Bronchial asthma and diseases of the cardiovascular system. Basic drugs for angina pectoris
If you have been diagnosed with coronary heart disease, angina pectoris, your doctor will definitely prescribe you treatment - drug therapy, which he will recommend taking constantly, without breaks. Why do you need to take medications regularly? And what drugs are used to treat angina pectoris, in what doses.
The first and most important thing in the presence of angina pectoris: prevent complications of the disease (myocardial infarction, life-threatening disorders heart rate, development of severe heart failure) and death, prolong your life.
Second and no less significant: improve the quality of your life, make it complete, eliminate pain.
There are several main groups medicines for the treatment of angina pectoris. Let's figure out how they work and why doctors prescribe them for treatment.
Treatment of angina pectoris: drugs and doses
Treatment of angina pectoris involves taking medications such as antiplatelet agents, statins, beta blockers, calcium antagonists, inhibitors, nitrates, and cytoprotectors. Doses are prescribed by a doctor.
Antiaggregates help prevent the formation of blood clots (thrombi), reduce the aggregation (sticking together) of platelets - blood cells that are responsible for the formation of a blood clot. The list of antiplatelet agents includes: aspirin, cardiomagnyl, thienopyridines.
Antiaggregates
Aspirin (acetylsalicylic acid)
Aspirin(acetylsalicylic acid) is the main antiplatelet agent; it is prescribed to all patients suffering from angina (with the exception of those who cannot tolerate it, for example, allergy sufferers with the “aspirin triad”). The dose of aspirin is 75-150 mg daily. Taken once, every 20-30 minutes. after meal. Typically in the afternoon.
Pay attention to the low dose! IN regular tablet aspirin 500 mg, this dose has been taken as an analgesic and antipyretic for more than 100 years! For angina pectoris, no more than 1/4 tablet is recommended. This dose effectively prevents thrombosis and is quite safe for the stomach. When taking aspirin regularly ( acetylsalicylic acid) more high doses there is a possibility of developing erosions and stomach ulcers.
Since patients with angina pectoris require constant use of aspirin as treatment, special, safer forms for long-term use have been developed.
Cardiomagnyl (aspirin + magnesium hydroxide)
Cardiomagnyl (aspirin + magnesium hydroxide) 75 and 150 mg. Magnesium hydroxide, which is part of the tablet, stimulates the formation of special protective substances in the stomach wall of a patient with angina pectoris that prevent the formation of ulcers and erosions.
Enteric-coated aspirin (AspirinCardio 100 mg, ThromboAss 50 and 100 mg, CardiASK 50 mg, etc.). The special coating does not allow the tablet to dissolve in the stomach; absorption of aspirin occurs in the intestines. Important: these tablets must be taken whole, you cannot break them or chew them (otherwise you will damage the shell and the protective effect will disappear)!
Thienopyridines (clopidogrel, prasugrel, ticlopidine)
Thienopyridines (clopidogrel, prasugrel, ticlopidine) - have a very pronounced antiplatelet effect, hundreds of times stronger than aspirin. The prescription of these drugs (usually together with aspirin) is necessary in cases where the risk of thrombosis is very high: unstable angina, acute coronary syndrome(“pre-infarction conditions”), acute myocardial infarction and operations on the heart vessels (stenting, coronary artery bypass grafting, etc.).
Thienopyridines are also prescribed as a treatment for those patients who cannot take aspirin due to intolerance or contraindications.
Important: Tell your doctor if you have previously had a stomach ulcer, duodenum(DPK) or erosive gastritis, as well as unstable blood pressure with frequent crises, rises above 160-170/100 mm Hg. Art. This information will help your doctor make your antiplatelet treatment safe.
It has been proven that regular use of antiplatelet drugs can reduce the incidence of myocardial infarction, strokes and death in patients with angina pectoris by up to 23% (in every 23 people out of 100)!
After coronary angioplasty and stenting operations, doctors recommend joint reception aspirin and clopidogrel for a certain period (from a month to several years).
Statins
Statins- anti-atherosclerotic drugs, reduce the level of “bad” cholesterol in the blood (total cholesterol, LDL, triglycerides), increase the level of “good” cholesterol (HDL). At long-term use the drug in a dose that allows you to control cholesterol at the target level is capable of stop the growth of atherosclerotic plaques and even reduce their size. Target cholesterol levels depend on the prevalence of atherosclerosis in the body and concomitant diseases(for example, diabetes mellitus). Ask your doctor what your target levels should be and monitor the effectiveness of treatment (blood tests for cholesterol and lipids) at least 4 times a year.
There is no habituation to statins or development of dependence; treatment with statins should be carried out continuously. If you stop taking it on your own, then within one month after stopping the drug, your blood lipid levels return to baseline.
Statins are capable reduce the risk of myocardial infarction and stroke up to 30-40% (in every 30-40 people out of 100), and in diabetics this effect is more pronounced! The fact that statins save lives became known after several large studies involving thousands and tens of thousands of patients with angina pectoris, diabetes mellitus, peripheral atherosclerosis.
Four drugs in this group are registered in Russia: simvastatin (Zocor), rosuvastatin (Crestor), atorvastatin (Liprimar) and fluvastatin (Leskol).
How to take statins
Take statins in the evening (before bedtime). There are medications that can be taken at any time of the day. Nausea and stool disturbances are possible. The use of statins is not recommended for persons with active liver disease or during pregnancy and breastfeeding. Very rare undesirable effect- muscle pain. If you start taking the drug and notice soreness in all the muscles of your body, be sure to tell your doctor to avoid unwanted complications.
If you do not tolerate statins well or taking the maximum therapeutic dose does not allow you to control lipid levels, then it is possible to reduce the dose and add a cholesterol absorption inhibitor, ezetimibe. Your doctor may also recommend the use of other lipid-lowering drugs for treatment: fibrates, nicotinic acid delayed release.
Beta blockers
Beta blockers- reduce the heart rate (pulse), thereby reducing the work performed by the heart and the need of the heart muscle (myocardium) for oxygen, improving blood supply to the heart, reducing the number of angina attacks and increasing exercise tolerance.
Beta blockers prevent and treat abnormal heart rhythms (arrhythmias). This is especially important after suffered a heart attack myocardium, when arrhythmia often becomes life-threatening. Regular intake of beta-blockers can prevent the death of patients who have had a heart attack, up to 40% (in every 40 people out of 100!). Therefore, they are recommended to be prescribed to all patients after a heart attack, in the absence of contraindications.
Beta blockers normalize blood pressure. In most patients, angina pectoris is combined with arterial hypertension, in this case, taking a beta-blocker "kills two birds with one stone" - we treat hypertension and angina at the same time.
Some beta-blockers have proven to be able to prevent the development of heart failure. These include metaprolol succinate (BetalocZOK), bisoprolol (Concor), nebivalol (Nebilet), carvedilol (Dilatrend). This effect, as well as all of the above, is possible only with regular long-term use of the drug.
How to take beta blockers
Take a beta blocker daily, in the morning (long-acting drugs, about 24 hours) or twice a day (morning and evening). The dose of the beta blocker is selected individually. The dose is considered effective if your heart rate while taking the drug at rest is 50-60 beats per minute. In this case, everything appears medicinal effects drug.
You should not suddenly stop taking the beta blocker - in the first days, your pulse may reflexively increase sharply and your health will worsen. In those patients with angina who are taking a beta blocker to maintain correct rhythm and prevention of arrhythmia, after discontinuation, interruptions in heart function may resume.
Undesirable effects of beta blockers are characteristic mainly of non-cardioselective drugs (for example, decreased potency), and in modern highly cardioselective drugs they occur rarely, usually with increasing doses. It is undesirable to prescribe beta blockers to patients with bronchial asthma and chronic obstructive pulmonary disease (COPD), atherosclerotic artery disease lower limbs(obliterating atherosclerosis).
Calcium agonists
Calcium agonists- are able to dilate the vessels of the heart, increasing the flow of blood to the heart muscle (myocardium), thereby reducing the number of angina attacks. They are divided into three main groups with characteristic features.
Drugs from the group of dihydropyridine calcium antagonists (nifedipine) can be prescribed together with beta blockers, or instead of beta blockers (if intolerance or contraindications to the latter). The first generations (nifedipine) increase the heart rate, so the tablets short acting(nifedipine 10 mg) is prohibited for angina pectoris. There are special prolonged forms (osmo-adalat, corinfar-retard, nifecard) containing from 20 to 60 mg of nifedipine. The third generation of drugs (amlodipine, felodipine) practically does not increase the pulse rate and is taken once a day.
Drugs from the verapamil and diltiazem group reduce the heart rate; combined use with beta blockers is contraindicated due to the risk of bradycardia and other complications. It has been proven that regular use of calcium antagonists can reduce the incidence of strokes.
If-channel inhibitors (coraxan)
If channel inhibitors, the only representative today is ivabradine (Coraxan). The drug is able to reduce the heart rate (pulse), thereby reducing the number of angina attacks. Unlike beta blockers, this inhibitor is effective only in sinus rhythm, does not affect cardiac arrhythmias and blood pressure, and is symptomatic drug(eliminates symptoms of the disease). The effect on the prognosis has not yet been proven (research is ongoing). An inhibitor can be prescribed instead of beta blockers (if intolerable or contraindicated to the latter) or together with beta blockers to achieve target value Heart rate (50-60 beats per minute).
