14 best drugs for the heart and blood vessels

*Overview of the best according to the editors of Healthy Food Near Me. About selection criteria. This material is subjective, is not an advertisement and does not serve as a guide to the purchase. Before buying, you need to consult with a specialist.

If you open any modern national manual on cardiology, on cardiovascular diseases, then regardless of the country that published this weighty work, the most important, primary problems of cardiology will be the same. True, for this, countries must be developed, that is, the average life expectancy must be longer, in any case, 70 years. Diseases associated with natural aging will then manifest differently than in African countries, where life expectancy sometimes does not exceed 50 years. So, what are the “three pillars” of modern cardiology, and what diseases of the heart and blood vessels require a variety of modern medicines?

“Whales” of modern cardiology

First of all, it is arterial hypertension, or, as they used to say, hypertension. Hypertension leads to various complications, such as hypertensive crises, cardiomyopathy, kidney and vascular damage. A hypertensive crisis can also lead to a stroke.

The second big problem in cardiology is atherosclerosis. Atherosclerotic changes in blood vessels, the appearance of plaques in them, is fraught with the development of cardiovascular complications, which are called “vascular catastrophes”. They are the main causes of death in developed countries in old age: these are heart attacks and strokes, that is, myocardial infarction and cerebral infarction.

The “third whale” on which modern cardiological science stands is coronary heart disease. The heart is the organ that is most sensitive to oxygen deficiency, as it literally works like a pump. If the brain is extremely sensitive to glucose deficiency, then a violation of coronary blood flow can lead not only to a typical angina attack, but also to myocardial infarction, to sudden coronary death.

The next big problem is various rhythm and conduction disturbances of the heart. Atrial fibrillation, ventricular arrhythmia, slowing of the heart rate (bradyarrhythmias), various blockades may either not be felt, or lead to severe, sometimes incompatible with life complications, for example, ventricular fibrillation and flutter.

Cardiologists also deal with individual pathological changes in all three layers of the heart, that is, the endocardium, myocardium and pericardium. These include acquired and congenital malformations, myocardial inflammation, cardiomyopathies and alcoholic heart disease, heart tumors, which are very rare, and infective endocarditis and pericarditis, which are much more common.

It should not be forgotten that the heart pumps blood not only into the aorta, and then into the systemic circulation, saturating all organs and tissues with oxygen. The heart also pumps blood into the pulmonary artery, so that in the lungs it gives up carbon dioxide and is saturated with oxygen. The problem of the pulmonary circulation is most often expressed in the so-called pulmonary hypertension, with the formation of stagnation and hypertrophy of the right heart, the appearance of the so-called “cor pulmonale”, or cor pulmonale.

Close to the problems associated with pulmonary hypertension and the pulmonary circulation, there is also a big problem of pulmonary embolism associated with thrombosis of venous origin. Any person who goes for a planned operation, for example, a knee or hip joint replacement, must undergo an ultrasound scan of the vessels of the lower extremities, namely the venous bed, before the operation. And during the postoperative period, he must tightly bandage the legs with an elastic bandage, or wear compression underwear, specially selected for the compression class. At the same time, low molecular weight heparins, for example, fraxiparin, are prescribed. This avoids the separation of venous thrombi, and their entry into the pulmonary artery.

Since the veins of the systemic circulation increase in size along the course of blood flow, venous thrombi easily penetrate first into the inferior vena cava, then into the right atrium, right ventricle, and then into the pulmonary artery. But after that, the pulmonary artery begins to split into branches, which diverge into the lobes and segments of the lungs, to saturate the blood with oxygen. And when a thrombus clogs a certain caliber of the vessel, the corresponding part of the lungs is switched off from gas exchange. If the clot is large, then it can completely stop the blood flow in the lungs, and this condition will be very serious, and can lead to death.

Finally, a big, but far from the last problem of cardiology is considered to be heart failure, and mainly chronic heart failure, when the pumping function of the heart is not enough to pump the volume of circulating fluid. The strength of the myocardium is reduced, and edema begins to accumulate in the body. Cardiac edema first appears on the legs, and can be intermittent, and disappear by morning, because in a horizontal position, the venous return of blood to the heart from the lower extremities is facilitated.

