Main groups of drugs for the treatment of chronic heart failure, use, indications for the treatment of CHF

Principles of drug treatment of heart failure

Heart failure is a disease in which the functioning of the myocardium is impaired due to weakening of the muscle. In this case, there is poor circulation, blood stagnation, swelling of the limbs and other manifestations.

Basic principles of therapy:

• Facilitating the functioning of the heart by reducing the myocardial oxygen demand.
• Normalization of blood circulation.
• Elimination of edema by stimulating blood filtration in the kidneys.
• Relief of associated symptoms.
• Increased performance and improved night sleep.

Thanks to taking medications, the specialist achieves significant improvement, and the patient can lead a normal life, following all the rules and recommendations.

Classification of medications

Experts divide pills for heart failure into several groups depending on the mechanism of action and other features.

The most common groups of medications:

• ACE inhibitors.
• Cardiac glycosides.
• Diuretic medications.
• Beta blockers.
• Metabolic drugs.
• Nitrates.
• Sedative and sympathomimetic drugs.
• Antithrombotic drugs.

In the treatment of pathology, drugs from other groups are used. The treatment regimen is drawn up in each case individually.

Symptoms

Heart failure is a pathophysiological syndrome that manifests itself in a variety of symptoms. They will differ depending on which part of the heart is affected. Highlight:

1. Left ventricular failure is a condition caused by the inability of the left ventricle to move into the aorta all the blood flowing to it from the pulmonary veins, and is characterized by stagnation of blood in the pulmonary circulation.
2. Right ventricular failure is a condition caused by a decrease in the contractility of the right ventricle, characterized by stagnation in the systemic circulation.

Common symptoms are:

• shortness of breath;
• orthopnea;
• decreased exercise tolerance;
• night cough;
• wheezing;
• weight gain (>2 kg per week) or weight loss (in severe heart failure);
• loss of appetite;
• confusion of thinking (especially in old age);
• depression;
• strong heartbeat;
• fainting;
• swelling in the legs.

Symptoms of heart failure

A person has difficulty with physical activity. In later stages, one may experience similar symptoms even at rest. As a result of poor blood circulation, all organs and systems of the body will suffer.

Cardiac glycosides

Drugs in this group are used for arrhythmia and tachycardia, as well as any form of heart failure. They are prescribed in the post-infarction period for some patients, as well as for angina pectoris.

Medicines are in most cases of natural origin, since they contain extracts from medicinal plants. The drugs relieve acute symptoms of heart failure, as well as kidney disorders.

List of prescribed tablets

Several medications are used to treat heart failure:

Each medication is also available in the form of a solution for intramuscular administration, but the tablet form is more convenient for home use.

Diet for heart failure

Proper nutrition will help patients improve their quality of life. Here are the basic tips:

• Limit your salt intake, which causes water retention in the body and aggravates symptoms such as swelling of the legs, shortness of breath, and rapid heartbeat. Therefore, you should not only stop salting your dishes, but also give up foods that contain significant amounts of salt - canned food, sausages, chips, salted nuts, etc. Season your dishes with lemon juice, basil, cumin;

• Limit fluid intake to 2 liters per day - this will help reduce leg swelling and shortness of breath;

• Eat small meals 4-5 times a day to avoid filling your stomach, nausea, shortness of breath or flatulence;

• Avoid animal products, which are undesirable in the prevention and treatment of cardiovascular diseases (especially those with high cholesterol);

• Fill your diet with potassium. Choose foods rich in this element (tomato paste, dried apricots, figs, dates, potatoes, sea fish, soy);

• Eat plenty of vegetables and fruits.

As for physical activity, it must be present in the patient’s daily life. However, the strength of the permitted loads depends on the degree of neglect of the disease. The same applies to human sexual activity.

Diuretics

Tablets for heart failure with a diuretic effect help remove excess fluid from the body, which accumulates in the tissues as a result of the inability of blood to circulate normally through the vessels. They stimulate glomerular filtration in the kidneys, which increases the amount of urine and facilitates the work of the heart.

Medicines are prescribed for severe swelling of the lower extremities, as well as for frequent urination at night, when the heart is able to pump blood normally without additional stress. This is why in patients with heart failure, nighttime diuresis exceeds daytime diuresis.