How to take Coraxan
Coraxan is taken 2.5-5-7.5 mg 2 times a day (morning and evening). Ivabradine is not recommended if:
Heart rate at rest is below 60 beats/min (before treatment), severe arterial hypotension (SBP - below 90 mm Hg and DBP - below 50 mm Hg), severe liver failure is present, weakness syndrome is diagnosed sinus node, sinoatrial block or AV block III degree, permanent form of atrial fibrillation, chronic heart failure III-IV stages according to the NYHA classification (there is not enough clinical data yet), an artificial pacemaker was implanted.
Angiotensin-converting enzyme inhibitors (ACEIs)
Angiotensin converting enzyme inhibitors(ACEI) - for angina pectoris, they are prescribed to prevent the development of heart failure. Therefore, drug doses are usually lower than for the treatment of hypertension. If after a MI you develop symptoms of heart failure or doctors identify impaired LV function, adding an ACE inhibitor to your therapy will significantly reduce the risk of death and the likelihood of a recurrent MI. The effect of drugs such as ramipril, trandolapril, zofenopril, enalapril has been proven. If these drugs are poorly tolerated, it is possible to replace them with angiotensin receptor antagonists.
ACE inhibitors can be prescribed for angina pectoris and without a history of myocardial infarction - their ability to slow down the progression of atherosclerosis has been proven. The effect of the drugs ramipril and perindopril has been proven.
Nitrates
Nitrates- used to relieve anginal pain due to angina pectoris for more than 100 years! They are symptomatic (painkillers) drugs, do not affect mortality and life expectancy. The effect of nitrates is to short-term expansion of blood vessels supplying the heart.
There are many forms of nitrate release, for various situations. For example - short-acting nitrates, nitroglycerin in the form of sublingual tablets (under the tongue), spray (Izoket, Nitromint, etc.) for quick removal an attack of angina. Instantly relieves pain, lasts for 10-15 minutes. They are used not only to stop an attack that has already occurred, but also to prevent it (for example, before the start of physical activity or in other situations in which, in your opinion, an angina attack may develop). Capable of sharply reducing blood pressure for a short time.
Rules for using short-acting nitroglycerin:
Nitrates of moderate duration of action (nitrosorbitol, isosorbide mononitrate and dinitrate 20 and 40 mg, etc.) act for several hours (up to 6 hours) and are used to prevent angina attacks. As a rule, these forms of nitrates are prescribed 2-3 times a day. Remember - if nitrates enter your body continuously, then after a few days the sensitivity of your vessels to nitroglycerin will decrease significantly and the drug will no longer prevent angina attacks. Therefore, when treating with nitrates average duration action requires “nitrate-free intervals” of up to 6-8 hours. Your doctor will prescribe you to take the drug for the morning and afternoon (before 17.00), or for the afternoon and evening, etc. Avoid developing tolerance to nitrates long-acting nitrates(retarded forms of nitrates, 50 mg). Such drugs are taken once a day, the effect lasts up to 10 hours, providing the necessary intervals to restore vascular sensitivity.
Remember: Long-acting nitrates cannot be the main method of treatment! It is recommended to prescribe nitrates only if you are taking the main groups of drugs in an effective dose, but you continue to have angina attacks. Short-acting nitrates - used as required.
Taking nitrates is relatively often associated with the appearance of side effects(primarily headaches), the development of addiction (tolerance) to the drug when taken regularly, the possibility of “rebound” syndrome when the drug enters the body abruptly.
Cytoprotectors
Cytoprotectors- protect against the death of heart muscle cells during episodes of acute and chronic oxygen deficiency (ischemia), allowing the cells to produce energy to contract the heart using less oxygen. There is an evidence base for the drug trimetazidine (Preductal MV). The drug has no contraindications (except for individual intolerance) and side effects.
Doctor-patient partnership- pledge successful treatment angina pectoris.
Pharmacological group.
Alpha and beta blockers.
Effect of the drug
The drug reduces the load on the heart, dilates peripheral vessels and reduces the heart's need for oxygen. Due to this, the heart rate decreases and the blood pressure.
Indications for use
Angina pectoris.
Contraindications
Bradycardia, that is, a decrease in heart rate below 50 beats per minute, a decrease in blood pressure (hypotension).
Liver dysfunction.
Severe degree of heart failure.
Liver failure.
Heart rhythm disturbances.
Side effects
Gastrointestinal tract: diarrhea, nausea, vomiting, loss of appetite. Cardiovascular system: arrhythmias, cold hands and feet, pain in the heart, decreased heart rate, swelling of the ankles. Nervous system: headache, insomnia, or, conversely, increased drowsiness, mood changes and increased fatigue.
Urinary system: urinary disorders.
Respiratory system: shortness of breath (feeling of lack of air) and bronchospasm. Reproductive system: problems with potency in men.
Blood: increased bleeding, increased blood sugar and cholesterol levels. Reduced tear production and dry mouth.
Weight loss.
Bones and muscles: pain in muscles and joints. Allergic reactions: skin rash and itching.
During the first two weeks, the drug is prescribed at 12.5 mg twice a day. Then the dose is increased to 100 mg per day (that is, 50 mg 2 times a day). By decision of the attending physician, in the absence of proper therapeutic treatment the dose can be increased further.
Dosage of the drug for children
It is still not recommended to use the drug during pregnancy, because it has been established that this leads to a slower heartbeat of the fetus, a decrease in its blood pressure and the occurrence of oxygen deficiency.
When prescribing the drug to a nursing mother, her child should be switched to artificial formula.
Remarks
Discontinuation of the drug should be gradual. Do not use the drug at the same time as drinking alcohol. People suffering from psoriasis should take the drug with caution.
AMLOTOP
Pharmacological group
This drug belongs to the group of calcium channel blockers.
Release form
Available in tablets of 5 and 10 mg.
Effect of the drug
It has a long-term antihypertensive effect, that is, it reduces high blood pressure (the effect of the drug lasts a day).
The drug also has an antianginal effect, that is, it dilates peripheral blood vessels and reduces the heart’s need for oxygen.
Indications for use
Angina pectoris.
Contraindications
Fainting (collapse).
The drug should be used with caution in elderly patients and people with diabetes.
Side effects
Gastrointestinal tract: pain in the stomach, nausea and vomiting, pencreatitis, dry mouth, bloating, bowel problems (diarrhea or constipation).
Nervous system: mood changes, headache and dizziness, decreased sensitivity, depression, sleep disturbances, increased fatigue and irritability.
Cardiovascular system: shortness of breath (feeling of lack of air), arrhythmias, swelling of the ankles, chest pain.
Urinary system: increased frequency of urination, increased number of urinations at night. Reproductive system: impaired potency. Bones and muscles: pain in joints and muscles. Changes in body weight, both upward and downward. Skin: increased sweating. Allergic reactions: skin rash and itching, angioedema.
Dosage of the drug for adults
The initial dose of the drug is 5 mg per day, then it is increased to 10 mg per day. The attending doctor selects the dose. He also determines the duration of treatment.
Dosage of the drug for children
The
Use of the drug during pregnancy and lactation
Amlotop should not be used during pregnancy and breastfeeding.
Remarks
A gradual reduction in the dose of the drug is required; abrupt withdrawal is prohibited. It is necessary to closely monitor your body weight and reduce the amount of salt consumed. During treatment with the drug, you must carefully monitor your condition. oral cavity and visit the dentist.
PRESTARIUM
Pharmacological group
ACE inhibitor.
Release form
The drug is available in tablets of 2.4 and 8 mg.
Effect of the drug
The drug helps lower blood pressure, normalizes heart function, and reduces the load on it. Increases resistance to physical activity in patients with angina pectoris.
Indications for use
Reducing the risk of complications in patients suffering from angina pectoris.
Chronic heart failure.
Arterial hypertension.
Contraindications
History of severe allergic reactions.
Side effects
Gastrointestinal tract: bowel dysfunction (diarrhea or constipation), nausea and vomiting, abdominal pain.
Cardiovascular system: severe decrease in blood pressure. Nervous system: ringing in the ears, headache and dizziness, muscle weakness and convulsions. Respiratory system: difficulty breathing, bronchospasm, dry cough. Skin: increased sweating. Allergic reactions: pruritus and rash, angioedema.
Dosage of the drug for adults
The dosage is calculated by the attending physician depending on the disease, its course and the patient’s condition.
Dosage of the drug for children There is no data showing that the use of the drug is safe in children under 18 years of age.
Use of the drug during pregnancy and lactation
The drug is prohibited for use during pregnancy and breastfeeding.
RIMEKOR
Pharmacological group
A drug that improves metabolic processes in the heart in conditions oxygen starvation.
Release form
Rimecor is available in 20 mg tablets.
Effect of the drug
The drug improves metabolic processes in the heart during oxygen starvation (ischemia). Reduces the frequency of angina attacks and increases resistance to physical activity. Rimecor also has an antianginal effect.
Indications for use.
Angina pectoris.
Attacks of dizziness caused by vascular changes.
Visual and hearing impairment, tinnitus resulting from oxygen deprivation of the brain.
Contraindications
Age up to 18 years.
Pregnancy and breastfeeding period.
Kidney and liver failure.
Individual intolerance to the drug.
Side effects
Allergic reactions: skin rash and itching.
Dosage of the drug for adults Prescribed 1 tablet 3 times a day with meals. The doctor determines the duration of Rimecor therapy individually in each specific case.