But in the afternoon, by the evening, when a person is on his feet all day, he gradually develops congestive cardiac edema, and with an increase in heart failure, these edema cease to disappear. Shortness of breath appears, exercise tolerance decreases, fluid begins to accumulate in the abdominal cavity with the formation of ascites, sometimes in the pericardial cavity. The liver, neck veins swell, and such patients become severely disabled.

The answer of pharmacology

According to the problems of cardiovascular pathology, modern pharmacology has introduced a large number of powerful and highly specialized drugs into the arsenal of drugs, which are used according to strict indications. Today’s review includes 14 drugs that are successfully used in a variety of cardiovascular diseases. All of these drugs belong to different classes of drugs, and the review can be considered to list 14 different classes of drugs used to treat cardiovascular disease.

In each class, you can find many other representatives that have a different chemical structure, and not just analogues of this particular drug. For example, in the group of beta-blockers, ACE inhibitors, statins to reduce the level of “bad cholesterol” there are not just a few representatives, but even several generations of these drugs. But we will not take into account this complexity and branching of drug classifications. Our task is to show the variety of means for the treatment of cardiovascular pathology.

Some of these medicines are used to treat several diseases at once. For example, diuretics, or diuretics, are needed to eliminate excess fluid in congestive cardiovascular insufficiency, and they are also used to treat hypertension in order to reduce pressure. Similarly, the calcium blocker or “antagonist” verapamil can be used not only to lower blood pressure in hypertension, but also as a drug that normalizes heart rhythm. Finally, the well-known antiplatelet agent acetylsalicylic acid (“heart aspirin”) is needed for many cardiovascular diseases, atherosclerotic lesions, coronary heart disease, and so on.

Rating of the best drugs for the heart and blood vessels

Rating of drugs for the treatment of diseases of the heart and blood vessels

This list, of course, was not created for self-treatment. You will not find dietary supplements there – nutritional supplements like Capilar, drugs like Mildronate or Meldonium, who gained worldwide fame thanks to his “sports career”. Here you will not find validol, which, in fact, are irritating mints, and, unlike nitroglycerin, is not able to stop an angina attack.

All these are serious medicines, and this review serves to broaden one’s horizons, to understand what kind of arsenal modern cardiology has. You or your relatives may have been prescribed some of these drugs. For each medicinal product, an international non-proprietary name, or INN, is first given. Then, if available, the name of the originator product that first entered the market. After that, generics, trade names, or commercial copies. The price range for drugs corresponds to the end of April 2020 for pharmacies of all forms of ownership in the Russian Federation. The inclusion of drugs in the list is dictated by the National Clinical Guidelines, the National Clinical Guidelines for Cardiology, and separate protocols for managing patients for each of the diseases listed above.

Cardiac glycosides – Digoxin

Rating: 4.9

Digoxin belongs to cardiac glycosides, and is a purified natural compound isolated from woolly foxglove. It is a cardiotonic, a pacemaker that helps reduce arrhythmias. Digoxin, it increases the strength of myocardial contractions, but as compensation, it slows down the heart rate and reduces conduction. It is used for chronic heart failure, and some types of arrhythmias. Heart failure is a condition in which the strength of the myocardium is not enough to pump the existing volume of fluid and eliminate edema. Therefore, digoxin, like other cardiac glycosides, is very helpful in this.

Cardiac glycosides are used in very small dosages: these tablets are 250 micrograms each, that is, a quarter of a milligram, and even then this is sometimes a lot. The dose is selected with great care, and in chronic heart failure, the dose can even be reduced to 1/4 tablet, that is, up to 62,5 micrograms, or up to 1/16 mg, moreover, under ECG control. This is a life-saving drug, and one pack of 50 tablets, which can last for a very long time, is sold at a price of 40 to 60 rubles, by the Latvian manufacturer Grindeks.

Advantages and disadvantages

It takes a lot of knowledge and experience to prescribe cardiac glycosides and treat patients. The patient can very quickly become intoxicated with cardiac glycosides (digitalis intoxication). These symptoms will be ventricular tachycardia, extrasystoles, various rhythm disturbances, food refusal, nausea and vomiting, sleep disorders, yellow-green coloring of objects, and other alarming signs. There are also contraindications for use. These are some types of arrhythmias and blockade.