List of prescribed tablets

Loop diuretics and other diuretics in tablet form are used for treatment.

The most effective means:

• Lasix – loop diuretic based on furosemide. It is prescribed in the form of tablets for oral administration. Usually the patient takes 1-2 tablets in the morning, the course duration rarely exceeds 7 days. The drug is contraindicated in case of allergies, acute and chronic renal failure. The price of the medicine is from 100 rubles.

• Hydrochlorothiazide is a thiazide diuretic based on the active substance of the same name in tablet form. Patients are prescribed 1 tablet in the morning, duration of administration is up to 10 days. The product is not used for severe diabetes, allergies and renal failure. Price – from 60 rub.
• Espiro is a potassium-sparing diuretic based on eplerenone. It is prescribed for a course of up to 10 days with daily use of 1 tablet (0.25 mg) in the morning. Do not use the medicine if you are intolerant of its components, have high levels of potassium in the blood, or have kidney failure. Price – from 800 rub. for 30 tablets.

Lasix is ​​additionally available in the form of a solution for intravenous and intramuscular administration, but it is used in a hospital setting.

Symptoms of pathology

In the early stages, the patient most often does not show any signs of CHF. As the disease progresses, the following symptoms of chronic heart failure may appear:

• dyspnea;
• cough;
• fatigue;
• weakness;
• fainting;
• loss of appetite;
• urge to urinate at night;
• rapid and irregular pulse;
• palpitations (feeling of the heart working - “how it’s pounding”);
• enlarged liver or abdomen;
• swollen legs and ankles;
• sleep may be interrupted due to shortness of breath;
• weight gain.

ACE inhibitors

Drugs from this group are prescribed to patients with heart failure and hypertension. In combination with diuretic medications, they help remove excess fluid from the body, dilate blood vessels and lower blood pressure.

Such medications also ease the work of the heart and improve the patient’s quality of life. In most cases, they are prescribed on an ongoing basis.

List of prescribed tablets

• Enalapril contains the component of the same name as an active substance. Tablets are taken 2 times a day, 1 piece. Sometimes they are prescribed in a course of 2-3 weeks, but most often - on an ongoing basis. The drug is contraindicated for hypotension and bradycardia. It is not prescribed for allergies to components. Price – from 20 rub. for 10 tablets.

  
  Enalapril is a vasodilator medication that hypertensive patients take every day.

• Capoten is a drug from the group of ACE inhibitors in tablet form. Contains captopril. Patients are prescribed 1-2 tablets per day for 10-14 days. Many patients take pills constantly. The drug is contraindicated if you are allergic to its components, have high levels of potassium in the blood, or have a narrowing of the renal artery. Price – from 170 rub.
• Enap is an ACE inhibitor based on enalapril in the form of tablets, helps lower blood pressure, facilitates heart function in case of heart failure. Prescribed for continuous use in the amount of 1-2 tablets per day. Do not use in cases of severe hypotension and allergies to components. Price – from 60 rub. for 10 tablets.

The main groups of drugs used to treat chronic heart failure (CHF)

1) ACE inhibitors;
2) angiotensin receptor blockers;

3) diuretics;

4) b-blockers;

5) aldosterone antagonists

6) cardiotonic drugs (cardiac glycosides);

Modern possibilities of pharmacological effects on the renin-angiotensin system.

ACE inhibitors

(captopril, enalapril, lisinopril, ramipril, perindopril, etc.)

Mechanism of action: block the activity of ACE, which promotes the conversion of inactive angiotensin I into highly active angiotensin II.

Effects of ACE inhibitors:

systemic arteriolar vasodilation, venous vasodilation, prevention of dilatation progression and reverse development of left ventricular hypertrophy, coronary vasodilation, improvement of regional blood flow in organs and tissues, reduction of blood volume, suppression of bradykinin destruction, potassium retention.

The positive effect on symptoms, quality of life, and prognosis in patients with CHF has been fully proven.

NB! ACEIs are necessarily indicated for all patients with CHF, regardless of the etiology, stage of the process and nature of CHF.

Angiotensin receptor blockers (BAT1)

(losartan, candesartan, valsartan)

turn off the RAAS more completely. BAT 1 can be used as a replacement if you are intolerant to ACE inhibitors. BAT 1 does not cause cough.

