Coronary heart disease is the abbreviation of coronary atherosclerotic heart disease, which is a heart disease caused by coronary atherosclerosis that leads to myocardial ischemia, hypoxia or necrosis due to narrowing of the lumen, spasm or obstruction. Currently, the drugs used in the treatment of coronary heart disease are divided into two categories: one is to reduce symptoms and improve ischemia, such as metoprolol, isosorbide mononitrate, nitroglycerin, amlodipine, etc.; the other is to prevent myocardial infarction and improve the prognosis of the drug, such as aspirin, clopidogrel, atorvastatin, perindopril, temsirolimus and so on. So many drugs, how to take it is reasonable?

When a drug is best taken depends on a variety of factors, such as the pharmacokinetics of the drug (length of half-life, the effect of food on drug absorption, the presence or absence of a first-pass effect, etc.), the body's biorhythm, and the body's tolerance to the drug. Below I will give you an introduction to the commonly used drugs for coronary heart disease.

Drugs to reduce symptoms and improve ischemia

1Lorazepam (also called beta blockers)

Lorazepam can both reduce symptoms and improve ischemia, as well as prevent myocardial infarction and improve prognosis. They are the drugs of choice for coronary heart disease. Commonly used are metoprolol tartrate tablets (Betalucil), metoprolol succinate extended-release tablets, and bisoprolol tablets.

（1Metoprolol Tartrate Tablets

Because the bioavailability of metoprolol tartrate increases by 40% when taken with a meal, the drug should be taken on an empty stomach in order to avoid bradycardia. Due to the short half-life, the drug needs to be administered 2-3 times daily.

(2) Metoprolol succinate extended-release tablets

Metoprolol succinate extended-release tablets are scored in the center and can be taken by breaking along the scores, but should not be chewed or crushed and should be taken with at least half a cup of liquid. It can be taken on an empty stomach or after a meal as food does not affect its bioavailability. It is taken once a day, preferably in the morning (sympathetic arousal in the morning results in high blood pressure and fast heart rate).

(3) Bisoprolol Fumarate Tablets

It should be taken in the morning and can be taken with a meal. Take the whole tablet with water and should not be chewed.

2nitrate drugs

As the body tends to develop tolerance to nitrates. Therefore, care should be taken to give adequate drug-free intervals when administering the drug

(Usually there should be a 6 to 8 hour daily break) to avoid reduced efficacy.

(1)Isosorbide Nitrate TabletsDuration of action 2 to 4 h. Usually 5 to 10 mg once, 2 to 3 times a day, total 10 to 30 mg a day.

(2)Isosorbide mononitrate tabletsDuration of action is 4-5 h. Usually 20 mg once, twice a day.

(3)Isosorbide Mononitrate Extended Release TabletsDuration of action 12h, once a day.

(4)nitroglycerine tablets

Nitroglycerin tablets are ineffective when taken orally due to hepatic first pass effects. They need to be taken sublingually and are used only for angina attacks.

3diphenhydramine

Amlodipine benzenesulfonate tablets and felodipine extended-release tablets are long-acting preparations and are recommended to be taken in the morning.

4Metabolism-enhancing drugs - Trimetazidine

Trimetazidine optimizes myocardial energy metabolism by modulating myocardial energy substrates and inhibiting fatty acid oxidation.Improve myocardial ischemia and left heart function, relieve angina pectoris.

Trimetazidine hydrochloride tablets.Take 20 mg three times daily with three meals.

Drugs to prevent myocardial infarction and improve prognosis

1 Aspirin

Aspirin has an anti-platelet aggregation effect and prevents thrombosis. Currently commonly used is aspirin enteric-coated tablets, which should be taken half an hour before meals.

2statin (loanword)

Statins are not only effective in lowering total cholesterol and LDL cholesterol levels and reducing cardiovascular events. Statin therapy also has beneficial effects such as slowing plaque progression, stabilizing plaque and anti-inflammation. Because cholesterol synthesis is more active at night, statins are usually taken at night or before bedtime, but long-acting atorvastatin and Rosuvastatin can be taken at any time of the day.

3Prilosec/sartan

The Guidelines for the Rational Use of Medications in Coronary Artery Disease state that prilosec or sartans should be used in all high-risk coronary artery disease patients with stable angina combined with diabetes mellitus, heart failure, or left ventricular systolic insufficiency.

Perindopril is recommended to be taken once a day early in the morning before meals.

Timosartan can be taken with or after a meal.

The above is a summary of the common drugs used in coronary heart disease, I hope to help friends with coronary heart disease. If you want to know more about the rational use of drugs, please pay attention to "Liu pharmacist words medication".

Hello, I'm Dr. Knowles Blue.

Coronary heart disease is a chronic disease, as of now it can not be cured, so coronary heart disease needs to take long-term medication to control. Most patients with coronary heart disease are required to take a variety of drugs for a long time, many patients will feel very strange, is not a drug to treat a disease? Why does coronary heart disease need so many kinds of drugs? So many drugs for coronary heart disease, which are to be sure to eat, and not necessarily eat? How to arrange? Always again a lot of questions, then try to explain today.