The patient should be under observation during the entire period of treatment, and preferably as often as possible, at least once every 3-4 days, do ECG monitoring at the stage of dose selection. It is strictly forbidden to change the dose, you need to take the drug every day at the same time, measure the pulse, and if it has become less than 60 beats per minute, you must immediately notify the doctor about this. It is advisable not to skip a dose. Cardiac glycosides are one of the most serious drugs that exist in medicine.

Vasodilators – (isosorbide mononitrate – Efoks long)

Rating: 4.8

This drug is intended for the treatment of angina, but not to relieve the attack itself, but to prevent the onset of the following attacks, that is, for planned treatment. Nitroglycerin, or its inhaled form, can be used to stop attacks. Efox Long is produced by the German company Schwarz Pharma, and a package of 30 prolonged-release tablets of 50 mg can be purchased at prices ranging from 230 to 360 rubles. The drug has a vasodilating effect, and therefore improves coronary blood flow, producing an antianginal effect. The drug reduces the oxygen demand of the heart muscle, which increases the coronary reserve. In addition, isosorbide mononitrate reduces blood flow to the right side of the heart, reduces pressure in the pulmonary circulation, which significantly helps prevent pulmonary edema.

A medicine is shown for the prevention of angina attacks in patients with coronary heart disease, it is also prescribed after a myocardial infarction. An additional indication is the treatment of pulmonary hypertension. You need to take the medicine inside after a meal, drinking one glass of water. Usually a dose of one tablet once a day is sufficient.

Advantages and disadvantages

The drug must be prescribed according to strict indications. It cannot be used for shock, at low pressure, in conjunction with Viagra and analogues, since they enhance the effect of the drug. It is prohibited in case of anemia and acute myocardial infarction, with pulmonary edema of toxic origin and under the age of 18 years. There are many conditions and diagnoses when Efox long requires caution, such as glaucoma. Since the drug dilates the blood vessels, a specific symptom of “nitrate” headache may sometimes occur, but it decreases after a few days and usually disappears. Also, patients feel dizziness, redness of the skin of the face, a feeling of heat and tachycardia.

There is also an interaction of the drug with other drugs that make up an impressive list. There are also symptoms of an overdose, such as dizziness, a pronounced decrease in pressure and palpitations. But if you take this medicine according to the indications and taking into account all the circumstances, then the drug really prevents angina attacks, they become less frequent and less intense, and protect the patient from a heart attack. In addition, the medicine saves from cardiogenic pulmonary edema, that is, from cardiac asthma.

Diuretic – Torasemide (Britomar, Diuver, Lotonel, Trigrim)

Rating: 4.8

It is a loop diuretic and is generally more potent than furosemide. About an hour after taking the medicine inside, a diuretic effect develops in tablets. It reaches its maximum peak on average after 4-5 hours, and the duration of the diuretic effect is from 8 to 10 hours. This highly active loop diuretic is shown in a variety of edematous conditions, in chronic renal and heart failure, in hepatic, that is, protein-free edema, and in various forms of arterial hypertension.

Torasemide is produced in the form of a Spanish-made Britomar preparation at a price of 420 rubles for 30 tablets of 10 mg. A good generic of European quality is produced by Pliva from Croatia, 20 tablets of 10 mg each will cost from 360 rubles, and in a dosage of 5 mg – from 230 rubles. It is advisable to use torasemide for edema at a dose not exceeding 1 or 2 tablets of 10 mg once a day. If we are talking about renal edema, then the initial dose is two 10 mg tablets once a day, and for hepatic edema, the dose is usually half as much. However, the maximum single dose should not exceed 40 mg. The drug can be prescribed for long-term treatment, and in the case of arterial hypertension, a dosage of 5 mg once a day is quite sufficient.

Advantages and disadvantages

The main advantage of torasemide is the lower excretion of potassium in the urine, greater activity than furosemide, and the duration of the effect. It is also important that elderly patients do not need to change the dosage. However, the drug has standard contraindications, such as allergy to sulfonamides, low potassium levels, severe dehydration, acute glomerulonephritis, and age under 18 years. Torasemide is categorically contraindicated in case of an overdose of cardiac glycosides, that is, with digitalis intoxication.