Use of the drug during pregnancy and lactation
The drug is prohibited for use during pregnancy and breastfeeding.
Remarks
When treated with Rimecor, the need for nitrates is significantly reduced.
SIDNOFARM
Pharmacological group
The drug belongs to the group of antianginal drugs and is a peripheral vasodilator, that is, it causes dilation of peripheral blood vessels.
Release form
Available in tablets of 2 mg in packs of 30 pieces.
Effect of the drug
Sidnopharm dilates peripheral veins, reduces the heart's need for oxygen and improves blood circulation in the heart. The effect of the drug begins 1 hour after administration and lasts about 8 hours.
Indications for use
Contraindications
Arterial hypotension, that is, a decrease in blood pressure.
Individual intolerance to the drug.
Side effects
Gastrointestinal tract: decreased appetite. Nervous system: increased fatigue, decreased response, headache and dizziness.
Cardiovascular system: decreased blood pressure, increased heart rate. Allergic reactions: skin rash and itching.
Dosage of the drug for adults
The drug is prescribed 1/2-1 tablet 2 times a day with meals or immediately after meals.
Use of the drug during pregnancy and lactation
The drug is prohibited for use at the beginning of pregnancy (the first three months); in the future, Sidnopharm can be prescribed to a pregnant woman only by strict indications.
When prescribing Silnofarm, a nursing mother should transfer her baby to artificial feeding.
Remarks
The drug does not relieve angina attacks and should not be used for this. It should be taken with caution by people who have had a stroke or suffer from glaucoma. During treatment with Sidnopharm, you should avoid drinking alcohol and driving a car.
The drug enhances the effect antihypertensive drugs.
TENOX
Pharmacological group
The drug is a calcium channel blocker.
Release form
Available in tablets of 5 and 10 mg.
Effect of the drug
Tenox has an antianginal effect, that is, it expands peripheral arteries. Reduces stress on the heart and oxygen deficiency during angina pectoris.
Indications for use
Angina pectoris.
Arterial hypertension.
Contraindications
Collapse (fainting with decreased blood pressure).
Arterial hypotension.
Individual intolerance to the drug.
Side effects
Gastrointestinal tract: pain in the stomach, nausea and vomiting, dry mouth, bloating, stool disorders (both constipation and diarrhea).
Cardiovascular system: arrhythmias, swelling of the ankles and feet, feeling of lack of air (shortness of breath), palpitations, chest pain.
Nervous system: increased fatigue, mood changes, dizziness and headache, sleep disturbances, convulsions. Respiratory system: breathing problems, nosebleeds.
Urinary system: painful urge to urinate, increased number of nighttime urinations, predominance over daytime ones.
Reproductive system: decreased potency. Bones and muscles: pain in joints and muscles, arthrosis.
Skin: rash, changes in skin color. It is observed extremely rarely.
Allergic reactions: skin rash and itching, angioedema, urticaria.
Dosage of the drug for adults
For angina pectoris, the drug is prescribed 5-10 mg per day in one dose. For arterial hypertension, the dosage is as follows: 2.5-5 mg per day in one dose.
Dosage of the drug for children
Use of the drug during pregnancy and lactation
The drug is prohibited for use in pregnant and breastfeeding women.
Remarks
It is necessary to monitor the condition of teeth and gums, as well as weight during treatment with Tenox.
It is necessary to limit consumption table salt.
Discontinuation of the drug should occur gradually.
egilok
Release form
The drug is available in tablets of 25, 50 and 100 mg.
Effect of the drug
The drug has antianginal and antiarrhythmic effect. Reduces blood pressure.
Indications for use
Prevention of angina attacks.
Heart rhythm disturbances.
Arterial hypertension.
Treatment of migraine attacks.
Contraindications
Decrease in heart rate.
Heart failure and cardiogenic shock.
Heart blocks.
Decreased blood pressure (hypotension).
Simultaneous use with verapamil.
Individual intolerance to the drug.
Heart rhythm disturbances, blockades.
Side effects
Gastrointestinal tract: abdominal pain, bowel movements (diarrhea or constipation), nausea and vomiting.
Cardiovascular system: decreased or increased heart rate, heart pain, decreased blood pressure. Nervous system: headache and dizziness, decreased memory and attention, drowsiness, increased fatigue, weakness, sleep disturbances.
Decreased vision and tinnitus. Respiratory system: bronchospasm, feeling of lack of air (shortness of breath), nasal congestion.
Reproductive system: decreased potency and sexual desire.
Skin: redness of the skin, skin rash and itching, increased sweating.
Dosage of the drug for adults
For angina pectoris, 50-100 mg is prescribed twice a day.
For arterial hypertension, 50-100 mg per day is prescribed in one or two doses.
Dosage of the drug for children
The drug is not used in children.
Use of the drug during pregnancy and lactation
When using the drug during pregnancy, delays in fetal development, decreased blood pressure, blood sugar and decreased breathing are possible.
When prescribing the drug to a nursing mother, her baby should be switched to artificial feeding.
EFOX LONG
Pharmacological group
The drug belongs to the group of antianginal drugs.
Release form
Available in 50 mg tablets. Effect of the drug
The drug dilates peripheral veins, reduces the heart's need for oxygen and increases the resistance of the myocardium to physical stress during angina pectoris.
Indications for use
Angina pectoris.
Chronic heart failure.
Pulmonary hypertension.
Contraindications
Arterial hypotension (low blood pressure).
Pericarditis.
Acute period myocardial infarction.
Cardiogenic shock.
Cardiac tamponade.
Collapse (fainting with a strong drop in blood pressure).
Individual intolerance to the drug.
Concomitant use with phosphodiesterase inhibitors.
Brain hemorrhage.
Traumatic brain injury.
Lactase deficiency.
Hereditary galactose intolerance.
Toxic pulmonary edema.
Side effects
Gastrointestinal tract: nausea and vomiting. Cardiovascular system: decreased blood pressure.
Nervous system: headache at the beginning of treatment, dizziness, lethargy. Allergic reactions: skin rash and itching. Loss of consciousness.
Dosage of the drug for adults
The drug is prescribed 50 mg 1 time per day after meals.
Use of the drug during pregnancy and breastfeeding The effect of the drug on the course of pregnancy and the child has not been studied, therefore it is not recommended to use it during pregnancy and breastfeeding.
Remarks
The drug should be used intermittently, otherwise resistance to all nitrate drugs may occur.
ACRIDIPINE
Release form
The drug is available in the form of 5 mg tablets.
Effect of the drug
The drug has antihypertensive, antiatherosclerotic, antithrombotic and antiauginal effects.
Indications for use
Angina pectoris.
Arterial hypertension.
Contraindications
Individual intolerance to the drug.
Heart failure.
Arterial hypotension.
Myocardial infarction.
Cardiogenic shock.
Increased heart rate.
Side effects
Gastrointestinal tract: nausea, vomiting, abdominal pain, jaundice, pencreatitis, dry mouth.
Reproductive system: impotence.
Dosage of the drug for adults
Prescribed 5 mg of the drug per day.
Dosage of the drug for children
The drug is prohibited for use in children under 18 years of age.
Use of the drug during pregnancy and lactation
The drug is approved for careful use under supervision during pregnancy and is prohibited during breastfeeding.
AMLORUS
The drug belongs to the calcium channel blockers.
Release form
Effect of the drug
Indications for use
Arterial hypertension.
Angina pectoris.
Contraindications
Individual intolerance to the drug.
Cardiogenic shock.
Side effects
Gastrointestinal tract: nausea, vomiting, pain in the stomach, jaundice, pencreatitis, dry mouth, increased appetite, bloating.
Cardiovascular system: shortness of breath, decreased blood pressure, edema, palpitations, hot flashes, chest pain, migraine. Nervous system: headache, dizziness, drowsiness, mood changes, increased fatigue, trembling limbs, depression, nervous exhaustion, insomnia, gait disturbance.
Respiratory system: respiratory distress, cough, nose bleed. Urinary system: painful urge to urinate, difficulty urinating.
Reproductive system: decreased potency and impaired sexual desire. Bones and muscles: pain in muscles and joints, arthrosis.
Allergic reactions: skin itching, rash, urticaria.
Dosage of the drug for adults
Prescribed 5 mg 1 time per day.
Dosage of the drug for children
The drug is prohibited for use in children under 18 years of age.
Use of the drug during pregnancy and lactation
LESKOL FORTE
The drug belongs to the lipid-lowering drugs.
Indications for use
Atherosclerosis.
Angina pectoris.
Hypercholesterolemia.
Contraindications
Individual intolerance to the drug.
Liver diseases.
Side effects
Gastrointestinal tract: nausea, vomiting, abdominal pain, hepatitis.
Nervous system: headache, dizziness, insomnia, sensory disturbance.
Bones and muscles: pain and muscle weakness. Allergic reactions: skin itching, rash, urticaria.
Dosage of the drug for adults
80 mg of the drug is prescribed once a day.
Dosage of the drug for children
Prescribed 20-80 mg of the drug once a day.
Use of the drug during pregnancy and lactation
The drug is prohibited for use during pregnancy and breastfeeding.
Women who are in childbearing age, it is necessary to use contraceptives when using this drug.
MEDARUM 20
The drug belongs to the drugs that improve the condition of the heart muscle.
Release form
The drug is available in the form of 20 mg tablets.