1, the first thing to know what coronary heart disease is all about

The full name of coronary heart disease is called coronary atherosclerotic heart disease, because of coronary atherosclerosis, resulting in blockage of coronary artery lumen, or even the formation of thrombus, so that the blood supply to the heart is affected, myocardial ischemia enough to produce angina pectoris, myocardial infarction, heart failure, etc., in effect, it is the myocardium's blood supply is in short supply. So coronary heart disease drug treatment will include antiplatelet, lower cholesterol, increase income (bracket blood vessels), less expenditure (reduce myocardial oxygen consumption) and so on.

2、Lower cholesterol - statins

(1) Principle: The root cause of coronary heart disease is actually atherosclerosis as mentioned earlierAccording to current research, the most important factor in atherosclerosis is high cholesterol, and statins not only lower cholesterol, but are also anti-inflammatory and stabilize arterial plaques., which is why statins are essential.

(2) Drug usage: commonly used statins are lovastatin, simvastatin, pravastatin, fluvastatin, atorvastatin, resuvastatin, pitavastatin, among these statins, atorvastatin and resuvastatin are the most commonly used in coronary heart disease, post-stenting, because these two belong to the third generation of statin, long-acting, effective, although according to the time of its action, it is possible to eat any time of the day, but most of them are still recommended to be taken at night.

2. Antiplatelet - aspirin, clopidogrel, tegretol

(1) Principle: Most patients who experience acute myocardial infarction do so because of arterial plaque rupture, which results in localized thrombus formation.The coronary arteries are almost completely blocked. Aspirin is the most important and effective anti-platelet and anti-thrombotic drug, so it is necessary for the treatment of coronary heart disease. In addition, for those who have had an acute infarction, coronary stenting, coronary artery bypass graft surgery, due to a "relative instability", more likely to form blood clots, so to take two anti-platelet aggregation of drugs at the same time, that is, in addition to aspirin, plus clopidogrel or Tegretol, this kind of This "relative instability" usually lasts for 1 year.

(2) Drug usage: enteric-coated aspirin is recommended, to be taken on an empty stomach every day after waking up.Do not take it after breakfast, as this reduces the irritation of aspirin on the stomach; clopidogrel can be taken both morning and evening, once a day, and can usually be taken with aspirin; tegretol needs to be taken twice a day, morning and evening, before and after meals.

3. Increase income - nitrates

(1) Principle:Just like we don't have any money in our pockets, we have to find ways to make more money, there is not enough blood flow to the myocardium, we have to find ways to increase the blood flow to the myocardium, so how can we do that through medications? Nitroglycerin, isosorbide nitrate, isosorbide mononitrate, diltiazem (non-dihydropyridine calcium antagonist), etc., all of these drugs are able to dilate the coronary arteries, so that the blood flow is larger, to a certain extent, to increase blood supply.

(2) Drug usage:Nitroglycerin, fast-acting, sublingual, a few minutes to play a role, but the duration is also short, so it is generally used in emergencies, each time a piece, every 5 minutes can be used again, if you use three times the chest pain can not be relieved, it is necessary to consult a doctor as soon as possible, this may not be simple angina, be alert to myocardial infarction. Isosorbide nitrate and isosorbide mononitrate, are to relieve angina, take 2 to 3 times a day, not very convenient, isosorbide mononitrate extended-release tablets, the effect of a long time, once a day to eat, so that the convenience of the point. Diltiazem has a similar effect, can relieve coronary artery spasm, extended-release tablets once a day. These drugs are all part of the relief of symptoms, do not necessarily have to eat, depending on individual symptoms, no angina can not eat.

4. Reduced expenditure - beta-blockers

(1) Principle:In the same way, if you don't have money in your pocket, you will find ways to save money, and if there is not enough blood flow to the heart muscle, we have to find ways to reduce the blood oxygen consumption of the heart muscle, and the medication used is the beta blocker, such as metoprolol, a class of drugs, to make the heart beat a little bit slower, and the blood oxygen required for the heart to beat 60 times per minute is completely different from beating 90 times, and that is very easy to understand.

(2) Drug usage:Let's talk about the most commonly used Metoprolol, which is available in regular and extended-release tablets; regular tablets have to be taken three times a day, before three meals, which is relatively inconvenient, especially in the middle of the day, when it is easy to forget; and extended-release tablets of Metoprolol succinate, which are taken once a day, just before breakfast. The dosage of this drug can vary greatly from person to person, ranging from half a tablet to four tablets, and the main goal is to keep the heart rate at 55-60 beats per minute.

5. Inhibition of myocardial remodeling - Prilosec/sartan

(1) Principle:This class of drugs may be more difficult to understand, simply put when a myocardial infarction, heart failure, the human body will spontaneously carry out the rearrangement of cardiomyocytes, changes in the composition of the tissue, etc., which is not good for the heart, we want to think of ways to inhibit this process through drugs, Prilosec / sartans are the most commonly used drugs.

(2) Drug usage:Hypertensive potty know, Puli / sartan is antihypertensive drugs, yes, but used to post-infarction patients can inhibit myocardial remodeling, if the patient is combined with hypertension, of course, also be able to lower blood pressure, if there is no hypertension, the regular dose is not easy to cause hypotension. The first choice of Prilosec, taken before breakfast, but some people with Prilosec develop a violent cough, then change to sartan, choose a long-acting, once a day.