The interaction of this diuretic with other drugs should also be considered. It enhances the effect of high blood pressure drugs, increases the nephrotoxic and ototoxic effects of antibiotics, and against the background of taking acetylsalicylic acid, especially in large doses, its toxic effect may appear. If the patient has a diagnosis of diabetes mellitus, then it should be borne in mind that the appointment of this diuretic weakens the effect of drugs to reduce blood sugar concentration, this is important for long-term use.

Beta-blocker – bisoprolol (Concor, Bidop, Cordinorm, Coronal)

Rating: 4.8

Concor is a selective beta-1 blocker that works in many diseases: arterial hypertension, angina pectoris, and congestive heart failure. That is, he is able to solve as many as three main tasks of modern cardiology. Tablets with a dosage of 5 and 10 mg No. 30 from Merck are in great demand, at a price of 250 to 300 rubles. – this is an original drug, and in therapeutic doses it does not affect the beta-2 adrenoreceptors of the pancreas, skeletal muscles and smooth muscles. Therefore, it is much milder than its predecessors, such as propranolol. It must be taken according to the indications described above, at a dosage of first 5 mg once a day, and then with an increase in the dose to 10 mg once a day. The maximum recommended dose is 20 mg once daily.

Advantages and disadvantages

Despite its popularity and effectiveness, it should not be prescribed for bradycardia, sinus node block, low blood pressure, severe bronchial asthma, and severe peripheral circulatory disorders, such as Raynaud’s syndrome. He also has side reactions: dizziness, slowing of the heart rate, a feeling of coldness and numbness in the limbs. It interacts with many other drugs, so only a doctor should prescribe it. But, despite all its disadvantages, Concor is a highly effective drug that is suitable for the treatment of cardiovascular pathology, both alone and in combination with other drugs.

Peripheral vasodilator – pentoxifylline (Trental, Vasonit, Flexital)

Rating: 4.8

Since there is not only a heart, but also vessels united in the cardiovascular system, then pentoxifylline is the very medicine that acts on the vessels, expanding them, acting as a vasodilator. Therefore, this medicine is indicated for narrowing or poor patency of the arteries, with trophic ulcers, vascular disorders of the retina, with impaired cerebral or cerebral blood flow. It is used in the pathology of peripheral vessels. Trental reduces blood viscosity, improves its fluidity. It reduces platelet aggregation and reduces the concentration of fibrinogen. It is necessary to take pentoxifylline 1 tablet of 100 mg 3 times a day, and then the dose can be doubled, but not more than 1200 mg per day, or 400 mg at a time. The Indian division of Sanofi produces Trental in a dosage of 100 mg No. 60 at a price of 460 to 520 rubles.

Advantages and disadvantages

If a remedy improves the fluidity of the blood, then all conditions where it is harmful will be contraindications. These are massive bleeding, hemorrhage, acute heart attack, gastric and duodenal ulcers, and similar conditions. It is also not recommended for use in pregnant women, and side effects may include dry mouth, headache, and a feeling of blood rush to the skin. But without this drug, gangrene, trophic skin ulcers, including diabetic ones, and even diseases such as degenerative and vascular diseases of the ear, leading to hearing loss, are treated worse.

Calcium blocker (antagonist) – nifedipine (Cordaflex, Corinfar, Fenigidin)

Rating: 4.7

Cordaflex is a representative of a large group of calcium channel blockers, or calcium antagonists. It is not an antiarrhythmic drug, unlike Verapamil, but it perfectly helps patients with hypertension, angina pectoris with vasospasm, as well as chronic coronary heart disease. A popular dosage is 10 mg, produced by the Hungarian company Egis. A package of such tablets will cost no more than 100 rubles, but it will last for a long time.

The drug is taken before meals, at the initial dose of one tablet three times a day, if necessary, the dose can be doubled. The great advantage of Cordaflex and its analogues is the possibility of its use at the beginning of a hypertensive crisis or an attack of angina pectoris. The tablet must be chewed, held in the mouth under the tongue so that it begins to be absorbed into the bloodstream, and only then swallowed and washed down with water. But this applies only to simple Cordaflex, and not to prolonged-release tablets.