Diuretics

Basic principles in the treatment of CHF with diuretics

1) use of diuretics together with ACE inhibitors;

2) prescribe with aldosterone antagonists;

3) prescribe the drug that is the least active and effective for a given patient;

4) diuretics should be prescribed daily in minimal doses to achieve the necessary positive diuresis (for the active phase of treatment +800-1000 ml, for the maintenance phase +200 ml with body weight control)

Drugs used to treat CHF:

Hydrochlorothiazide is the drug of choice for the treatment of moderate CHF.

Furosemide is a powerful diuretic. For severe CHF, doses vary from 20 to 500 mg for persistent edema.

Ethacrynic acid is a powerful loop diuretic.

Bumetanide is similar in action and effectiveness to furosemide.

Torsemide is the drug of choice for long-term therapy. The effect is comparable to furosemide. Lasts for a long time. Bioavailability 80%. Fewer electrolyte disturbances due to the antialdosterone mechanism. Blocks the entry of calcium into cells and reduces the degree of myocardial fibrosis and improves LV diastolic filling.

Causes of refractoriness to diuretics and ways to correct them

B-blockers

(carvedilol, bisoprolol, metoprolol)

With long-term use, beta-blockers not only do not reduce, but even increase left ventricular ejection fraction; in addition, beta-blockers reduce heart rate, have an antiarrhythmic effect, and reduce energy expenditure by the heart muscle. It has been proven that carvedilol, bisoprolol, and metoprolol can prolong the life of patients.

Basic principles of treatment of CHF with b-blockers:

1) apply only in addition to ACE inhibitors;

2) starting therapy with 1/8 of the average therapeutic dose;

3) slowly increase the dose (2 times in 2 weeks)

4) optimal doses for the treatment of CHF: carvedilol - 25 mg 2 times a day, bisoprolol -10 mg/day, metoprolol -200 mg/day.

Aldosterone antagonists

Spironolactone is a competitive antagonist of aldosterone receptors.

For long-term treatment together with an ACE inhibitor, spironolactone is used in small doses of 25-50 mg/day, prescribed either 1 time in the morning, or 2 times, but in the first half of the day. The drug can improve the prognosis and reduce mortality in patients with CHF.

In case of severe decompensation and worsening of CHF, spironolactone is used in high doses of 150-300 mg/day. The inclusion of spironolactone in the complex treatment of CHF makes it possible to overcome refractoriness to treatment in the most severe patients.

Shows maximum effectiveness in combination with other neurohormonal modulators and defines the principle of triple neurohormonal blockade in the treatment of CHF : aldosterone antagonist + b-blocker + ACE inhibitor or BAT 1

Cardiotonic drugs (cardiac glycosides);

is currently used .

Mechanism of action:

-strengthen and shorten systole;

- lengthen diastole;

-suppress excitability and inhibit the automatism of the sinus node;

-reduce the activity of the sympathoadrenal and renin-angiotensin systems, causing peripheral vasodilation.

Indications for cardiac glycosides:

1) a combination of heart failure and tachyarrhythmias;

2) tachyarrhythmias;

3) ineffectiveness of ACE inhibitors and diuretics;

4) acute heart failure.

Currently, long-term use of small doses of cardiac glycosides is used: the patient receives a fixed dose of the drug daily. The full therapeutic effect occurs after 5-7 days, from which point the dose becomes automatically maintenance. Dose up to 0.25 mg/day.

Glycoside intoxication

manifests itself

cardiac, gastrointestinal, neurological, eye symptoms.

Treatment

: withdrawal of cardiac glycoside, treatment of rhythm disturbances caused by glycoside intoxication, unithiol, Fab fragments of antibodies for binding cardiac glycosides (dihybid).

Source: //cyberpedia.su/12x994d.html

Beta blockers

Tablets from the beta blocker group are often used to relieve signs of heart failure, as well as arterial hypertension, tachycardia and arrhythmia.

They help reduce the myocardium's need for oxygen, causing it to contract less frequently. This eases the load on the muscle and helps normalize the functioning of the organ. In addition, medications lower blood pressure levels.