Effect of the drug
The drug improves metabolism in the heart muscle. Has antianginal, antihypoxic effects. Dilates the blood vessels of the heart.
Indications for use
Angina pectoris.
Vestibular disorders, such as tinnitus and hearing loss.
Dizziness of vascular origin.
Contraindications
Individual intolerance to the drug.
Liver failure.
Side effects
Gastrointestinal tract: nausea, vomiting, stomach pain.
Allergic reactions: skin itching, rash, urticaria.
Dosage of the drug for adults
Prescribed 20 mg of the drug 2 times a day.
Dosage of the drug for children
The drug is prohibited for use in children under 18 years of age.
Use of the drug during pregnancy and lactation
The drug is prohibited for use during pregnancy and breastfeeding.
MONOCHINQUE
The drug belongs to antianginal agents.
Release form
The drug is available in tablet form.
Effect of the drug
The drug has an antianginal effect. Reduces the load on the heart and reduces its need for oxygen. Increases resistance and endurance to physical activity in people suffering from coronary heart disease.
Indications for use
Angina pectoris.
Myocardial infarction.
Chronic heart failure.
Contraindications
Individual intolerance to the drug.
Cardiogenic shock.
Acute stage myocardial infarction.
Arterial hypotension.
Angle-closure glaucoma.
Hemorrhagic stroke.
Side effects
Gastrointestinal tract: nausea, vomiting. Cardiovascular system: decreased blood pressure, increased heart rate. Nervous system: headache, dizziness.
Facial redness.
Allergic reactions: skin itching, rash, urticaria.
Dosage of the drug for adults
Prescribed 20-40 mg 2 times a day.
Dosage of the drug for children
The drug is prohibited for use in children under 18 years of age.
Use of the drug during pregnancy and lactation
The drug is prohibited for careful use under medical supervision during pregnancy and is prohibited during breastfeeding.
Comment
The effect of the drug is enhanced by alcohol, as well as simultaneous use with calcium channel blockers and antihypertensive drugs.
NIFECARD HL
The drug belongs to the calcium channel blockers.
Release form
The drug is available in the form of tablets of 30 and 60 mg.
Effect of the drug
The drug has antihypertensive, antianginal and antisclerotic effects.
Indications for use
Arterial hypertension.
Angina pectoris.
Contraindications
Individual intolerance to the drug.
Cardiogenic shock.
Reduced blood pressure.
Acute period of myocardial infarction.
Unstable angina.
Side effects
Gastrointestinal tract: nausea, vomiting, abdominal pain, jaundice, pancreatitis, dry mouth.
Cardiovascular system: shortness of breath, decreased blood pressure, hot flashes, swelling of the legs, arrhythmias, chest pain. Nervous system: headache, dizziness, increased fatigue, drowsiness. Urinary system: increased frequency of urination.
Dosage of the drug for adults
Prescribed 30-60 mg 1 time per day. The tablet should be taken whole, without breaking or chewing.
Dosage of the drug for children
The drug is prohibited for use in children under 18 years of age.
Use of the drug during pregnancy and lactation
The drug is prohibited for use during pregnancy and breastfeeding.
ASPIKOR
Pharmacological group
The drug belongs to non-steroidal anti-inflammatory drugs (NSAIDs), an antiplatelet agent.
Release form
Effect of the drug
Indications for use
Unstable angina.
Stroke prevention.
Contraindications
Individual intolerance to the components of the drug.
Hemorrhagic diathesis.
Bronchial asthma.
Side effects
Cardiovascular system: pain and tightness in the chest, hot flashes, increased blood pressure, increased heart rate. Nervous system: tinnitus and dizziness.
Blood: anemia and increased bleeding. Respiratory system: bronchospasm. Allergic reactions: urticaria, skin itching and rash, angioedema.
Dosage of the drug for adults
Dosage of the drug for children
Use of the drug during pregnancy and lactation
The use of the drug during pregnancy is not recommended, since taking NSAIDs in the first trimester of pregnancy can lead to congenital defects development, and in the third trimester - cause inhibition labor activity, increased bleeding in both mother and baby. The drug is contraindicated!
AGREGAL
Pharmacological group
Release form
Effect of the drug
The drug prevents platelet aggregation and prevents the development of atherothrombosis.
Indications for use
Unstable angina.
After a myocardial infarction.
Atherosclerosis (prevention of ischemic disorders).
Peripheral arterial diseases.
Contraindications
Individual intolerance to the components of the drug.
Acute bleeding.
Liver failure.
Side effects
Gastrointestinal tract: constipation or diarrhea, abdominal pain, nausea.
Blood: decreased levels of neutrophils and platelets. Hematomas.
Nervous system: weakness, headache and dizziness.
Urinary system: blood in urine.
Dosage of the drug for adults
The drug is prescribed 1 tablet 1 time per day, regardless of time and meal intake.
Use of the drug during pregnancy and lactation
The drug is prohibited for use during pregnancy and breastfeeding.
ATSEKAPDOL
Pharmacological group
The drug belongs to nonsteroidal anti-inflammatory drugs (NSAIDs), an antiplatelet agent.
Release form
The drug is available in the form of enteric-coated tablets.
Effect of the drug
The drug has an analgesic, anti-inflammatory, antipyretic effect, and prevents platelet aggregation.
Indications for use
Unstable angina.
Prevention of myocardial infarction in obesity, atherosclerosis, and in old age.
Prevention of recurrent myocardial infarction.
Prevention of thromboembolism after vascular surgery.
Stroke prevention.
Prevention of deep vein thrombosis.
Contraindications
Individual intolerance to the components of the drug.
Hypersensitivity to other NSAIDs.
Erosion and ulcers of the gastrointestinal tract.
Hemorrhagic diathesis.
Bronchial asthma.
Gastrointestinal bleeding.
Combined use with methotrexate.
Side effects
Gastrointestinal tract: gastrointestinal bleeding, heartburn, nausea, vomiting, pain in the stomach, ulcerative lesions mucous membrane of organs digestive system.
Cardiovascular system: pain and tightness in the chest, hot flashes, increased blood pressure, increased heart rate.
Nervous system: tinnitus and dizziness. Blood: anemia and increased bleeding. Respiratory system: bronchospasm. Allergic reactions: urticaria, skin itching and rash, angioedema.
Dosage of the drug for adults
The drug is prescribed at 100-200 mg of the drug per day. The duration of treatment is long and is selected by the attending physician individually in each specific case.
Dosage of the drug for children
Use of the drug during pregnancy and lactation
The use of the drug during pregnancy is not recommended, since taking NSAIDs in the first trimester of pregnancy can lead to congenital malformations, and in the third trimester it can cause inhibition of labor and increased bleeding in both mother and baby. The drug is contraindicated! When using the drug during breastfeeding, the baby should be switched to artificial feeding with formula.
DETROMB
Pharmacological group
The drug belongs to the group of antiplatelet agents.
Release form
The drug is available in the form of film-coated tablets.
Effect of the drug
Indications for use
Unstable angina.
Contraindications
Individual intolerance to the components of the drug.
Liver failure.
Acute bleeding.
Side effects
Allergic reactions: urticaria, skin itching and rash.
Dosage of the drug for adults
Dosage of the drug for children
Use of the drug during pregnancy and lactation
The drug is prohibited for use during pregnancy and breastfeeding.
KALCHEK
Pharmacological group
The drug belongs to the group of calcium channel blockers.
Release form
The drug is available in tablet form. Effect of the drug
The drug has an antianginal, antispasmodic effect. Reduces blood pressure and promotes dilation of blood vessels.
Indications for use
Angina pectoris.
Arterial hypertension.
Contraindications
Individual intolerance to the components of the drug.
Arterial hypotension.
Side effects
Gastrointestinal tract: constipation or diarrhea, nausea, vomiting, abdominal pain. Cardiovascular system: shortness of breath, hot flashes, increased heart rate. Nervous system: weakness, headache and dizziness, drowsiness. Urinary system: increased frequency of urination. Edema.
Reproductive system: impotence. Gingival hyperplasia.
Allergic reactions: urticaria, skin itching and rash.
Dosage of the drug for adults
The drug is prescribed at a dose of 5 mg of the drug per day. In severe cases there may be an increase daily dose up to 10 mg.
Dosage of the drug for children
Use of the drug during pregnancy and lactation
The use of the drug during pregnancy is possible only for strict health reasons. minimal doses and under the supervision of a doctor. When using the drug during breastfeeding, the baby should be switched to artificial feeding with formula.
CLEXANE
Pharmacological group
The drug is a direct-acting anticoagulant. It is a low molecular weight heparin.
Release form
The drug is available as a solution for injection.
Indications for use
Deep vein thrombosis.
Unstable angina.
Myocardial infarction.
Contraindications
Individual intolerance to the components of the drug.
Side effects
Bleeding.
Blood: thrombocytopenia.
Allergic reactions: urticaria, skin itching and rash.
Dosage of the drug for adults
The drug is administered only subcutaneously, intramuscular use is excluded. The dosage is calculated individually in each specific case, depending on the patient’s condition and the severity of the disease.
Dosage of the drug for children
Use of the drug during pregnancy and lactation
When using the drug during breastfeeding, the baby should be switched to artificial feeding with formula.
PERLINGANITE
Pharmacological group
The drug belongs to antianginal agents. It is a peripheral vasodilator.