Advantages and disadvantages

The advantage of this drug is the ability to take it at the beginning of a hypertensive crisis or an attack of angina pectoris. But, unfortunately, when the attack is already expressed enough, taking the drug will no longer help. Hence the conclusion that he helps patients only with “experience”, who can perfectly feel the initial signs. The drug is inexpensive, of European quality, and may well be in the first aid kit of any patient with hypertension and angina pectoris, along with beta-blockers and nitroglycerin.

ACE inhibitor – lisinopril (Diroton)

Rating: 4.7

Lisinopril is a member of a large group of angiotensin-converting enzyme inhibitors, or ACE inhibitors. The scope of its application in cardiology is diverse. These are various forms of hypertension, including renal or renovascular, congestive heart failure, and even acute myocardial infarction. The drug dilates peripheral vessels, and lowers blood pressure. Its mechanism of action is associated with a decrease in the formation of angiotensin, and a decrease in the release of aldosterone. One of the quality Lisinopril is the drug Diroton of the Hungarian company Gedeon Richter. Tablets of 5 mg, designed for a two-week course, can be purchased at a price of 180 to 210 rubles. It is necessary to take the medicine at first 10 mg 1 time per day, but not more than 40 mg.

Advantages and disadvantages

ACE inhibitors also have contraindications. They cannot be used for bilateral renal artery stenosis, aortic orifice stenosis, or arterial stenosis of a single kidney. They should be used with caution in low blood pressure, or in a hypovolemic state, systemic diseases of the connective tissue. But this drug can be perfectly combined with other agents, enhancing or adding in combinations, which will lead to an optimization of the therapeutic strategy.

Angiotensin receptor antagonist – Losartan (Cozaar, Vasotenz, Lozap, Lorista)

Rating: 4.7

The original Cozaar is manufactured by Merck Sharp and is the very first angiotensin receptor antagonist to be marketed. One package of 28 tablets of 100 mg will cost inexpensively, from 170 to 210 rubles, despite the fact that this is an original drug. The task of Cozaar is to block the receptors for angiotensin, and interrupt its vasoconstrictor, or vasoconstrictor effect. Its connection with angiotensin receptors is very specific, and therefore it is used in arterial hypertension, in chronic heart failure, if patients are not helped by ACE inhibitors, or if they are intolerant. Also very important is its task to protect the kidneys in patients with type 50 diabetes who have protein in the urine. Its intake slows the progression of renal failure, as it reduces pressure in the renal arteries. For hypertension, it must be taken at a dose of 100 mg once a day, and XNUMX mg is just the maximum daily dose.

Advantages and disadvantages

The drug is contraindicated in severe violations of liver function, during pregnancy, during breastfeeding and under the age of 18 years. There are a large number of diagnosticians when Cozaar should be used with caution, such as renal artery stenosis, aortic or mitral stenosis, severe heart and kidney failure. The drug has some side effects, but in general it is very well tolerated. Diarrhea, dizziness, or coughing may most often occur.

Lipid-lowering statins – Atorvastatin (Liprimar, Atoris, Lipinorm, Torvacard, Tulip)

Rating: 4.6

Liprimar, or the original atorvastatin, is produced by the American company Pfizer, and one pack of 30 pieces of 40 mg each will cost an average of 600 rubles. This is much more profitable than using the original rosuvastatin. Any atorvastatin is indicated for disorders of lipoprotein metabolism, for angina pectoris and infarction as a means of secondary prevention, and for chronic ischemic heart disease. All tablets are unmarked, film-coated and indivisible. According to international data, atorvastatin, in dosages up to 80 milligrams, reduces total cholesterol by 30-46%.

This is a very good indicator, and at a dose of 80 mg it reduces the risk of myocardial ischemia and mortality by 16% after a course of four months, and the risk of repeated emergency hospitalization for angina pectoris threatening a heart attack – reduces by almost 26%.

Liprimar can be taken at any time of the day, regardless of meals. Before starting treatment, and during treatment, high cholesterol should be controlled by diet, exercise, and weight loss. Only under these conditions will any statin “work”. You also need to treat the underlying disease.