In conclusion, coronary heart disease is a chronic condition that requires long-term medication, with or without stents or bypasses. Some of them must be taken, such as aspirin and statin; some of them depend on the situation, such as clopidogrel, tegretol, nitrates, beta blockers, prilosec/sartan, etc.. Try to choose the one you take once a day, in the morning on an empty stomach, not easy to forget; statin can choose to take before bedtime, the effect is better.

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This is a good question, we in order to cooperate with the work of public health health management, almost all the doctors take part of the patients' family doctor's duties, we found that many patients with coronary heart disease have this question - when should the drugs be taken, and even some patients are tired of taking too many drugs, and they are too lazy to go back to Ask the doctor, so every time a large number of drugs together, completely disregard the effectiveness of the drug;

In fact, taking medication is very simple, especially for patients with coronary artery disease, which is very regular. In order to make it clearer to you, here is an example of the medication taken by a certain patient after cardiac stenting, as follows:

1, aspirin enteric-coated tablets: this is the basic medication for patients with coronary heart disease, the main role is to inhibit platelet aggregation, to prevent thrombosis, oral once a day (100mg), can significantly reduce the risk of infarction or recurrence; because it is an enteric-coated preparation, suitable for fasting, so most of the requirements in the morning or bedtime, but I recommend taking in the morning, because the length of the time after dinner to go to bed, depending on the person. The length of time varies from person to person, some people eat at 18:00, go to bed at 22:00, before bedtime is basically in a fasting state; but some patients may eat dinner at 19:00, go to bed at 21:00, 2 hours is not enough for the stomach to complete the emptying, and if the dinner and then eat some indigestible meat will be even more difficult to empty, this state is not considered to be a fasting, it is simply not suitable for aspirin enteric-coated tablets; therefore. In my personal opinion.Taking aspirin enteric-coated tablets is best when you wake up at 6 to 7 a.m., because this is when the fasting is really done!

2, clopidogrel bisulfate tablets: the drug can be used with aspirin for cardiac stenting within the first year of antiplatelet therapy, or for patients with coronary artery disease intolerant of aspirin, it and aspirin, is also used for antiplatelet aggregation of drugs, but the mechanism of action with aspirin is not the same; the drug and the relationship between the meal is not great, can be taken at any time, however, because the cardiac stenting However, because of the requirement of "double resistance" to platelets after cardiac stent intervention, the drug can be taken at any time.Clopidogrel is better taken with aspirin enteric-coated tablets, which can work synergistically for a more dramatic effect.

3, atorvastatin calcium tablets: in general, the liver's synthesis of cholesterol will become active at night, and statins are mainly used to limit the synthesis of cholesterol by the liver, so statins will be more effective when taken at night; however, this is only limited to statins with a shorter half-life, such as simvastatin with a half-life of 2 hours, pravastatin with 1.5 hours and fluvastatin with a half-life of 0.5 hours; whereas atorvastatin calcium tablets have a half-life of 14 hours, which means that its effect can last all day long. The half-life of atorvastatin calcium tablets is 14 hours, which means that its effect can last for the whole day, so atorvastatin calcium tablets do not have to be taken at night before bedtime.Meals have no effect on atorvastatin calcium tablets.

4, Metoprolol Succinate Extended-Release Tablets: Regarding the choice of Betalax, it is recommended to consider Metoprolol Succinate Extended-Release Tablets because it only needs to be taken once a day, whereas Metoprolol Tartrate Tablets need to be taken twice a day in order to maintain the effect of the drug throughout the day;The drug is recommended to be taken in the morning; eating meals does not affect the effectiveness of the drug.

5, isosorbide mononitrate extended-release tablets: relative to isosorbide nitrate tablets, isosorbide mononitrate extended-release tablets are more suitable for patients to take for a long time, because all nitrate drugs are easy to produce drug resistance, and the longer the time to take, the more likely that drug resistance will be produced; in this regard, isosorbide mononitrate extended-release tablets to be much better, itYou only need to take it once a day, also provides us with a period of nearly 12 hours of low nitrate concentration in order to minimize the onset of tolerance.

6, enalapril maleate tablets: this is a kind of angiotensin-converting enzyme inhibitor, for patients with coronary heart disease after stenting, it is not only used to lower blood pressure, it also has the role of reducing cardiac load and improving cardiac function, so it is also necessary to take this kind of drug;Recommended to take once a day, in the morning, meals do not affect the effectiveness of the drug！

As can be seen from the above, these six drugs can all be taken together with aspirin enteric-coated tablets in the morning, only one time to complete the whole day's medication, but we do not recommend this, the more types of drugs taken at one time, the more complex their interactions will be, and the greater the impact on people's health; therefore, we recommend that aspirin enteric-coated tablets be taken orally in the morning on an empty stomach, clopidogrel bisulfate tablets, metoprolol succinate extended-release tablets, enalapril maleate tablets (If you have a weak stomach, you can take metoprolol and enalapril after breakfast), atorvastatin calcium tablets and isosorbide mononitrate extended-release tablets at night before bedtime!

The above is purely personal opinion and for reference only!

China's cardiovascular disease has more than 300 million people, including coronary heart disease as high as 10 million people, coronary heart disease harm, self-evident, disability and death rate is very high.

In order to prevent further aggravation of coronary heart disease, we need to take coronary heart disease related drugs for a long time to prevent. So the question is, so many drugs for coronary heart disease, when to eat more reasonable?

