Beta blockers are divided into two subgroups. Their task is the same. Only the ways to achieve the goal differ. Drugs such as Bisoprolol, Atenolol, Concor, etc. have a selective effect on the receptors. The following drugs soften the effects of drugs that stimulate high blood pressure: Nadolol, Pindolol, Sotalol and others .
Before prescribing such a drug, the doctor takes into account the characteristics of the patient's body. He must determine his age, blood pressure level, as well as a number of other parameters. The presented drugs can stabilize the pressure in the vessels. The myocardium becomes less susceptible to toxins. The affected area, which was formed as a result of a heart attack, is reduced.
Inhibitors of ARB, ACE
Considering the groups of drugs for the treatment of myocardial infarction, it is necessary to identify inhibitors of ARB, ACE. They are aimed at reducing the body's production of substances that help to reduce the lumen of blood vessels. In complex treatment, such medications help lower blood pressure. They reduce blood flow to the myocardium. The burden on the kidneys is also reduced.
Inhibitors of ARB and ACE have approximately the same effect. However, there are some differences. ACE inhibitors include drugs such as Enap, Lisinopril, Captopril, etc. Drugs are recommended to be taken before meals. The dosage is prescribed by the doctor individually for each patient. One of the ACE inhibitors is used once a day.
ARB inhibitors have a similar effect on the body. They act on certain receptors. In vessels, they respond to the presence of angiotensin. ARB inhibitors help maintain a normal lumen of the vascular bed. They do not narrow, which helps to maintain a normal level of blood pressure. Also, the presented category of drugs does not allow the walls of the myocardium to grow. This reduces the risk of having a second attack.
The pharmaceutical market offers many such drugs for the treatment of myocardial infarction. The names of the most famous ARB inhibitors are as follows: “Atakand”, “Diovan”, “Angiakand”, “Losartan” and others. Dosage is monitored by the physician during treatment of the patient. The patient should take similar drugs even after discharge from the hospital.
Nitro drugs
Another group of drugs is used to treat myocardial infarction - nitro drugs. They are able to increase the amount of nitric oxide in the blood. This contributes to the relaxation of blood vessels. The flow of venous blood to the heart is reduced. Myocardial tension from this decreases. Such an effect reduces pain.
Nitro drugs are used as an emergency aid in the development of an attack. With prolonged use, the presented group of medicines significantly reduces the risk of a heart attack. To treat the effects of an attack, certain nitro drugs are used:
- Trinitrolong. Plates with the substance are fixed on the gums. The drug is gradually released, providing a lasting effect on the body.
- "Sustonit." It is taken orally. Its dosage is quite large (prescribed by a doctor). The action is quite long.
- "Sustak." Available in capsule form. They are washed down with water. You can not chew the drug.
- Nitrong Means of long action.
- Nitro-Mac. Performs the functions assigned to it within 8-10 hours.
- "Sustabukkal." Lozenges. Long exposure to the body.
The listed funds are made on the basis of nitroglycerin. Excipients, which are part of such medications, give them a prolonged effect, which is important for the condition after myocardial infarction. Drugs for the treatment of ailment based on nitroglycerin are used in combination with ointments (Nitrol, Miovin, etc.).
Anticoagulants
If the blood is too thick, it becomes harder for the heart to pump it. This leads to increased pressure. Oxygen deficiency in tissues also develops. This reduces the likelihood of a heart attack again. Anticoagulants thin the blood, do not allow the appearance of clots in it.
One of these medicines is Arikstra. The composition contains fondaparinux sodium and is actively used in the treatment of myocardial infarction. Preparations and doses are prescribed by the supervising doctor. The presented drug is administered subcutaneously. The dosage is prescribed based on blood coagulation indicators. It can be 2.5-10 mg.
For intravenous injection, Heparin is used. Similar drugs are Gempaksan, Eniksum, Kleksan. They are made on the basis of low molecular weight heparin. Medications of this class are prescribed in a dosage of 20 to 40 mg. The course lasts 1-5 weeks.
The drug "Pradax" is available in the form of capsules. They take 1-2 pcs. The tool can be taken no more than a year. Blood coagulability decreases markedly. Blood clots do not form during a therapeutic course. However, the doctor monitors the coagulogram indicators throughout the treatment.
Antiplatelet agents
Sometimes taking these medicines is not enough. With a prolonged effect on blood coagulability, such drugs are prescribed for the treatment of myocardial infarction, as antiplatelet agents, for example, Aspirin Cardio. It has a cautious effect on blood cells. This reduces side effects when taking the drug. Modern antiplatelet agents are:
- Brilinta. The first dose is 180 mg. These are 2 tablets. After this, this dose is divided into 2 doses.
- "The effect." A single initial dose is 60 mg. Then the drug is drunk daily at 10 m. The duration of the course is prescribed by the doctor.
Taking antiplatelet agents also has certain limitations. Otherwise, the likelihood of bleeding increases. This must be taken into account during therapy. Drugs for the treatment of myocardial infarction are combined with a diet. The patient must follow the doctor's instructions exactly so that the attack does not recur.
Having considered modern drugs for the treatment of myocardial infarction, you can understand the features of therapy. Correct action avoids relapse.