Release form
The drug is available in the form of a concentrate for the preparation of a solution for infusion.
Effect of the drug
The drug has a relaxing effect on the tone of vascular smooth muscles. Reduces blood flow to the right atrium, reduces the load on the heart and myocardial oxygen demand.
Indications for use
Angina pectoris.
Acute left ventricular failure.
Acute myocardial infarction.
Hypertensive crisis.
Contraindications
Individual intolerance to the components of the drug.
Collapse.
Cardiogenic shock.
Toxic pulmonary edema.
Diseases with increased intracranial pressure.
Arterial hypotension.
Side effects
Gastrointestinal tract: nausea, vomiting. Cardiovascular system: decreased blood pressure, increased heart rate. Nervous system: weakness, lethargy, headache and dizziness. Allergic reactions: urticaria, skin itching and rash.
Dosage of the drug for adults
The dosage is calculated individually in each specific case, depending on the patient’s condition and the severity of the disease. Administration of the drug begins with a minimum dose, gradually therapeutic dose increases until the desired result is achieved.
Dosage of the drug for children
Use of the drug during pregnancy and lactation
The use of the drug during pregnancy is possible only for strict health reasons in minimal doses and under the supervision of a doctor.
PLAGRIL
Pharmacological group
The drug belongs to the group of antiplatelet agents.
Release form
The drug is available in the form of film-coated tablets.
Effect of the drug
The drug prevents platelet aggregation from the first day of use.
Indications for use
Unstable angina.
Previous myocardial infarction, stroke for the purpose of preventing atherothrombotic complications.
Contraindications
Individual intolerance to the components of the drug.
Liver failure.
Acute bleeding.
Hemorrhagic syndrome.
Side effects
Gastrointestinal tract: dry mouth, nausea, vomiting, abdominal pain, diarrhea. Peptic ulcer stomach or intestines. Cardiovascular system: decreased blood pressure, vasculitis. Nervous system: weakness, headache and dizziness. Bleeding. Bruising. Blood: leukopenia, thrombocytopenia. Respiratory system: bronchospasm. Leather: increased sweating. Bones and muscles: pain in muscles and joints. Urinary system: in rare cases, increased blood creatinine and glomerulonephritis.
Allergic reactions: urticaria, skin itching and rash.
Dosage of the drug for adults
The drug is prescribed 75 mg of the drug 1 time per day.
Use of the drug during pregnancy and lactation
The drug is prohibited for use during pregnancy.
When using the drug during breastfeeding, the baby should be switched to artificial feeding with formula.
FRAGMIN
Pharmacological group The drug belongs to direct-acting anticoagulants. It is a low molecular weight heparin.
Release form
The drug is available in the form of an injection solution.
Effect of the drug
The drug has an antiplatelet effect.
Indications for use
Deep vein thrombosis.
Prevention of thrombosis and thromboembolism in surgery.
Thromboembolism pulmonary artery.
Prevention of blood clotting during hemodialysis.
Unstable angina.
Myocardial infarction.
Contraindications
Individual intolerance to the components of the drug.
Conditions threatened by the development of bleeding (vascular aneurysm, hemorrhagic stroke).
Immune thrombocytopenia.
Bleeding.
Recent injuries or surgical interventions on the organ of vision, hearing or central nervous system.
Side effects
Bleeding.
Blood: thrombocytopenia.
Pain at the injection site.
Allergic reactions: urticaria, skin itching and rash.
Dosage of the drug for adults
The drug is administered only subcutaneously 1-2 times a day, intramuscular use is excluded. The dosage is calculated individually in each specific case, depending on the patient’s condition and the severity of the disease.
Dosage of the drug for children
Use of the drug during pregnancy and lactation
The drug is prohibited for use during pregnancy.
When using the drug during breastfeeding, the baby should be switched to artificial feeding with formula.
EGITHROMB
Pharmacological group
The drug belongs to the group of antiplatelet agents.
Release form
The drug is available in the form of film-coated tablets.
Effect of the drug
The drug prevents platelet aggregation from the first day of use.
Indications for use
Unstable angina.
Previous myocardial infarction, stroke for the purpose of preventing atherothrombotic complications.
Contraindications
Individual intolerance to the components of the drug.
Liver failure.
Acute bleeding.
Hemorrhagic syndrome.
Side effects
Gastrointestinal tract: dry mouth, nausea, vomiting, abdominal pain, diarrhea. Peptic ulcer of the stomach or intestines. Cardiovascular system: decreased blood pressure, vasculitis. Nervous system: weakness, headache and dizziness.
Bleeding.
Bruising.
Blood: leukopenia, thrombocytopenia.
Respiratory system: bronchospasm.
Skin: increased sweating.
Bones and muscles: pain in muscles and joints.
Urinary system: in rare cases, increased blood creatinine and glomerulonephritis.
Allergic reactions: urticaria, skin itching and rash.
Dosage of the drug for adults
The drug is prescribed 75 mg of the drug 1 time per day.
Dosage of the drug for children
Use of the drug during pregnancy and lactation
The drug is prohibited for use during pregnancy.
When using the drug during breastfeeding, the baby should be switched to artificial feeding with formula.
Bronchial asthma manifests itself as sudden attacks of suffocation caused by obstruction of the bronchial tubes.
It was described by Hippocrates, G.I. Sokolsky and S.P. Botkin. The latter explained asthma attacks by spasms of the smooth muscles of the bronchi. Bronchial asthma has wide use among the population of all countries: in the USA about 3%, in England and Wales 0.9% of the population suffer from bronchial asthma.
Etiology and pathogenesis
Increased tone and relaxation play a role in the mechanism of occurrence of the attack of suffocation itself. sympathetic nerve. This leads to a spasm of the smooth muscles of the bronchi and a narrowing of their lumen with the release of abundant secretion from the bronchial mucosa and swelling of the latter, making breathing difficult. This mechanism of development of an attack of bronchial asthma is supported by the fact that with the help of an injection of adrenaline, which excites the sympathetic nervous system, and atropine, which paralyzes the endings vagus nerve, it is possible to interrupt (stop) an attack of bronchial asthma.The reason for the increased excitability of the parasympathetic (vagus nerve) and relaxation of the sympathetic nervous system is explained by various authors not the same. Some speak in favor of the allergic nature of bronchial asthma, that is, the increased sensitivity of patients to a number of protein and plant substances (allergens), the entry of which into the body, even in minute quantities, causes an allergic reaction. Others adhere to the neurogenic theory of the origin of asthma. The basis for the allergic nature of asthma was clinical observations when asthma occurred when inhaling perfume, the smell of flowers, ursol (from furriers), ipecac (from pharmacists), from contact with freshly cut hay (hay fever), as well as from eating certain types of fish, crayfish, eggs, strawberries, etc. d. The allergic nature of bronchial asthma is also proven by the fact that other allergic diseases- urticaria, eczema, angioedema, which speaks in favor of the nonspecificity of allergens. As a result of this, the same allergen can cause various allergic diseases - in some cases bronchial asthma, in others - urticaria, or both diseases at the same time. The allergic nature of bronchial asthma is supported by the facts of cure for asthma attacks by removing the allergens that cause the attack.
For manifestation allergic reaction preliminary sensitization of the body is necessary - hereditary or acquired, which can cause asthma attacks only with prolonged exposure to allergens in relation to which it is observed increased sensitivity.
There are many supporters of the neurogenic theory of the origin of bronchial asthma. Asthma attacks under the influence of emotional experiences - disorders of the autonomic nervous system or in persons with traumatic brain injuries, as well as as a result reflex irritations, coming from a deviated nasal septum, an inflamed gallbladder, nasal polyps, etc., give reason to consider bronchial asthma as a psychoneurosis.
Infection has a great influence on the course of bronchial asthma. Pneumonia, influenza, tonsillitis, sinusitis and others infectious foci create in the body favorable conditions for the development of allergies, sensitization of the body by metabolic products pathogenic flora and protein breakdown in the foci of infection. These same foci of infection become sources of pathological reflexes.
There is a natural connection between the state endocrine system and the course of bronchial asthma ( puberty, menstruation, pregnancy, breastfeeding, etc.). Among endocrine glands It is necessary to isolate the adrenal glands, which play an important role in sensitization of the body. This is proven by the beneficial effect of cortisone, prednisolone and ACTH (adrenocorticotropic hormone of the anterior pituitary gland) on the course of bronchial asthma.
Pathological anatomy
Pulmonary emphysema is observed in patients with bronchial asthma. In the small and medium bronchi there is mucus, the walls of the bronchi are thickened, eosinophils and Charcot-Leyden crystals are found in their lumen: the alveoli are uneven, dilated, and their walls are thinned, the septum between them is torn in places. Hypertrophy and expansion of the right ventricle of the heart is observed.Symptoms of bronchial asthma
Asthma attacks occur suddenly, most often at night. Sometimes they are preceded by tightness in the chest, general weakness, drowsiness, yawning, tickling in the nose, and stuffy nose. In cases food allergies Nausea, heartburn, etc. appear as prodromal phenomena.During an attack, the patient usually takes sitting position, resting your hands on some hard object to facilitate breathing. At the same time, the auxiliary muscles are very tense - the scalenes, sternocleidomastoid muscles, and abdominal muscles. Often, during an attack, patients jump out of bed and open a window or window to facilitate breathing. The appearance of the patients is frightened, the face is pale, the body is covered with perspiration. Breathing is rare or difficult, mainly due to exhalation, which is performed with a whistle that can be heard at a distance. Body temperature is normal or slightly elevated. The neck veins swell, the pulse is rare, blood pressure is lowered. The chest increases in volume, as it freezes in the position of inhalation. Percussion sound with tympanic tone; lower limits lungs are lowered, their excursion is limited, acute emphysema occurs. Absolute stupidity heart is not determined due to swelling of the lungs. A huge amount of whistling and scraping rales is heard in the lungs.