List of prescribed tablets

There are several drugs that are effective and help alleviate the disease:

• Anaprilin is a propranolol-based tablet that has a pronounced antiarrhythmic effect. Prescribed in courses of 1-3 weeks, you need to take 1 tablet 2-3 times a day, depending on the severity of the condition. The drug is not used for myocardial infarction, bronchial asthma, allergies. Cost – from 30 rubles.
• Betaloc is a beta-blocker based on metaprolol. It has antianginal, antiarrhythmic and hypotensive effects. Not prescribed for hypotension and bradycardia, in the acute period of myocardial infarction. The daily norm is 2-3 tablets, they must be taken for 2-4 weeks. The price of the product is from 140 rubles.
• Vasocardin - another remedy in the form of tablets based on metoprolol. The patient is prescribed 1 tablet 3 times a day for 3 weeks. The drug is contraindicated in case of allergies to its components, atrioventricular block, myocardial infarction. Its cost is approximately 60-80 rubles.

It is not recommended to take such medications without first consulting a doctor.

Diuretic medicine: list of tablets for hypertension and heart failure

It is unlikely that you will be able to select the most effective medications from a huge list of diuretics. The effect of treatment depends on many factors. For example, on the nature of the disease, the individual characteristics of the patient, taking other medications, and much more. However, we can name several drugs that are most often used in medical practice. The most popular medications include:

• Amiloride;
• Esidrex;
• Bumetanide;
• Furosemide;
• Mannitol;
• Glycerol;
• Urea.

Important! Diuretics have a number of side effects. They should be used strictly as prescribed by a doctor. Self-medication can be extremely dangerous to your health.

Diuretic drugs have been used in the treatment of hypertension for half a century; these drugs help lower blood pressure by ridding the human body of excess fluid and salts.

This function is performed by the kidneys, producing a larger volume of urine.

For heart failure, diuretics are almost always recommended.

They help improve the patient’s condition, reduce the load on the heart and blood vessels, which is created due to excess water in the human body.

Diuretics for hypertension are included in composite therapy, and occupy a major place in the process of lowering blood pressure. Numerous studies have shown that drugs with such properties act safely on the patient’s body and successfully combat surges in blood pressure.

An ideal classification of drugs with a diuretic effect should take into account all aspects of their effect on the human body. Unfortunately, it does not exist in the modern world, since all diuretics have a diverse chemical structure.

In this regard, they are fundamentally different from each other, having different principles of influence and the duration of this effect on the human body.

Previously, there were attempts to create a classification according to which area of ​​the nephron of the kidney they exert their influence on. But, a number of certain diuretic drugs not only activate the functioning of the kidneys, but also affect other internal systems of the body.

Some drugs, penetrating along with the bloodstream into the kidneys, exhibit activity along the entire length of the nephron.

In view of this circumstance, it is not possible to create a coherent system that could combine all medications of this group that rid the human body of excess water. The following types of drugs in this category are distinguished:

• The thiazide group is most often prescribed for hypertension. The tablets affect the human body slowly and very weakly, and the side effects from taking them are never pronounced.
• The loop group stimulates the kidneys to speed up and increase urine production, thus helping the body get rid of water and salt.
• The potassium-sparing group gives a weak diuretic effect, but enhances the effectiveness of treatment with other groups of diuretics.
• Aldosterone antagonists block the synthesis of the hormone, which is responsible for retaining fluid and salts in the body.
• Natural diuretics are medicinal plants and herbs, on the basis of which diuretic decoctions/tinctures are prepared.

As a rule, which diuretic to choose, whether it will be the only remedy or included in a specific treatment regimen, the doctor decides individually, depending on the patient’s condition, the course of his illness and other factors influencing it

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Calcium channel blockers

Drugs from this group block slow calcium channels, which allows them to have antiarrhythmic, antianginal and hypotensive effects. Thanks to this, the manifestations of heart failure are weakened.

Drugs are prescribed in the following cases:

• Arterial hypertension.
• The recovery period after myocardial infarction.
• Swelling of the limbs.
• Arrhythmia and angina of varying severity.
• Tachycardia.

Medicines are taken in courses of 2-4 weeks.