First, cornerstone number one: aspirin.It has antiplatelet aggregation properties and should be taken long term by all patients with coronary artery disease as long as they do not have a peptic ulcer, aspirin allergy, or bleeding.

Aspirin enteric-coated tablets need to be taken on an empty stomach, as for the morning up to take, or take before bedtime is currently inconclusive, Dr. Wang suggests that if time permits the morning up to take on an empty stomach.

Non-intestinal tablets are recommended to be taken with a meal!

Once a day!

Second, another cornerstone: statin.This is the other major cornerstone of coronary therapy, if coronary therapy has two legs, then statin and aspirin are the two legs of coronary therapy, and you can't do without either one, anti-inflammatory, lipid modulation, plaque stabilization. Watch out for liver damage, watch out for muscle damage, and watch out for blood sugar monitoring. Most statins need to be taken at night before bed, butThird-generation statins can theoretically be taken at any time because of the longer half-life time, so taking atorvastatin, resuvastatin, can be taken at any time.

(Definitive coronary heart disease especially after stenting, and after bypass, preferably with a third generation statin.)

Once a day!

Third, the icing on the cake: clopidogrel/tegretol.For those with acute coronary syndromes or post-stenting, this drug will not be new to you.Clopidogrel is recommended to be taken with aspirin. Once a day.。

TegretolIt is a new product that has a fast onset of action and is better suited for acute coronary syndromes, but also has a fast expiration date and needs to be taken twice a day, the first time with aspirin and the second time can be taken at bedtime.Twice a day.

Those after stenting can stop taking the drug after a minimum of a year to a year and a half.

Fourth, nitrates:Vasodilation.including nitroglycerin.Emergency angina is used, sublingual, fast-acting, note that after opening the bottle, there is a certain shelf life, three months will expire, theTake it in case of emergency.Isosorbide mononitrate, isosorbide nitrate, and also mononitrate extended-release tablets have different durations of action.

1) Isosorbide nitrate tablets have an action time of 2-4 h, 2-3 times a day.

2) Isosorbide mononitrate tablets have an action time of 4-5 h, twice a day.

3) Isosorbide mononitrate extended-release tablets have an action time of 12h, once a day.

The most critical nitrate drugs are recommended to be taken with a blanking period, which means that you choose to take them during the day and not at night, and not during the day at night.

Fifth, diltiazem:Non-dihydropyridine calcium channel blockers, which are very important medications for angina relief, include diltiazem and diltiazem extended-release tablets. They can dilate blood vessels, control blood pressure, slow the heart rate, improve blood supply under the endocardium, relieve coronary spasm, and work wonders when angina attacks are frequent.

Diltiazem tablets, 30 mg three times a day.

Diltiazem extended-release tablets, 90mg, once a day. Take early in the morning, before or after meals.

Sixth, betalactam: beta-blocker, Metoprolol tartrate, metoprolol succinate, the purpose of which is to achieve a reduction in myocardial oxygen consumption by controlling the heart rate, in the relief of angina pectoris and the control of heart failure and prevention of arrhythmias, plays an irreplaceable role, the dosage must be to achieve the target heart rate, rather than use on even.

Metoprolol tartrate, twice a day.

Metoprolol succinate, once a day. Take it early in the morning, before or after meals.

Seventh, Puri/Sartan:ACEIs and ARBs, that is, prilosec and sartans, are antihypertensive drugs, although they are antihypertensive drugs, such as fosinopril, enalapril, chlosartan, valsartan and so on. But at the same time, they are able to inhibit ventricular remodeling and prevent cardiac enlargement, which is mandatory for application after acute myocardial infarction, and bethanechol and called the cornerstone of heart failure treatment. Prilosec may trigger a dry cough, if not tolerated, choose sartan.

Long-acting medications, (short-acting commonly known as captopril, three times a day) are generally recommended once a day, and can be adjusted if blood pressure is not optimal, to be taken early in the morning, before or after meals.

Eighth, trimetazidine:It can effectively improve myocardial metabolism, increase oxygen utilization, improve myocardial hypoxia, and provide new ideas for the relief of angina pectoris.

Three times a day, before and after meals.

Ninth, nicorandil:It is a nitrate compound, which has the effect of preventing intracellular calcium ions from freeing, increasing the permeability of the cell membrane to potassium ions, expanding coronary blood vessels, continuously increasing coronary blood flow, and inhibiting coronary artery spasm, and in expanding coronary blood vessels, it doesn't affect the blood pressure, heart rate, myocardial contraction force, and myocardial oxygen consumption, and it's another sharp edge of the anti-anginal pain.

Three times a day, before and after meals.

Tenth, Chinese medicines, which need to be taken under the guidance of the relevant doctor.

Coronary heart disease drug treatment is very careful, and is not appropriated and copied, not to mention the cat and the tiger, need to be different from person to person, individualized treatment.

If you have any questions about coronary heart disease, please leave a comment or private message!

How do patients with coronary artery disease schedule their daily medications? This is an area that many times is not taken seriously by clinicians, but patients themselves sometimes cannot know much about it. However, clinically experienced cardiologists will try to minimize the number of times patients take their medications, for example, if they are able to take their medication once a day, not twice, and if they are able to take their medication twice a day, not three times, which is in line with the idea of recommending the use of longer-acting medications nowadays. This is also in line with the current recommendation of using long-acting drugs, because it can improve patient compliance, and reducing the number of times the medication is taken will help to reduce the number of cases of forgetting to take the medication. In particular, many older people who take their medication three times a day are likely to forget once or twice, and this decline in adherence can have fatal consequences.