The duration of the attack and its severity is not the same in different persons and in the same patient different periods his illness. The attack lasts from several minutes to several days. Resolution of the attack begins with a cough, initially with the release of scanty, viscous glassy sputum, and subsequently mucopurulent sputum. The patient falls asleep after an attack, and then usually his health quickly improves if we are talking about fresh cases of bronchial asthma, not complicated by chronic bronchitis, pulmonary emphysema, or pneumosclerosis.
In some cases, the attack does not end in the next few hours and continues for days and weeks; the sputum produced does not bring relief. These attacks are referred to as "asthmatic condition" (status asthmaticus). Attacks of bronchial asthma can be repeated in a certain sequence. At first, attacks are rare. Sometimes they repeat every month, week or become continuous, and over time they lose their characteristic course and manifest themselves only as chronic bronchitis, worsening in spring and autumn. Attacks of bronchial asthma caused by allergens can later be provoked by physical or emotional stress, cold wind, various odorous substances. The occurrence and course of bronchial asthma are influenced by climate and meteorological conditions. Cyclones make attacks more frequent, and staying in high mountains - 1000-1200 m above sea level - stops or makes them rare.
Diagnostics
Recognizing bronchial asthma in typical cases is not difficult. Choking with difficulty in exhaling, acute pulmonary emphysema, the presence of Courshman spirals, Charcot-Leyden crystals, and eosinophilia in the sputum make the diagnosis obvious.Differential diagnosis should be made between cardiac, symptomatic and hysterical asthma. Disease of the heart and blood vessels (hypertension, myocardial infarction, cardiosclerosis, etc.), enlargement of the left ventricle of the heart, congestion in the pulmonary circulation and in the liver, lack of effect from the use of adrenaline, as well as pulmonary edema with significant amount moist rales, and sometimes pink-colored foamy sputum, exclude bronchial asthma. Symptomatic asthma is observed with pneumosclerosis and emphysema. In hysterical asthma there is a superficial and rapid breathing without any objective changes in the lungs, sputum, blood, i.e., there is no emphysema and variable wheezing in the lungs during an attack, difficulty exhaling, glassy sputum and eosinophilia.
Forecast
The prognosis depends on the frequency of attacks and the degree of changes in the lungs and nervous system. Bronchial asthma, which exists for many years, can lead to emphysema, chronic bronchitis, pneumosclerosis and pulmonary heart failure and be fatal due to complications caused by it. Death during the attack itself is extremely rare, and then mainly in older people. Patients with rare attacks and without associated complications outside of attacks they are quite functional. Persons with frequent attacks and significant changes in the respiratory and circulatory system have limited ability to work or are completely disabled.Treatment and prevention
Interrupting an attack is best achieved by injecting 0.5-1 ml of a 0.1% solution of adrenaline hydrochloride (recipe No. 36) under the skin, which stimulates the sympathetic nervous system and after 2-3 minutes relieves spasm of the smooth muscles of the bronchi, while simultaneously paralyzing the endings of the vagus nerve. The effect of adrenaline lasts no more than 1-2 hours, so during prolonged attacks, repeated injections are possible (up to 8-10 times a day). Contraindications for the use of adrenaline are: a) increased sensitivity to it, manifested by headache, body tremors, palpitations; b) hypertension, angina pectoris, cardiovascular failure.Recently, drugs have been used - norepinephrine, isoprenaline, euspiran.
The adrenaline drug ephedrine (recipe No. 30) has a weaker but longer-lasting effect. When taken orally (0.025 g tablets), it acts for 4-6 hours, with subcutaneous injection its effect appears no earlier than after 30 minutes. Ephedrine sometimes causes side effects(insomnia, dysuria), which are relieved with simultaneous use diphenhydramine (prescription No. 173), luminal (prescription No. 110), etc. Most often, ephedrine is prescribed for moderate bronchial asthma, as well as to prevent the development of attacks. To relieve attacks, theophedrine and the Czechoslovakian drug antastman are also used, which consists of datura, henbane, belladonna, containing atropine and related alkaloids, soaked in a 10% solution of potassium nitrate. It is necessary to burn 1/2 teaspoon of this drug and inhale the smoke.
Against attacks of bronchial asthma, you can also use a 0.1% solution of atropine sulfate (recipe No. 35) in an amount of 1-2 ml; its use is indispensable when asthma is combined with angina pectoris, coronary sclerosis, circulatory disorders, as well as pulmonary heart failure. Eufillin should be administered intravenously with 20 ml of 40% glucose solution slowly, sometimes it is given in the form of suppositories. You can use aminophylline substitutes - diaphyllin 1 ml intramuscularly (1 ml 24% diaphyllini gluteosi) or intravenously (5 ml 48% diaphyllini venos). IN last years for bronchial asthma received wide application hormonal drugs- cortisone, prednisolone, prednisone and ACTH, which often bring patients out of a severe asthmatic state. ACTH is administered intramuscularly at 10-20 units 2-3 times a day, cortisone - 100 mg per day, and prednisone and prednisolone - 25 mg. Hormone therapy is contraindicated in case of concomitant atherosclerosis, hypertension, peptic ulcer.
For mild forms of bronchial asthma, you can prescribe Kellin 0.02 g 2 times a day, papaverine - 0.03 g, Tifen - 0.015 g 2-3 times a day. I. I. Traskova and M. D. Skrypnik’s liquid is prescribed subcutaneously as an antispasmodic and anti-asthmatic agent. It paralyzes the endings of the vagus nerve and relaxes the smooth muscles of the bronchi, causing dry mouth and blurred vision. Platiphylline (0.002-0.006 g), which is prescribed for the same purpose instead of atropine, does not cause side effects.
For bronchial asthma, aminophyllum is also used (recipes No. 26, 26a and 27); it energetically expands the bronchi, kidneys and coronary vessels, therefore its use is indispensable when asthma is combined with angina pectoris, coronary sclerosis. In cases where attacks of bronchial asthma are combined with sinusitis, tonsillitis, sinusitis, frequent exacerbations chronic bronchitis or pneumonia beneficial influence The course of asthma is affected by treatment with antibiotics. The most effective in these cases are antibiotics (penicillin in the form of aerosols 100,000-200,000 units in 2 ml physiological saline 1-2 times a day). A vaccine made from the patient's sputum is also recommended. During an attack of bronchial asthma, injections of drugs - morphine, pantopon - are contraindicated, since the latter depress the respiratory center and can cause asphyxia and death. You can administer 2 g of chloral hydrate in an enema with 20 ml of saline, which sometimes stops an attack. Treatment with sleep is contraindicated, since during sleep the tone of the vagus nerve increases and an asthma attack can be provoked. During an attack, the patient's condition is alleviated by mustard plasters and cups on the chest, outside of an attack - expectorants - thermopsis (recipe No. 60), ammonium chloride (recipe No. 44), alkalis, as well as potassium iodide(recipe No. 190), which thins phlegm.
A radical remedy for the treatment of bronchial asthma is to reduce the body's reactivity. For this purpose, it is necessary to regulate the patient’s lifestyle, strengthen his nervous system with sedatives and restoratives, bromides, luminal, hydrotherapy, psychotherapy, breathing exercises, sports and physical education.
At the same time, those allergens to which the patient has been shown to be hypersensitive should also be eliminated, for which purpose one can change both the profession and the nature of the work. Where allergens have not been identified, protein therapy, tissue and shock therapy, hyperthermia, treatment bee venom, acupuncture (acupuncture). Sometimes attacks of bronchial asthma stop when you change your place of residence. It should be taken into account that some patients feel good in mountainous places, others - on the seashore. Spa treatment It is recommended to carry out in Kislovodsk, Teberda, on the Crimean coast.
The picture on the right shows a narrowed bronchus in asthma.
It is impossible to cure bronchial asthma completely, at least not modern medicine I haven't figured out this method yet. But you can take control of how the disease behaves and influence its outcome. People who are attentive to their health and have a diagnosis of asthma that was made on early stage, due to which treatment was started in a timely manner, they may not remember for years that they have this disease. In the absence of treatment, asthma worsens more often, asthma attacks become prolonged, severe and uncontrollable. This leads to disruption of the functioning of not only the respiratory organs, but also the entire human body. After respiratory systems oh, the cardiovascular system suffers.
In patients with bronchial asthma, the heart begins to work worse because:
during an exacerbation of the disease, respiratory failure occurs; during an attack, pressure in the chest rises; adverse reactions heart problems arise due to the systematic use of beta2-adrenergic agonists by asthmatics.
Asthmatics may experience the following complications from the cardiovascular system:
arrhythmias (from extrasystoles to ventricular fibrillation); pulmonary hypertension; acute and chronic cor pulmonale; myocardial ischemia.