Advantages and disadvantages

The risk of overdose and complications is dose related. The higher the dose, the more the activity of liver enzymes can confidently increase, and usually when the dose is reduced, the enzymes return to normal. Therefore, a strict contraindication to taking Liprimar will be an active liver disease, such as hepatitis, or an increase in the activity of ALT and AST by more than 3 times compared to the norm.

Do not use the drug for pregnant, lactating women, as well as under the age of 18 years. It is forbidden to take it together with fusidic acid (a natural antibiotic of fungal origin). Patients with a history of liver disease and a risk of developing rhabdomyolysis, or muscle breakdown, should be taken with great caution.

Disaggregants – acetylsalicylic acid (TromboASS, Aspirin cardio, Cardiask, Trombopol)

Rating: 4.6

The mechanism of action of ASA is the irreversible inactivation of a specific enzyme, type 1 cyclooxygenase. As a result, the sticking between each other, first of all, of platelets, their gluing, and as a result, the formation of blood clots is reduced. In addition, acetylsalicylic acid improves the activity of plasma to dissolve the fibrin clot, or fibrinolytic activity.

It is important that after a single dose at a dosage of 75 to 150 mg, this effect persists for 7 days. Currently, low-dose acetylsalicylic acid is the “gold standard” for reducing the risk of thrombotic complications.

It is advisable to use ASA before meals, and drink plenty of fluids. In primary prevention, a dose of 50 mg can be limited, and if a person has several factors, or if he is overweight, then a single dose is 100 mg daily (up to 150 mg). Such prophylactic therapy should be long-term, for several months.

Advantages and disadvantages

Nevertheless, despite all the advantages of ASA, are they constantly looking for how to replace aspirin for blood thinning? The most important negative property of aspirin is the ability to exacerbate stomach ulcers, duodenal ulcers, erosive gastritis, and even with exacerbation of these diseases, there may be gastrointestinal bleeding. It is also dangerous to use aspirin in bronchial asthma, and especially in the presence of sinus polyposis. As a result, a severe reaction may develop. It is strictly forbidden to take ASA in children due to the possibility of developing severe disorders (Reye’s syndrome), and so on.

Anticoagulants: Vitamin K antagonist – Warfarin (Warfarin Nycomed)

Rating: 4.5

Warfarin is a drug that does not act on the heart, and not even on the vessels, but on the blood. It is an anticoagulant, and it prevents the formation of various emboli in the blood, which can cause cardioembolic stroke, pulmonary embolism, venous thrombosis, as well as the cause of myocardial infarction or the occurrence of the same thromboembolic complications in patients with transplanted heart valves. The drug acts on the synthesis of vitamin K, and slows down the synthesis of blood coagulation factors associated with it, its anticoagulant effect is associated with this, which develops to the maximum a week after the start of administration.

The drug is taken according to the schemes prescribed by the doctor, and while taking Vrfarin, you need to regularly monitor the INR, every month, and also before starting treatment. Patients use warfarin for a long time. Warfarin-Nycomed can be considered one of the highest quality drugs, and 50 tablets of 2,5 mg each will cost from 90 to 110 rubles, which is inexpensive when it comes to health and life.

Advantages and disadvantages

A disadvantage can be considered regular monitoring of INR, strict adherence by the patient to the prescribed dose. Fever, alcohol intake, can increase the effect of warfarin, and even cause bleeding. It is contraindicated in severe damage to the liver and kidneys, low platelets, arterial aneurysms, gastric and duodenal ulcers, as well as a high risk of bleeding. But if used correctly, Warfarin protects the patient from many severe thromboembolic complications.

omega 3-NJK (Solgar)

Rating: 4.5

Perhaps Omega 3 fatty acids are the only dietary supplement on our list. But these acids, which are found in fish oil, contribute to a significant reduction in “bad cholesterol”, they reduce insulin resistance in type 700 diabetes, can improve the quality of lipid-lowering therapy in atherosclerosis, and help improve the sugar profile in type 3 diabetes, which very often complicates the course of the heart. – vascular pathology. These capsules (2 mg each) provide one of the best concentrated fish oils with an optimal content of omega-60 polyunsaturated fatty acids. It is necessary to take one capsule 800 times a day with meals. A pack of 2000 of these capsules, designed for a month, can cost from XNUMX to XNUMX rubles. Anchovy, mackerel and sardine are used in the production of these capsules.