Commonly used medications for coronary artery disease, broadly including the following categories: aspirin, clopidogrel, tegretol, statins, nitrates, betalactams, diphenhydramine, sartans, prilosec, trimetazidine, and sometimes glucose-lowering medications for some patients.

Among these listed medications that one could potentially take three times a day are analgesics in the nitrate group, captopril and trimetazidine in the prilosec group. Personally, Dr. Chang doesn't like to use medications that are taken three times a day because patients have to remember to take one or two small pills especially at noon each day, and it's especially easy to forget to take them. I would replace the analgesic with isosorbide mononitrate in a once-a-day or twice-a-day dosage form. Vasopressor I would just have the patient take twice a day or not use Vasopressor at all. Captopril I would switch to a long-acting pulsatilla, a once-a-day pulsatilla, such as fosinopril, perindopril, etc.

In this way, most patients can take their medication once in the morning and once in the evening, without having to remember to take 1-2 small tablets specifically at noon, while the therapeutic effect is not only not affected, but better. Convenient for the patient at the same time, it also improves patient compliance and reduces the number of times they forget to take their medication.

This is my specific feelings about the use of drugs for patients with coronary heart disease, its starting point is all for the sake of the patient, the starting point is the clinical front line of the specific use of feelings, only the introduction of dry goods. I hope my introduction will be helpful to you.

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Coronary heart disease patients often have to serve a large number of drugs, many friends are more confused about how to eat so many drugs, is the morning to eat together? Should they take them in the morning or at night? Eat on an empty stomach or after meals?

Coronary heart disease patients do have more drugs, the standard has a statin lipid-lowering drugs, aspirin and at least one other anti-platelet drugs, metoprolol and other drugs to inhibit myocardial oxygen consumption, in addition to often take nitrate drugs, anti-arrhythmic drugs, some traditional Chinese medicines, control of blood pressure, blood glucose and other medicines, as few as three to five, more than a dozen kinds of drugs to take up is indeed a bit of a headache. Simply put, these drugs should be categorized and taken in this way:

1. Statin lipid-lowering drugs.Statin lipid-lowering drugs are a must for all patients with coronary artery disease. If you are taking a long-acting antihypertensive drug such as atorvastatin or resveratrol, you can take it at any time of the day; if you are taking other short-acting lipid-lowering drugs such as pravastatin or simvastatin, you should take it in the evening before going to bed.

2. Antiplatelet drugs such as aspirin.Enteric-coated aspirin can be taken in the morning on an empty stomach and at night before bedtime, while drugs such as clopidogrel and tegretol have less of a food effect and can be taken before or after meals, and may have a somewhat smaller gastrointestinal effect when taken after meals.

3. Beta-blockers such as metoprolol.Long-acting metoprolol and bisoprolol can be put into a single dose in the morning; short-acting metoprolol needs to be taken 2 to 3 times a day.

4, Nitrates and other drugs that dilate the coronary arteries.Long-acting nitrates (e.g., Isradipine, Xincang, etc.) are taken once in the morning; short-acting nitrates (e.g., anticardiac pain) are taken three times a day; and nitroglycerin can be taken temporarily under the tongue if angina pectoris is an acute attack. Chinese medicines such as musk heart pill can be taken three times a day.

5. Anti-arrhythmic drugs.Some patients with coronary artery disease are often combined with atrial fibrillation, premature beats and other arrhythmias, and often take antiarrhythmic drugs such as sotalol and amiodarone. These antiarrhythmic drugs need to be taken under the direction of a doctor at regular intervals (e.g., every 8 hours), and often need to be reviewed to monitor the electrocardiogram, which should be taken under the direction of a cardiologist, and can be reviewed regularly at cardiology outpatient clinics.

6. Other.Patients with combined heart failure often need to take ACEI drugs (e.g., perindopril), usually once a day in the morning, and diuretics (e.g., spironolactone, furosemide, etc.), usually once a day in the morning. In the case of nocturnal spontaneous angina, diltiazem and other drugs to prevent coronary artery spasm need to be taken at night before going to bed. Combined hypertension and diabetes mellitus at the same time in accordance with the requirements of hypertension and diabetes mellitus medication.

Coronary artery disease patients most of the drugs are taken in the morning, may need seven or eight kinds of drugs at once, the elderly patients can be a few kinds of drugs slightly staggered for a period of time in separate doses may be better.

What should be the correct daily medication schedule for patients with coronary artery disease?

Coronary heart disease is a relatively common cardiovascular disease, coronary heart disease usually have no symptoms, but if the condition is not well controlled, it is easy to angina pectoris, myocardial infarction, heart failure and so on, the patient's life and health threat. Therefore, patients with coronary heart disease usually must pay attention to long-term standardized medication.

Coronary artery disease patients are careful about the time of day they take their medication

Patients with coronary artery disease are usually accompanied by chronic conditions such as high blood pressure. In addition, control of arterial plaque requires medications such as aspirin and statins, which vary in the optimal time to take them.