Cardiac arrhythmias in patients with bronchial asthma
Arrhythmia is a disturbance in heart rhythm during and between attacks of bronchial asthma. Normally, the human heart contracts in sinus rhythm, that is, the pulse is 60-90 beats per minute. Deviations from sinus rhythm upward is called tachycardia. This is what is observed in asthmatics during an attack of suffocation, when the pulse quickens to 130-140 beats. Between attacks during the period of exacerbation, the pulse keeps on upper bound norm or goes beyond it (90-100 beats per minute). In this case, not only the frequency, but also the rhythm of heart contractions can be disrupted. The more severe course takes asthma, the more pronounced and prolonged it becomes sinus tachycardia.
The change in heart rate during bronchial asthma is due to the fact that, in an effort to compensate for the lack of oxygen due to impaired respiratory function, which affects all tissues and organs in the body, the heart has to pump blood faster.
A patient with bronchial asthma with tachycardia may feel:
Irregularity of the heart. Patients describe this condition as “the heart is fluttering,” “the heart is breaking out of the chest,” “the heart is freezing.” Weakness, dizziness. This general symptom for both tachycardia and severe respiratory failure that develops during an asthma attack. Lack of air. Patients complain of shortness of breath, a feeling of tightness in the chest.
Fortunately, sinus tachycardia in bronchial asthma occurs infrequently. Typically, patients with this complication have accompanying pathologies from the cardiovascular and respiratory systems. Tachycardia in asthmatics requires differentiated therapy. Due to its absence it is possible fast development heart failure, increases the risk sudden stop heart during an attack of suffocation.
The actual treatment of heart rhythm disturbances in patients with asthma has two directions:
It is necessary to transfer the underlying disease from the exacerbation phase to the phase of stable remission. It is necessary to normalize heart function through oxygen therapy and medication: beta blockers (bisoprolol, sotalol, nebivolol and others); 
inhibitors of If channels of the sinus node (ivabradine, Coraxan, etc.); herbal preparations(hawthorn, valerian, motherwort), if the asthmatic is not allergic to them.
Pulmonary hypertension as a complication of bronchial asthma
One of the most common reasons development of acquired pulmonary hypertension are chronic respiratory diseases - bronchial asthma, tuberculosis, COPD, pulmonary fibrosis and others. The disease is characterized by an increase in pressure in the pulmonary artery, which at rest exceeds normal by 20 mm Hg, and during exercise by 30 mm Hg or more. Like sinus tachycardia, pulmonary hypertension in asthmatics is compensatory.
Symptoms of pulmonary hypertension are shortness of breath (present at rest and worsened by physical activity), dry cough, pain on the right side under the ribs, cyanosis. 
This pathological condition also eliminated by oxygen therapy. To reduce pressure in the pulmonary artery, use:
slow calcium channel blockers (nifedipine); adenosinergic drugs (aminophylline); diuretics (furosemide).
Right ventricular failure (cor pulmonale)
Acute cor pulmonale, or right ventricular failure, often develops during a prolonged attack of suffocation or during status asthmaticus. The pathology is acute dilatation the right parts of the heart (with a decrease in their contractile function) and the pulmonary artery. Hypoxemia develops. There is stagnation in big circle blood circulation The lungs swell and irreversible changes occur in their tissue.
Chronic cor pulmonale, characterized by extreme dystrophy of the right ventricle, often incompatible with life, even resuscitation measures cannot help. 
Cor pulmonale has the following symptoms:
feeling of tightness in the chest; feeling of lack of air; dizziness; swelling of the upper, lower extremities, neck, face; vomit; blood pressure surges; fainting.
The goals of treating cor pulmonale are to preserve the patient’s life and normalize his blood circulation. For this purpose, conservative and surgical methods are used.
The conservative method includes taking anticoagulants, beta blockers, vasodilators. In order to alleviate the patient's condition, he is prescribed painkillers. 
In the absence of effect from drug treatment or according to direct indications, the patient undergoes cardiac surgery.
Asthma as a cause of coronary heart disease
Coronary heart disease occurs when, due to bronchial asthma, the blood supply to the myocardium is disrupted, as a result of which the heart muscle receives insufficient oxygen.
The acute form of myocardial ischemia is infarction, while the chronic pathological process manifests itself in periodic attacks angina pectoris.
A patient with ischemia complains of shortness of breath, irregular heart rhythm, rapid pulse, chest pain, general weakness, swelling of the extremities.
The prognosis of the disease largely depends on how quickly and fully the patient received medical care.
Treatment of myocardial ischemia is carried out with drugs belonging to three groups:
antiplatelet agents (clopidogrel); β-blockers (bisoprolol, carvedilol); hypocholesterolemic drugs (lovastatin, rosuvastatin).
Difficulty in diagnosing cardiovascular complications in asthmatics
It is not easy to identify certain complications of the cardiovascular system in a person diagnosed with bronchial asthma only by their symptoms because they are in many ways similar to the symptoms of the underlying disease. Therefore, it becomes necessary to use additional methods diagnostics, such as:
Auscultation of the heart. Electrocardiography. Echocardiography. Ultrasound. X-ray examination.
The cause of death for asthmatics in the vast majority of cases is cardiovascular disease. Therefore, from the moment a person is diagnosed with bronchial asthma, there is a need to monitor the work of his heart. Early detection any possible complications on the part of this organ significantly increases the ability to live long and fully.
Video: Bronchial asthma symptoms and treatment. Signs of bronchial asthma
What is bronchial asthma? This disease is chronic inflammation respiratory tract person, accompanied by shortness of breath, most often with cough. This happens because the respiratory channels are too sensitive; the more they are irritated, the more they will narrow and produce fluid, which, of course, will disrupt the breathing process.
Tachycardia is practically the most common heart disease. If the heart rate regularly exceeds the threshold of 90 beats per minute, then the person is developing this disease. At the same time, you can sometimes hear your own heartbeat, especially when trying to fall asleep. You may also feel nervous, dizzy, and even faint.
It would seem that asthma and tachycardia can overlap, but in fact these diseases are quite closely related.
Work of the heart and respiratory organs
What is a heart? First of all, this muscular organ, which receives all the blood entering it, contracts and pushes it out. In simple words, the heart is a pump. It is located behind the sternum between the lungs, it is the size of a human fist, approximate weight- 300 grams.
Pathological changes in the functioning of the heart in patients can manifest themselves in the form of pulmonary hypertension and complicate other existing diseases of the respiratory system. In turn, diseases of the bronchopulmonary system negatively affect the functioning of the heart - signs of an increase in the volume of the right chambers of the heart are found. The biggest changes are happening in late stages bronchial asthma.
The bronchi is an organ responsible for completely different processes, namely, breathing processes. Thanks to them, gas exchange occurs in the human body.
In addition, the bronchi also have a large number of tasks, namely:
Temperature regulation – heating of incoming air. Humidification of incoming air due to secretion. The body is partially protected from infections; the ciliated epithelium of the bronchi is responsible for this, which removes bacteria to the outside.
Bronchial asthma affects more than 300 million people on the planet. This disease is the cause of disability in almost 2% of all cases, and in 1.4% - the cause of hospitalization, and also reduces life expectancy in men by an average of 6 years, in the fairer sex - by 13.
In recent years, the situation has only worsened, the number of patients is growing, especially since in many patients bronchial asthma develops simultaneously with diseases of the cardiovascular system and gastrointestinal tract. Over the years, scientists have received more and more information that tachycardia very often accompanies diseases of the bronchopulmonary system, and in certain cases determines the prognosis of a person’s life.
Ryazansky medical University conducted research on the topic “Frequency of occurrence of tachycardia in patients with asthma.”
The objective of the study was to study the causes and mechanisms of development of heart rate disorders in patients with asthma and to develop methods of the most effective therapy.
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The study involved 69 people with asthma and having a moderate to severe form of the disease. All patients passed full examination, which included Holtor monitoring, and also used an MKA-02 microcardiac analyzer.
After which people were given complex therapy, which included drug treatment of bronchial asthma and a drug to normalize the heart rhythm Diltiazem. Later they were additionally prescribed Trimetazidine. Observation of patients continued for 2 years.
As a result of this study, clear causal relationships between the severity of bronchial asthma and tachycardia were not determined, however, 40 patients out of 69 had sinus rhythm tachycardia, 15 people had atrial insufficiency, the rest had a violation contractile activity atria. It was thanks to these facts that it was found that bronchial asthma is actually associated with tachycardia.
The effect of bronchial asthma on heart function
To date, a complete cure for asthma is almost impossible, with the exception of asthma in children - in this case, a growing body with the help of drug therapy can overcome the disease. In adults, one can only control its development and, ultimately, influence its outcome.
People who have been diagnosed with this disease, due to their careful attitude to their health, can significantly improve their condition and quality of life through proper therapy.
However, if left untreated, the patient will soon develop asthma attacks, which over time will become long and completely uncontrollable. They lead to a violation of not only the functioning of the respiratory organs, but also the cardiovascular system.
In patients with asthma, the heart works more efficiently because:
during complications of the disease, respiratory failure appears; during an attack, pressure in the chest increases;
Complications affecting the functioning of the heart in asthmatics can manifest themselves in:
coronary heart disease; pulmonary heart; arrhythmias.
With advanced bronchial asthma, complications most often appear in the form of tachycardia, which entails:
increased heart rate; painful sensations in area chest; edema, the treatment of which is very difficult due to other processes.
Tachycardia with a violation of sinus rhythm is diagnosed in 95% of people with bronchial asthma.