List of prescribed tablets

• Verapamil is a calcium channel blocker, available in tablet form. Contains the substance of the same name as an active component. It is prescribed to patients for a course of 2 weeks with daily use of 1 tablet of the drug in the morning. Not used for allergies to the composition, hypotension and bradycardia. Not prescribed for left ventricular dysfunction. Price – from 120 rub.
• Nifedipine – a product in tablet form containing nifedipine as an active ingredient. Prescribed to patients for oral administration, 1 tablet daily for 2 weeks. Many patients take the drug constantly. The drug is contraindicated in case of intolerance to its components, hypotension and severe bradycardia. Price – from 50 rub.

• Amlodipine contains the component of the same name and is available in tablet form. It is prescribed to patients for a course of 10-14 days; no more than 10 mg of the drug must be consumed per day, that is, 1 tablet. The drug is contraindicated in acute pathologies of the heart and kidneys, allergies, severe hypotension. Price – from 30 rub.

Nitrates

Heart failure pills from this group have been used for more than 100 years. They are prescribed for angina pectoris, hypertension, arrhythmia and other heart pathologies. The drugs dilate blood vessels, prevent stagnation of blood in the veins and arteries, and also relieve pain that often occurs during an attack.

List of prescribed tablets

Nitroglycerin tablets are most often prescribed. It contains the active ingredient of the same name. Take 1 tablet during an attack, dissolving until dissolved. If necessary, repeat the dose after 40 minutes. in the absence of effect. You should not take more than 3 tablets per day.

The drug is contraindicated in the following cases:

• Cardiac tamponade.
• Hemorrhagic stroke.
• Glaucoma.
• Hypotension and bradycardia.
• Toxic pulmonary edema.
• Anemia.

Do not use the medicine if you are allergic to its components. Price – from 50 rub.

• Nitrosorbide is a drug in tablet form containing isosorbide dinitrate. Prescribed 1 tablet per dose. If necessary, you can repeat it after 2 hours. You are allowed to take no more than 4 tablets per day. The drug is contraindicated for traumatic brain injuries, increased intracranial pressure, and allergies. Price – from 30 rub.
• Cardiket contains isosorbide dinitrate and is available in tablets. Prescribed in a course of 10 days with daily use of 1 tablet in the morning and evening. Not used for cardiac tamponade, hyperthyroidism, severe bradycardia. Cost – from 80 rubles.

Metabolic drugs

Drugs to improve metabolism are prescribed to patients with heart failure, pathologies of nerve endings and blood vessels, as well as hypertension. They help normalize blood circulation, improve heart function, and nourish blood vessels. Additionally, the products stimulate tissue restoration.

List of prescribed tablets

• Actovegin – tablets based on an extract from the blood of dairy calves. Prescribed 1 tablet 2 times a day for 2-3 weeks. Do not use for allergies to the composition, pulmonary edema, anuria. Price – from 300 rub.

  
  Actovegin has a wide range of indications for use, incl. heart failure. The most common form for use is in ampoules, not tablets!

• Solcoseryl is a drug in the form of dragees containing an extract from the blood of calves. It is prescribed as a course of 2-4 weeks, you should take 1 tablet 2-3 times a day. Do not use if you are allergic to the components. Price – from 350 rub.

Diuretics for hypertension and heart failure

The pressure indicator decreases due to a decrease in the volume of circulating plasma and general vascular resistance. The susceptibility of vascular walls to vasoconstrictors decreases. Diuretics affect the flow of ions through vascular cells.

Important: The use of diuretics for hypertension, as well as for heart failure, virtually eliminates the risk of death from heart attack and stroke.

Hypertension and heart failure are among the most common problems among the elderly population. Such serious disruptions to the functioning of the cardiovascular system can lead to dangerous complications and cause premature death.

If hypertension and (or) heart failure occurs and develops, the patient is prescribed complex treatment aimed at smoothing the symptoms and eliminating the cause of the disease. In the treatment of pathology, a wide range of drugs are used, which differ greatly from each other in composition and principle of action. In this article we will look at such a part of therapy as diuretics for hypertension and heart failure.

Diuretics are diuretic drugs that normalize blood pressure and reduce the load on the heart. They should be used strictly as prescribed by a doctor.

Self-medication with diuretics can lead to serious and undesirable consequences.

To better understand how exactly this type of drug helps with hypertension and heart failure, we will try to sort out everything that is known about it.