• High blood pressure medication should be taken according to the changing pattern of blood pressure

Although all high blood pressure, but each hypertensive patient's blood pressure change law is different, in the day, the person's blood pressure will have ups and downs, some people are high blood pressure during the day, low blood pressure at night, generally known as the "spoon type hypertension", characterized by two peaks and one valley; and some hypertensive patients are high blood pressure at night, low blood pressure during the day, known as the "non-spoon type hypertension". This is called "non-scoop hypertension".

Patients can then measure their blood pressure at 9~11 am, 16~18 pm and 2~3 am to judge the change pattern of their blood pressure. If it is spoon type hypertension, it is recommended to take antihypertensive drugs at 7:00 and 14:00. Nowadays, the general use of long-acting antihypertensive drugs, which need to be taken only once a day, then you can take the drugs at 7:00 in the morning, do not take the drugs before going to bed or at night. As for non-scoop or anti-scoop hypertension patients, they need to take medication before their peak blood pressure, they can go to the hospital to do a 24-hour ambulatory blood pressure monitoring, and then determine the best time to take their medication.

• Timing of Lipid-Lowering Drugs

Lipid-lowering drugs are mainly statins, which are not only capable of lowering lipids comprehensively, but also slowing down atherosclerosis, stabilizing plaques, and even reversing plaques, which is very suitable for patients with coronary heart disease.

Since the peak of cholesterol synthesis by the liver is mostly at night, statins are suitable to be taken at night or before bedtime, which is more effective than taking them during the day. Currently the commonly used clinical atorvastatin, resuvastatin, etc., are long-acting lipid-lowering drugs, taken once a day, not affected by food, so the patient can choose to take before or after dinner or before going to bed.

• Drugs to improve myocardial ischemia

Beta-blockers, also known as Lorazepam, are commonly available as Metoprolol Tartrate, Metoprolol Succinate, etc. If it is a regular tablet, the half-life is relatively short, and the medication is used 2-3 times a day, which can be taken on an empty stomach before meals; if it is an extended-release tablet, it only needs to be taken once a day, before and after meals, and it is recommended that it be taken in the morning.

Nitrates can also dilate blood vessels and improve symptoms of myocardial ischemia. Isosorbide mononitrate (Xincang) is commonly available on the market as a regular tablet to be taken twice a day with a meal, and as an extended-release tablet to be taken once a day at any time.

• Drugs to prevent myocardial infarction

The most common and familiar is aspirin, which inhibits platelet aggregation and prevents thrombosis, and is commonly used in the form of enteric-coated aspirin tablets, which are administered once a day and can be taken on an empty stomach before breakfast.

I am Dr. Huang, a cardiovascular physician dedicated to helping you manage your body by explaining the complexity and difficulty of disease knowledge in plain words. Your praise is my greatest motivation! Also, if you have family members with hypertension medication related problems, please pass this article on to them.

The first step should be to clarify what medications are taken by patients with coronary heart disease. The Rational Use of Medications for Coronary Heart Disease (second edition) recommends that secondary prevention of coronary heart disease include:

A: ACEI, antiplatelet therapy, (anti-platelet therapy) and anti-angina therapy;

B: Beta receptor blockers (beta blockers) and blood pressure control;

C: Smoking cessation (cigarette quitting) and lipid control (cholesterol lowering);

D: Rational diet (diet) and diabetes control;

E: Exercise and Education.

For the above medications, the pharmacist recommends the following:

1.ACEI:

ACEIs, which are also known as Priligy, can be taken early in the morning if they simply improve the remodeling of cardiac events, and are recommended to be taken before meals because food reduces the absorption of captopril. Other Puli can be taken before or after meals.

For patients who cannot tolerate ACEI can choose ARB class, also known as xx-sartan, the original drug Dyven (valsartan), Ambeno (Irbesartan/hydrochlorothiazide) should be taken before or during a meal, and there are no special requirements for other sartans.

2. Antiplatelet agents:

Currently commonly used drugs are mainly aspirin enteric-coated tablets, the application time of this drug has been debated for a long time, in fact, aspirin enteric-coated tablets in the morning or at night can be effective in achieving the purpose of antiplatelet aggregation, the key is that it should be taken before meals, because enteric-coated tablets will be taken after meals will be dissolved in the stomach, which increases the risk of gastrointestinal symptoms. Therefore, based on dietary requirements, if you can not guarantee that the fasting state before going to bed is best to take early in the morning.

Clopidogrel and somatogrel are another class of antiplatelet drugs. There are no special requirements for the time of taking the medication, and it is better to take it after meals if there are intolerable symptoms of the digestive tract.

3. Nitrates:

Nitroglycerin and isosorbide nitrate are often used during angina attacks, when they should be taken under the tongue. Isosorbide mononitrate is mainly used to prevent angina, if angina often occurs at night, then it is better to take before going to bed, if it occurs during the day after exertion, then it is better to take it in the early morning.

4. Beta-blockers

It is recommended to wake up early in the morning and feel your pulse first, if it is around 60 beats/minute then take the dose according to the doctor's prescription, if it is more than 70 beats/minute or less than 50 beats/minute then it is recommended to consult the doctor in time to adjust the dose. It should be noted that Metoprolol Tartrate then needs to be taken before meals, Metoprolol Succinate can be taken before or after meals, and Bisoprolol needs to be taken with meals.

