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Introduction: An Unexpected "Reunion"
Uncle Wang was rushed to the hospital a year ago because of sudden angina. After a series of tests, he was diagnosed with coronary heart disease and subsequently underwent cardiac stent surgery. After the operation, Uncle Wang recovered well, and Uncle Wang returned to the gardening life he loved, and the days seemed to be calm again.
One morning a year later, Uncle Wang felt chest tightness and shortness of breath again, and the familiar discomfort made him chuckle in his heart. The results of the re-examination showed that there was a blockage near the heart stent!
This time, in addition to heart problems, Uncle Wang also mentioned the stomach medicine he had been taking for a long time. Is there any connection between the two?
With this question in mind, let's discuss the precautions for cardiac post-stent medication, especially which drugs should not be taken at the same time as heart medications, and how to do a good job of self-management in daily life.
1. Cardiac stents: the "bridge" of life and the subsequent "maintenance"
Cardiac stent surgery, medically known as percutaneous coronary intervention (PCI), is one of the important methods for the treatment of coronary heart disease. By placing a stent in a narrowed or blocked coronary artery, blood flow is restored and blood supply to the heart muscle is improved, thereby relieving angina pectoris and preventing myocardial infarction. Successful surgery does not mean that it is done once and for all, and postoperative medication and lifestyle modification are equally important.
1. Anticoagulants: the "guardian saint" to prevent the regeneration of blood clots
After cardiac stenting, in order to prevent the formation of blood clots in the stent, doctors usually prescribe anticoagulant drugs, such as aspirin, clopidogrel, etc. These drugs inhibit platelet aggregation and reduce the risk of blood clots.
However, long-term use of anticoagulant drugs may also increase the risk of bleeding, so regular monitoring of blood count and coagulation function is required.
2. Statins: The "Cornerstone" of Plaque Stabilization
Statins, such as atorvastatin and rosuvastatin, are the basic drugs for patients with coronary heart disease. They are able to lower blood lipids, especially low-density lipoprotein cholesterol (LDL-C), reduce the formation and progression of atherosclerotic plaques, thereby stabilizing existing plaques and preventing rupture.
2. The "unexpected encounter" of stomach medicine and heart medicine
Uncle Wang has been taking a stomach medicine called proton pump inhibitor (PPI) for a long time, which is used to relieve symptoms such as stomach pain and stomach ulcers caused by excessive stomach acid. This class of drugs includes omeprazole, lansoprazole, etc., which is one of the commonly used gastric drugs in clinical practice.
1. The "conflict" between PPI and clopidogrel
Studies have shown that some PPI drugs, especially omeprazole, may inhibit an enzyme in the liver called CYP2C19, which is necessary for clopidogrel to be converted to its active form in the body.
Therefore, taking omeprazole and clopidogrel at the same time may reduce the anticoagulant effect of clopidogrel and increase the risk of cardiovascular events.
2. "Incompatibility" between calcium ion antagonists and certain gastric drugs
Another commonly used class of heart medications are calcium antagonists, such as nifedipine and amlodipine, which are mainly used to treat high blood pressure and angina. Some stomach medications, such as antacids containing aluminum and magnesium, may affect the absorption of calcium ion antagonists, thereby reducing their efficacy.
3. The "minefield" of medication for heart disease patients
In addition to the above-mentioned interactions between stomach medications and heart medications, there are some common drug combinations that also require special vigilance for heart patients.
1. Nonsteroidal anti-inflammatory drugs (NSAIDs) vs. anticoagulants
NSAIDs, such as ibuprofen and indomethacin, are often used to relieve pain and fever. However, these drugs may increase the risk of bleeding, which is further increased when combined with anticoagulants.
Therefore, patients with heart disease should try to avoid the use of NSAIDs when choosing analgesics, or use them with caution under the guidance of a doctor.
2. Diuretics with certain antibiotics
Diuretics, such as hydrochlorothiazide and furosemide, are commonly used to treat high blood pressure and heart failure. Some antibiotics, such as aminoglycosides (e.g., gentamicin) and sulfonamides (e.g., sulfamethoxazole), may affect diuretic excretion, causing the drug to accumulate in the body and increasing the risk of side effects.
3. Antidepressants and heart medications
Depression is common in people with heart disease, but antidepressants, especially tricyclic antidepressants (eg, amitriptyline, doxepin), may affect the conduction system of the heart and may increase the risk of arrhythmias when combined with heart medications.
Therefore, patients with heart disease should prioritize drugs that have less impact on the heart, such as selective serotonin reuptake inhibitors (SSRIs), when choosing antidepressants.
4. "Be careful" in life: self-management and prevention
In addition to avoiding drug-drug interactions, heart patients should also pay attention to the following points in their daily life to prevent re-blockage after cardiac stents.
1. Diet: Balanced nutrition, low salt and low fat
Traditional Chinese medicine emphasizes the "homology of medicine and food", and a reasonable diet is especially important for patients with heart disease. You should eat more foods rich in dietary fiber, such as vegetables, fruits, whole grains, etc., and eat less foods that are high in fat, salt, and sugar.
There is a folk saying that "disease enters from the mouth", and for heart patients, it is even more important to manage this mouth.
2. Moderate exercise: Combine movement and static, and do what you can
"Life lies in exercise", but people with heart disease need to exercise within their means. Moderate-intensity aerobic exercise, such as brisk walking, jogging, tai chi, etc., is recommended for at least 150 minutes per week. It is best to consult a doctor before exercising to develop an exercise plan that suits you.
3. Quit smoking and limit alcohol: stay away from poison and protect your heart
"Smoking and alcohol hurt the body", for patients with heart disease, it is necessary to resolutely quit smoking and limit alcohol. The nicotine in tobacco damages the endothelium of blood vessels and accelerates atherosclerosis; Excessive alcohol can lead to an increase in blood pressure, which increases the burden on the heart.
4. Regular review: monitor indicators and adjust them in time
Patients with heart disease should regularly review blood routine, coagulation function, blood lipids, electrocardiogram and other indicators in order to detect potential problems in time and adjust the treatment plan. It's like taking care of your car, only regular inspections can ensure that the machine is functioning properly.
5. Psychological Adjustment: Stay optimistic and have a peaceful mind
"Heart disease also needs heart medicine", heart disease patients are often accompanied by anxiety, depression and other psychological problems. You should learn to self-regulate, maintain an optimistic attitude, and seek help from a counselor if necessary. In traditional Chinese culture, it is especially important for heart patients to maintain a peaceful heart.
5. Conclusion: Doctors and patients work together to build a "heart" line of defense
Uncle Wang's case reminds us that cardiac stent surgery is not a peace of mind, and drug interactions and lifestyle adjustments are equally important.
As a patient, you should take your medication according to your doctor's instructions and do not change or stop taking your medication at will. At the same time, maintain good living habits and mentality, have regular check-ups, and communicate with doctors about changes in their condition in a timely manner. As physicians, it is also important to educate patients about the risk of drug-drug interactions and develop individualized treatment plans.
With the joint efforts of doctors and patients, we can build a solid "heart" defense line and make life after cardiac stents better. As the ancients said, "The heart of the doctor is the heart of the parents", I hope that every heart disease patient can get the best treatment and care, and enjoy a healthy and happy life.
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