Operating principle

Several centuries ago, a mercury preparation already appeared, which was widely used in the treatment of syphilis. The drug was not effective enough to treat the disease. But doctors noticed its diuretic effect. Mercury compounds have been replaced by safer drugs. Further modifications of diuretics led to the creation of better drugs.

But even in our time, the mechanism of action of diuretics is not fully understood. An increase in blood pressure can provoke a lack of sodium chloride in the body, which is replenished with diuretics. It is also possible that the mechanism of action is directly related to the vascular system.

A modern diuretic is a diuretic drug that accelerates the excretion of urine from the body, specifically acting on the kidneys, relieving general swelling, and reducing the amount of fluid in the vessels. The work of the kidneys is activated, as a result of which, along with urine, excess fluid and excess salts, which caused swelling, are intensively removed from the body.

Other diuretics block calcium channels, causing blood vessels to dilate and temporarily normalize blood pressure. Along with these, they have a positive effect on the functioning of the kidneys, but an overdose, on the contrary, will worsen the functioning.

Before prescribing such medications, the specialist examines the patient’s complete medical history, studies the levels of magnesium, uric acid and glucose in the blood, and takes into account the presence of heart failure and other diseases. Only after these measures have been taken, the doctor will prescribe you a diuretic drug with the appropriate dosage.

Why are diuretics prescribed for hypertension and how do they work? Read here about the use of Alpha-blockers for hypertension.

1. Thiazide - remove salt from the body with low intensity. Excellent for lowering blood pressure. Combine with other medications for high blood pressure. This type includes drugs such as: Hydrochlorothiazide, Chlorthiazide, Benzthiazide.
2. Thiazide-like - an analogue of the previous type.
   Also combined with taking other medications for high blood pressure. Includes the following drugs: Indapamide, Chlorthalidone, Clopamide. If this and the previous types of therapy are not effective, the patient is prescribed loop diuretics.
3. Loop - affect the filtration functions of the kidneys.
   They successfully activate the process of removing moisture and salt from the body. At the same time, they cause many adverse reactions. They enhance kidney function and remove fluid by 30% more. The intake of salts into the body is reduced and potassium is actively excreted. These include the following drugs: Torasemide, Furasemide, Ethacrynic acid.
4. Potassium-sparing - Removes sodium and chloride from the body by acting on the renal nephrons.
   The drug does not allow the active release of potassium, which is how the drugs got their name. This type of diuretic includes: Triamterene, Amiloride, Spironolactone.
5. Aldosterone antagonists - block the release of aldosterone, a hormone that promotes the retention of moisture and salt in the body.
6. Natural.
   Decoctions and infusions prepared from medicinal herbs.

What is the difference between Actovegin and Mexidol?

• Strong - most often - loop diuretics. The excretion of fluid through urine increases by 25-30%. The action begins immediately after administration and lasts up to several days. Used when necessary to immediately relieve swelling. Do not use more than 2-3 times a week to prevent critical dehydration.
• Medium strength – T diuretics. Used as an adjunct to the treatment of any disease. The action begins two hours after administration. Over the next 24 hours, the effect on the body continues.
• Weak – natural diuretics. They are often used to prevent edema or at the final stage of treatment of diseases associated with the accumulation of excess fluid in the body. They act rather slowly, increasing the outflow of fluid by less than 5%.

Let's try to understand what diuretics are in the treatment of hypertension. Before prescribing treatment with diuretics, the specialist conducts a thorough examination, selecting the optimal drug and the ideal dosage in order to achieve the most effective treatment.

Although diuretics have very beneficial properties, they can only eliminate the symptoms, but not the cause.

The dosage of diuretics for patients suffering from hypertension is quite low. Its effectiveness is higher than taking a diuretic in a high dosage.

This happens because high doses of diuretics provoke the development of a wide range of side effects, which negatively affects the patient’s condition as a whole.

Clinical studies have proven the effectiveness of drugs in this group in the fight against high blood pressure and the treatment of hypertension. For hypertension, gentle remedies are used that are not too intense, but systematically remove fluid.

In general, experts prefer long-term use of herbal infusions and decoctions. As well as potassium-sparing drugs. Thiazide agents are also often used.