Advantages and disadvantages

The disadvantage of these capsules is that they alone cannot cope with any cardiovascular disease, as well as their high price. But their addition to certain treatment regimens can significantly improve blood pressure, lipid spectrum, and sugar profile in type XNUMX diabetes associated with insulin resistance.

Aldosterone antagonists – Spironolactone (Aldactone, Veroshpiron)

Rating: 4.5

How does Veroshpiron work? Its action is different from thiazides and loop diuretics. It is a competitive antagonist of the mineralocorticoid hormone aldosterone, which regulates water-salt metabolism. Spironolactone “prohibits” aldosterone from retaining water and sodium, and potassium is saved by suppressing the corresponding effect of aldosterone, reducing the synthesis of specific enzymes in that part of the collecting ducts that depends on aldosterone. The diuretic effect, as mentioned above, will appear on average on the 4-5th day of treatment, and just as slowly, after a few days, a decrease in blood pressure will begin to be realized.

This medicine is used to treat arterial hypertension, and not as an independent agent for monotherapy, but in combination. It is prescribed in dosages from 25 to 100 mg per day, divided into 3-4 doses. It is inexpensive, and one pack of the drug, 25 mg each, in the amount of 20 pieces, produced by the Hungarian company Gedeon Richter in March 2020, will cost an average of 65 to 95 rubles.

Advantages and disadvantages

When prescribing Veroshpiron, it is always necessary to take into account the mineralocorticoid metabolism in the patient. It is contraindicated in Addison’s disease and high concentrations of potassium in the blood plasma, with low sodium and severe forms of renal failure, in pregnant women, toddlers, in childhood, and for some other reasons. You can, only carefully, use Veroshpiron with a high concentration of calcium in the plasma, and the presence of atrioventricular blockade. Arrhythmologists know that a high concentration of potassium increases the risk of developing this type of heart rhythm disturbance, and Veroshpiron, unlike other diuretics, just prevents the excretion of potassium from the body. A relative contraindication is diabetes mellitus, and especially diabetic nephropathy.

Antiarrhythmics — Lidocaine (Xylocaine, Xycaine)

Rating: 4.4

Of course, Lidocaine is much more widely known as a local anesthetic, for example, for small operations in dentistry. It is also an effective antiarrhythmic agent, which, unlike novocainamide, blocks not only open channels for sodium, but also those that are inactivated. This class of drugs has little or no effect on intracardiac conduction and therefore does not widen the ventricular QRS complex (the contraction time does not increase). Lidocaine selectively acts on damaged myocardial tissue, for example, during ischemia, and forms foci of local blockade of impulse conduction. It is important that Lidocaine has almost no effect on the tone of the autonomic nervous system, unlike novocainamide, it does not lower blood pressure and does not reduce cardiac output fraction.

Lidocaine is shown, like other drugs of this class, with the development of ventricular arrhythmias against the background of acute myocardial infarction, ventricular arrhythmias against the background of an overdose of cardiac glycosides, with the so-called digitalis intoxication. Indications – and other ventricular arrhythmias, such as extrasystoles, tachycardia.

Advantages and disadvantages

Adverse effects of lidocaine are dose-related and bradycardia and sinus arrest may occur. There is drowsiness and headache, numbness of the limbs, paresthesia, double vision and muscle twitching. Since Lidocaine can interact with other antiarrhythmic drugs, with the same novocainamide, it is strictly forbidden to independently attach any second drug to it without consulting an arrhythmologist.

Lidocaine is one of the most inexpensive drugs, and you can buy it at almost any pharmacy, of course, not as an antiarrhythmic drug, but as a local anesthetic. It is not intended for home use in Russia. 10 ampoules of 2 ml of 2% lidocaine produced by the domestic company Biosintez can be purchased even for 20 rubles.

Attention! This material is subjective, is not an advertisement and does not serve as a guide to the purchase. Before buying, you need to consult with a specialist.