5. Antihypertensive drugs

The above mentioned ACEI,ARB,β-blockers all have some antihypertensive effect, if the blood pressure of the above drugs does not reach the standard, you need to add a calcium antagonist, that is, diphenhydramine. It is recommended to take long-acting preparations or slow-controlled release preparations, avoid taking short-acting calcium antagonists. Generally antihypertensive drugs are taken early in the morning, but in the case of high blood pressure at night, i.e., antipyrine blood pressure, they should be taken before bedtime. In addition, some antihypertensive drugs containing diuretics, such as the combination preparation containing hydrochlorothiazide, should be avoided at night, so as to avoid the increase of nocturia, which affects the quality of sleep.

6. Lipid regulating drugs:

The main statins, atorvastatin and resuvastatin, have an action that lasts for 24 hours, so they can be taken at any time, but they need to be taken at the same time each day. Other statins should be taken at bedtime because cholesterol is synthesized at night. Some patients may not be able to reach the lipid level effectively on one statin alone, and may need to add ezetimibe, which is also taken at the same time each day and is not affected by food.

7. Hypoglycemic drugs

If the patient is combined with diabetes also need to actively control blood sugar, most of the hypoglycemic drugs need to be taken before meals, such as Glaxo XX. metformin tablets if you can tolerate his gastrointestinal symptoms then it can be taken before meals to increase the absorption of the drug, if you can not tolerate it then take it in the meal or after the meal; Acarbose needs to be chewed along with the first annoyance of the first mouth of the three meals. xx Lenitroxone, xx Lenitroxin, these two types of drugs are not affected by food and can be taken early in the morning.

These are the methods of taking common medications for patients with coronary artery disease, please leave a comment if you have missed anything.

The authoritative interpretation of Pharmaceutical Affairs, unauthorized reproduction, plagiarism will be punished.

What should be the correct daily medication schedule for patients with coronary artery disease?

Coronary heart disease is short for atherosclerotic heart disease of the coronary arteries. If you do not pay attention to controlling the condition, you are prone to angina pectoris, heart attack and other malignant cardiovascular events, which can lead to the death of the patient in severe cases.

How do patients with coronary artery disease schedule their medications for the day?

Coronary heart disease patients most often take nothing more than antihypertensive drugs to control blood pressure, nitrate and lorazepam to improve myocardial ischemia, aspirin and other drugs to prevent heart attacks, and statins to lower blood lipids and stabilize plaque. The following is a personal experience of a patient with an 18-year history of coronary artery disease, to see how he schedules his day and how he keeps his condition stable.

The 76-year-old moncler jackets for sale has been suffering from coronary heart disease for 18 years, in the process, he gradually summed up a set of lifestyle and medication program suitable for his own, at present the control of the disease is very stable, his day can be divided into five key time points.

① 5:00~6:00

This is the time to get up in the morning,moncler outlet online, he will first in bed to move the wrists and ankles, slowly sitting up, to prevent the rise of too fast myocardial ischemia. After getting up, he would drink a glass of warm water and take an aspirin to prevent the formation of blood clots.

② 7:00~8:00

This is the time to come back to eat breakfast after Ge went out for a walk, he likes to take antihypertensive drugs after meals, taking Prilosec, plus improve myocardial ischemia Lorazepam, once a day to take it can be more convenient, and is not easy to forget.

③ 12:00~14:00

At noon moncler outlet store, you will pay attention to eat a light diet, reduce dietary calorie intake, eat more fish and fruits and vegetables, eat less fat meat, lunch break after the meal, and sometimes outdoors in the sun, to promote the absorption of calcium, to prevent osteoporosis.

④ 15:00~17:00

In the afternoon Ge will go out to exercise, this time of the day the temperature is suitable, there is vision exposure, keep about 30 minutes of exercise every day can promote blood circulation, slow down the development of atherosclerosis.

5) 18:00~19:00

After dinner Ge will take a statin, mainly used to stabilize the plaque, so that the soft and mixed plaque becomes hard plaque, not easy to fall off and bleed to form a blood clot, statin and aspirin combined long-term application, is an effective means of preventing blood clots.

In addition to this, moncler outlet online you will also have regular reviews, usually 3 months will go to the hospital, do a comprehensive examination, usually at home, also insist on self-testing blood pressure, review the blood pressure data can also give the doctor's diagnosis to provide a certain basis for their own clear changes in their own disease, can be very good to prevent the high blood pressure caused by the cerebral hemorrhage and other accidents.

Lao Ge also said that a good state of mind is indispensable to coronary heart disease patients, usually cultivate some cultivation of hobbies, such as flowers, chess, travel, etc., to give up the irascible temper, good mood is the key to stabilize the condition.

I am Pharmacist Wang, dedicated to helping you manage your body by explaining complex and difficult disease knowledge in plain words. Your kudos are my greatest motivation! Also, if you have family members with coronary heart disease related problems, please pass this article on to them!

coronary heart diseaseThe full name iscoronary atherosclerotic heart diseaseThe heart disease is caused by atherosclerosis, in which the coronary arteries that supply blood to the heart muscle tissue are narrowed or even occluded, resulting in ischemia, hypoxia, or necrosis of the heart muscle tissue.

