Medications after a Stent or Heart Attack

if you are admitted to the hospital to receive a stent because you've had a heart attack or you have significant plaque buildup in your coronary arteries there is a group of medications that are commonly prescribed to prevent future cardiac events these medications and doses are chosen specifically for you and you should never stop them or change the doses without first speaking to a health care professional this video includes a summary of the most commonly ordered heart health medications for a more complete medication review full videos on each drug class can be viewed in hospital or online at home we strongly advise that you review the heart health medications you are prescribed you have been prescribed an ace inhibitor ask your nurse how to access these videos before we review these medications we must first look at the heart and how it works your heart is a muscle that continually pumps blood throughout the body to do its job the heart muscle needs a constant supply of oxygen and nutrients blood vessels that wrap around the heart called the coronary arteries provide the oxygen and nutrients to your heart via blood which flows easily through a healthy artery unfortunately in some people fatty deposits called plaque can build up within the artery wall and cause problems over time the artery may narrow reducing the flow of blood to the heart muscle this narrowing caused by plaque buildup is called atherosclerosis once a blockage causes a significant enough narrowing in the artery it will be more difficult for oxygen to be delivered to that part of the heart this can lead to chest pain also known as angina a heart attack may result when unstable plaque ruptures or breaks open in the coronary artery and a blood clot forms at the site blocking blood flow to the rest of the heart after your heart attack you were admitted to the hospital and had a procedure in the cath lab known as percutaneous coronary intervention or pci where a cardiology specialist inserted a wire mesh tube called a stent into the problem artery stents are useful because they act as scaffolding to help keep the area open however when the metal stent is initially exposed there is a risk of clot forming within the stent which can result in a second heart attack of this you will be required to take anti-platelet medications to prevent your platelets from sticking together and forming clots typically two antiplatelet medications are used together which we call dual anti-platelet therapy these are aspirin or asa in combination with either clopidogrel or plavix or ticagrelor also called bralenta aspirin will usually be prescribed for the rest of your life and the second anti-platelet agent is typically prescribed for the first year although the optimal duration for you will be determined by your cardiologist or internist the reason the clopidogrel or ticagrelor is stopped or reassessed in one year is because the inside layer of your artery will eventually grow over the stent covering up the exposed metal studies have shown that the combination of anti-platelet medications reduces the risk of future heart attacks and death from cardiovascular disease it is extremely important to remember to take these medications because if a clot were to form on your new stent it could result in a second heart attack note that if you are also taking a drug called an anticoagulant such as warfarin apixaban or rivaroxaban sometimes the doctor may not want you to take any asa with the clopidogrel or ticagrelor therefore make sure you understand which anti-clotting medications you are to take before you go home and follow the directions of your prescriber exactly since these drugs inhibit platelets and slow the clotting system you may find that you bleed a little bit more easily than before therefore do not be surprised if it takes a little longer to stop bleeding if you cut yourself or if you have occasional minor nose nosebleed or bruise more easily while unlikely if you do notice blood in your urine or stools or have a major nose bleed or bruising or any other bleeding that causes you concern contact your care provider right away if you have a past history of ulcers or stomach bleeds then a medication to lower the stomach acid like pantoprazole or called tecta may be prescribed while on the combination of anti-platelet medications this medication may only need to be continued until the ticagrelor or clopidogrel is stopped check with your healthcare provider you should also avoid other drugs which can increase the chance of bleeding such as ibuprofen or advil naproxen or aleve unless your doctor specifically wants you to take them if you need something for pain acetaminophen or tylenol is usually safe to take beyond antiplatelet drugs there is a group of medications that are ordered since they have all been shown to help lower the risk of having a heart attack in the future these are the statins beta blockers and ace inhibitors there are several statin medications available but atorvastatin also known as lipitor or rosuvastatin also known as crestar are most commonly prescribed statins block a special protein that your liver needs to make ldl cholesterol sometimes called the bad cholesterol this will lower your ldl level while there are other medications that can lower your ldl cholesterol statins have the best evidence for lowering your risk of having another heart attack this is true even for people with normal cholesterol levels if you have proven plaque issues you will be on a statin medication lifelong to learn more about how to safely take your statin therapy or how to manage potential side effects please refer to the educational video at the web address shown here beta blockers block the effect of adrenaline on the body adrenaline is a chemical produced by your body and released in times of increased stress which increases the squeezing strength of the heart this may be problematic following a heart attack therefore beta blockers will slow the heart rate lower blood pressure and decrease the squeezing strength of heart contractions like statins beta blockers lower the risk of having a heart attack in the future there are several different beta blockers available but many people will be prescribed either metoprolol or bisoprolol to learn more about how to safely take your beta blocker therapy or how to manage potential side effects please refer to the educational video at the web address shown here ace inhibitors can help the heart to recover after an injury such as a heart attack blood vessels leaving the heart also known as arteries are relaxed with the use of an ace inhibitor this can make it easier for your heart to pump it will also protect your heart and allow it to get stronger you may not notice significant improvements when you first begin taking this medication it is important to know that when taken regularly its protective role may prevent future hospital admissions and help you live longer with fewer symptoms for these reasons you might be prescribed this medication even if you don't have high blood pressure one of the most commonly prescribed ace inhibitors is ramipril also known as altays to learn more about how to safely take your ace inhibitor therapy or how to manage potential side effects please refer to the educational video at the web address shown here if you've had trouble remembering to take your medications in the past then you may consider using a reminder alarm on your phone or clock placing your medications in a weekly dose at or having your community pharmacy blister pack your medications when you are discharged you should receive a prescription from the cardiologist or internist for the anticipated duration of your clopidogrel also known as plavix or tichrolor also known as brilenta therapy please fill the prescription from the cardiologist or internist and use it for the intended duration when the prescription is written by the cardiologist it may help lower your drug costs with pharmacare or other insurance companies currently fair pharmacare provides income-based insurance for eligible drugs to all british columbia residents provided they register this is a separate registration requirement from the medical services plan or msp you can register or confirm your registration with pharmacare by calling 1-800-663-7100 or using the registration search function on the pharmacare website pharmacare is income-based the less a family earns the more help or coverage they get because the deductible for your insurance depends upon recent income your status may lapse if you have not filed your income tax in the past year if you are concerned about medication costs and do not believe that you have pharmacare insurance then please inform a member of your care team so we can address this need prior to discharge if you are registered with pharmacare but are concerned that your income has significantly decreased within the last couple of years due to disability or retirement then you can contact pharmacare to ask for an income review to assess if your deductible can be reduced every january your pharmacare deductible resets and must be paid off before this government plan contributes to your medication costs some people find this creates a larger burden on their finances early in the calendar year if so you can call pharmacare to sign up for the monthly deductible payment option to evenly distribute your medication payments throughout the year remember medications are only a part of your recovery plan lifestyle changes such as stopping smoking diet changes and doing appropriate levels of activity are all important in maximizing your heart health since smoking increases your risk of a future heart event by more than threefold your community pharmacist may help you select a nicotine patch or gum without cost for up to 12 weeks through the bc smoking cessation program several resources are available at the quit now website at www.quitnow.ca you may also consider contacting smoker's helpline to provide ongoing support throughout the quitting process this service has been shown to be up to eight times more successful than quitting without support you

Channel: Island Health

Views: 126,662

Keywords: Island Health, Vancouver Island Health Authority, VIHA

Id: _cfDo8hRxrs

Length: 12min 3sec (723 seconds)

Published: Wed Dec 23 2020