The heart rate in asthma changes due to the need to compensate for the lack of oxygen in violation of respiratory functions, which affect many organs and tissues of the human body. To do this, the heart begins to pump blood more intensely.
With tachycardia, a patient with asthma may feel:
Increased heart rate. Dizziness, general weakness and drowsiness. These symptoms are common to both respiratory failure and tachycardia. Shortness of breath, lack of air.
Tachycardia in people with asthma requires special therapy. If this is not done, heart failure may quickly develop, increasing the risk of unexpected cardiac arrest during an asthma attack.
How to treat tachycardia in bronchial asthma and possible complications
Patients with bronchial asthma require a special approach to treatment pathological changes heart rate. For sinus tachycardia, the most effective and safest would be an inhibitor of IF channels of the sinus node (Coraxan).
Its use will allow:
reduce the degree and duration of tachycardia; normalize heart contractions; improve lung hemodynamics.
For people with bronchial asthma, as well as tachycardia at the same time, the following will also be effective:
Nebivolol hydrochloride; Ivabradine; Bisoprolol; Sotalol; drugs plant origin– tinctures or tablets of hawthorn, peony, valerian, etc.
To treat asthma during its exacerbation, standard medications are used in this case:
anti-inflammatory (Dexamethasone); bronchodilators (Berodual, Salbutamol); expectorants (Ambroxol, ACC).
The exceptions are the frequently used sodium cromoglicate and sodium nedocromil, which are not recommended for use in the presence of tachycardia, since their use causes an increase in heart rate.
If not adequately treated, asthma complicated by tachycardia can lead to mass negative consequences, which can affect all systems and organs.
Complications can be divided into five main categories:
brain; gastrointestinal; metabolic; acute respiratory; heart and others.
List of possible complications of bronchial asthma, which, in the presence of tachycardia, can lead to death:
Pneumonia - this condition can, in turn, be complicated by heart failure. 
Status asthmaticus is a very prolonged suffocating attack; when complicated by tachycardia, it is very difficult to stop even for a specialist. Lung collapse- appears due to absolute blockage of the bronchus by mucus plugs. Acute respiratory failure - in this condition, the lungs and bronchi practically do not receive oxygen. Pneumothorax - due to a spontaneous increase in pressure in the lung, it ruptures.
To summarize, we can say that very often the cause of serious health problems and even death of an asthmatic is heart problems.
That is why, when diagnosing bronchial asthma, special attention should be paid to monitoring the functioning of the heart. The sooner any disturbances in the functioning of the cardiovascular system are identified, the higher the effectiveness of their treatment will be.
Do you still feel like being healthy is hard?
chronic fatigue (you get tired quickly, no matter what you do)… frequent headaches… dark circles, bags under the eyes... sneezing, rash, watery eyes, runny nose... wheezing in the lungs... exacerbation of chronic diseases...
Bondarenko Tatyana
Expert of the OPnevmonii.ru project
It is known that the most serious complications of bronchial asthma are those that arise from the cardiovascular system. If the heart suffers too seriously due to the severity of asthma, if treatment is ignored, the person may become disabled and lose the opportunity to live a normal life.
The picture on the right shows a narrowed bronchus in asthma.
It is completely impossible to cure bronchial asthma, at least modern medicine has not yet come up with such a method. But you can take control of how the disease behaves and influence its outcome. People who are attentive to their health and have a diagnosis of asthma that was made at an early stage, which is why treatment was started in a timely manner, may not remember for years that they have this disease. In the absence of treatment, asthma worsens more often, asthma attacks become long, severe and uncontrollable. This leads to disruption of the work of not only the respiratory organs, but the entire human body. After the respiratory system, the cardiovascular system suffers.
In patients with bronchial asthma, the heart begins to work worse because:
- during an exacerbation of the disease, respiratory failure occurs;
- during an attack, pressure in the chest increases;
- adverse reactions from the heart occur due to the systematic use of beta2-adrenergic agonists by asthmatics.
Asthmatics may experience the following complications from the cardiovascular system:
- arrhythmias (from extrasystoles to ventricular fibrillation);
- pulmonary hypertension;
- acute and chronic cor pulmonale;
- myocardial ischemia.
Heart rhythm disturbances in patients with bronchial asthma
Arrhythmia is an irregularity in heart rhythm during and between periods. Normally, the human heart contracts in sinus rhythm, that is, the pulse is 60-90 beats per minute. Deviations from sinus rhythm to a greater extent are called tachycardia. This is what is observed in asthmatics during an attack of suffocation, when the pulse quickens to 130-140 beats. Between attacks during exacerbation, the pulse remains at the upper limit of normal or goes beyond it (90-100 beats per minute). In this case, not only the frequency, but also the rhythm of heart contractions can be disrupted. The more severe the asthma, the more pronounced and prolonged the sinus tachycardia becomes. 
The change in heart rate during bronchial asthma is due to the fact that, in an effort to compensate for the lack of oxygen due to impaired respiratory function, which affects all tissues and organs in the body, the heart has to pump blood faster.
A patient with bronchial asthma with tachycardia may feel:
- Irregularity of the heart. Patients describe this condition as “the heart is fluttering,” “the heart is breaking out of the chest,” “the heart is freezing.”
- Weakness, dizziness. This is a common symptom for both tachycardia and severe respiratory failure, which develops during an attack of suffocation.
- Lack of air. Patients complain of shortness of breath, a feeling of tightness in the chest.
Fortunately, sinus tachycardia in bronchial asthma occurs infrequently. Typically, patients with this complication have concomitant pathologies of the cardiovascular and respiratory systems. Tachycardia in asthmatics requires differentiated therapy. Due to its absence, the rapid development of heart failure is possible, and the risk of sudden cardiac arrest during an attack of suffocation increases.
The actual treatment of heart rhythm disturbances in patients with asthma has two directions:
- It is necessary to transfer the underlying disease from the exacerbation phase to the phase of stable remission.
- It is necessary to normalize heart function through oxygen therapy and medication:
Pulmonary hypertension as a complication of bronchial asthma
One of the most common causes of acquired pulmonary hypertension is chronic respiratory diseases - bronchial asthma, tuberculosis, COPD, pulmonary fibrosis and others. The disease is characterized by an increase in pressure in the pulmonary artery, which at rest exceeds normal by 20 mm Hg, and during exercise by 30 mm Hg or more. Like sinus tachycardia, pulmonary hypertension in asthmatics is compensatory.
Symptoms of pulmonary hypertension are shortness of breath (present at rest and worsened by physical activity), dry cough, pain on the right side under the ribs, cyanosis. 
This pathological condition is also eliminated by oxygen therapy. To reduce pressure in the pulmonary artery, use:
- slow calcium channel blockers (nifedipine);
- adenosinergic drugs (aminophylline);
- diuretics (furosemide).
Right ventricular failure (cor pulmonale)
Acute cor pulmonale, or right ventricular failure, often develops during a prolonged attack of suffocation or during status asthmaticus. The pathology consists of acute expansion of the right parts of the heart (with a decrease in their contractile function) and the pulmonary artery. Hypoxemia develops. Stagnation occurs in the systemic circulation. The lungs swell and irreversible changes occur in their tissue.
Chronic cor pulmonale, characterized by an extreme degree of right ventricular dystrophy, is often incompatible with life; even resuscitation measures cannot help. 
Cor pulmonale has the following symptoms:
- feeling of tightness in the chest;
- feeling of lack of air;
- dizziness;
- swelling of the upper, lower extremities, neck, face;
- vomit;
- blood pressure surges;
- fainting.
The goals of treating cor pulmonale are to preserve the patient’s life and normalize his blood circulation. For this purpose, conservative and surgical methods are used.
The conservative method includes taking anticoagulants, beta blockers, and vasodilators. In order to alleviate the patient's condition, he is prescribed painkillers. 
In the absence of effect from drug treatment or according to direct indications, the patient undergoes cardiac surgery.
Asthma as a cause of coronary heart disease
Coronary heart disease occurs when, due to bronchial asthma, the blood supply to the myocardium is disrupted, as a result of which the heart muscle receives insufficient oxygen.
The acute form of myocardial ischemia is a heart attack, while the chronic pathological process manifests itself in periodic attacks of angina.
A patient with ischemia complains of shortness of breath, irregular heart rhythm, rapid pulse, chest pain, general weakness, swelling of the extremities.
The prognosis of the disease largely depends on how quickly and fully the patient received medical care.
Treatment of myocardial ischemia is carried out with drugs belonging to three groups:
- antiplatelet agents (clopidogrel);
- β-blockers (bisoprolol, carvedilol);
- hypocholesterolemic drugs (lovastatin, rosuvastatin).
Difficulty in diagnosing cardiovascular complications in asthmatics
It is not easy to identify certain complications of the cardiovascular system in a person diagnosed with bronchial asthma only by their symptoms because they are in many ways similar to the symptoms of the underlying disease. Therefore, it becomes necessary to use additional diagnostic methods, such as:
- Auscultation of the heart.
- Electrocardiography.
- Echocardiography.
- X-ray examination.
The cause of death for asthmatics in the vast majority of cases is cardiovascular disease. Therefore, from the moment a person is diagnosed with bronchial asthma, there is a need to monitor the work of his heart. Early detection of any possible complications from this organ greatly increases the opportunity to live long and fully.
Video: Bronchial asthma symptoms and treatment. Signs of bronchial asthma