Coronary heart disease has many different clinical classifications, and the specific classifications differ in their principles of treatment and the treatments that need to be used. Coronary heart disease can be divided into two main categories.Chronic myocardial ischemia syndromeas well asacute coronary syndrome.. Chronic ischemic syndromes are more common with stable angina, while acute coronary syndromes include unstable angina and acute myocardial infarction.

Once acute coronary syndromes are diagnosed, most of them will be admitted to the hospital for treatment, no matter whether stenting or bypass surgery is needed, including oral medication during hospitalization, which should be carried out in accordance with the arrangement of healthcare personnel. And really need to be at home to arrange their own medication time, mostly stable angina or acute coronary syndrome after discharge from the hospital recovery period, this time, the treatment of coronary heart disease is mainly based on the maintenance of some common oral drugs.

Taking advantage of this, let's talk about what oral medications are commonly used for coronary artery disease and what are some of the precautions to be taken in terms of the timing of the medication.

Common oral medications for coronary heart disease

The first major class of drugs, theDrugs that improve myocardial ischemia and reduce angina symptoms, these drugs are mainly:

• beta-blocker: It mainly reduces the heart rate, reduces the force of contraction during myocardial contraction, and lowers blood pressure, thus reducing the oxygen consumption of myocardial tissues and suppressing angina episodes. Commonly used drugs include, metoprolol, atenolol, bisoprolol and so on;
• nitrate drugs: Nitrates can directly dilate the coronary arteries and improve the ischemic state of myocardial tissue, thus relieving angina. The more commonly used drugs include, nitroglycerin, isosorbide 5-mononitrate, isosorbide mononitrate extended-release and so on. Now.For stable coronary artery disease, the use of long-acting nitrates is more advocated. It should be noted about nitrates that resistance can occur with 24 hours of continuous use, so patients with long-term application of nitrates need to ensure that there are 8-12 hours per day without nitrates or low concentrations of nitrates in the body;
• Calcium channel antagonists (CCB class): CCB drugs can relieve angina by improving coronary blood flow and reducing myocardial oxygen consumption, especially for angina caused by variant angina or coronary artery spasm. Representative drugs include, amlodipine, felodipine, nifedipine and so on;

In addition to the three categories above, there aretrimetazidine和nicorandilIt can also be used to improve symptoms of myocardial ischemia.

The second major group of drugs are those that prevent myocardial infarction and improve the prognosis of coronary heart disease, and these drugs are mainly:

• antiplatelet drug: Aspirin is the basic drug for antiplatelet therapy, inhibiting platelet aggregation and reducing the risk of thrombosis; clopidogrel reduces ADP-mediated platelet activation and aggregation by irreversibly inhibiting the platelet ADP receptor; and tegretol, a newer drug that inhibits the platelet ADP receptor, has a stronger and reversible antiplatelet effect;
• Statin lipid-lowering drugs: Statins are mainly used to lower cholesterol, especially LDL cholesterol, and have the effects of lowering blood lipids, protecting vascular endothelial cell function, and stabilizing atherosclerotic plaques, which can improve the long-term prognosis of coronary heart disease;
• Angiotensin-converting enzyme inhibitors (ACEI)或Angiotensin II receptor antagonist (ARB): ACEIs and ARBs are both drugs that act on the human renin-angiotensin-aldosterone system (RAAS), which not only have a blood pressure-lowering effect, but also have significant cardioprotective and renoprotective effects, which can reduce the risk of various cardiovascular events.

In addition to these medications, anticoagulants may be necessary for patients with acute coronary syndromes and for those who require coronary intervention, but, in general, anticoagulation is not necessary for patients with stable angina.

Coronary heart disease medication time to pay attention to

Regarding the dosing schedule of oral medications commonly used in coronary artery disease, it is now more advocated that it should be personalized according to individual differences.As a simple example, patients with coronary heart disease are often combined with hypertension, although the majority of patients with hypertension to daytime elevation of the main, but there is still a part of the nighttime blood pressure increase of the main patients, so for this part of the patient, antihypertensive drugs should be used in the night is better.

Of course, there are some medications for which there is a recommended duration of use in routine situations, and these include:

• Long-acting nitrates, such as isosorbide mononitrate extended-release tablets, are most often recommended to be taken orally early in the morning；
• Of the beta-blockers, metoprolol succinate extended-release tablets taken once a day, as well as bisoprolol fumarate, are generally recommended to be taken in the morning；
• Among the CCB class of drugs, Lacidipine, is mostly recommended to be taken in the morning and should be taken at the same time every day；
• Statin lipid-lowering drugs, mostly recommended to be taken at night。

Recommendations on medication for patients with coronary heart disease

Here, a few medication suggestions are given specifically to patients with coronary heart disease:

1. It is important to ensure medication compliance, which means that you must make sure that you take all of the medications that your doctor has ordered you to take every day, and you should make adjustments based on your lifestyle and work schedule, etc., to make sure that you don't miss any medications;
2. The timing of the medication is prioritized by the timing of the medication ordered by the doctor as well as the recommendations on the medication instructions. Doctors tend to time some medications according to the needs of the specific condition, and once the timing is wrong, sometimes the medication can be much less effective;
3. The timing and dosage of medication may vary with different medical conditions, and medication needs to be personalized, so don't be influenced by other people to easily change your cardiologist's original medication regimen and dosing schedule.

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