This hypertensive therapy is highly effective in conjunction with special diets that exclude foods containing sodium salts from the diet, replacing them with foods rich in potassium.

Long-term use of reduced doses of diuretics minimizes side effects. Gentle diuretics reduce the likelihood of stroke by 40% and myocardial infarction by up to 15%.

In the acute form of the disease, strong or moderate loop diuretics are prescribed. Excess water and salts are intensively removed from the body, reducing the likelihood of the occurrence and intensification of hypertension. At the same time, the venous flow to the heart decreases, as a result of which tissue swelling subsides. When using loop diuretics, doctors also prescribe drugs containing potassium, which is beneficial for the heart, which diuretics remove along with other salts.

For mild stages of the disease or chronic forms of heart failure, specialists prescribe medium thiazide medications, weak potassium-sparing drugs, or natural herbal remedies. Such drugs control the flow of urine and correct electrolyte abnormalities.

What is the difference between Validol and Corvalol?

When taking diuretics, the following rules must be observed:

• Eat foods rich in potassium;
• Follow the diet recommended by your doctor;
• Avoid alcohol or do not abuse it;
• Do not combine the use of diuretics and sleeping pills.

Therapy can only be effective if the specified rules and instructions of the attending physician are strictly observed. Preparation of a special diet plays a very important role. A large loss of fluid contributes to the loss of nutrients, which ultimately need to be replenished.

Side effects

Incorrect dosage or intolerance to the drug can cause nausea, drowsiness, weakness, dry mouth, possible diarrhea, and headache. The patient may also experience muscle weakness, arrhythmia, and skeletal muscle spasms. Possible decreased libido in men, increased blood sugar levels, allergies.

After taking Furosemide, effects such as increased urination, dry mouth, nausea, hearing loss, dizziness, skin rashes, and paresthesia may occur. The diuretic drug Uregit is irritating and can adversely affect hearing.

Side effects of aldosterone antagonists: diarrhea, vomiting, headache, convulsions, gynecomastia, skin rashes.

Menstruation disorders in women (if prescribed incorrectly), hirsutism, in men - impotence.

Osmotic diuretics, if heart failure is not properly treated, can increase plasma volume and increase the load on the heart. This can lead to pulmonary edema in heart failure.

1. Attacks of tachycardia or arrhythmia begin.
2. Vision and hearing deteriorate.
3. The pressure drops sharply. Dizziness and weakness appear, sometimes fainting.
4. A person is constantly tormented by an unreasonably strong thirst. This is a signal of dehydration.

• Hypertensive crisis: emergency care and further treatment.
• Symptoms and consequences of cerebral infarction.
• Read the instructions for using Aprovel here.

If you notice one or more of these symptoms, you must immediately stop taking diuretics and consult a specialist. In case of a serious condition, it is necessary to take a number of urgent measures:

1. Urgently replenish moisture removed from the body. Drink plain clean water in large quantities.
2. Increase the pressure. Drink strong black tea.
3. Urgently go to a specialist.

Antithrombotic drugs

Such drugs are prescribed for a tendency to blood clots, blood thickening during a heart attack, or heart failure.

The drugs slow down the formation of clotting factors and prevent platelet aggregation and attachment of clots to the walls of blood vessels.

List of prescribed tablets

The following medications are used to treat heart failure:

• Cardiomagnyl is a product based on acetylsalicylic acid. It is prescribed to the patient for a course of 14-20 days with the use of 1 tablet per day. Do not use if you have a tendency to bleeding, hemophilia, or ulcerative pathologies of the gastrointestinal tract. Price – from 150 rub.
• Plavix is ​​an antithrombotic drug based on clopidogrel. Prescribed in the amount of 1 tablet per day, the course lasts 2-3 weeks. Not used for lesions of the digestive tract, thrombocytopenia and allergies to the composition. Price – from 800 rub.
• Egitromb is another medicine containing clopidogrel. The patient is prescribed 1 tablet per day for 10 days. The drug is contraindicated in case of liver failure, internal bleeding, allergies. Price – from 730 rub.

Such drugs should only be taken as prescribed by a doctor.

Sedatives

Light sedatives are used for heart failure accompanied by hypertension, arrhythmia and tachycardia. They are indicated for insomnia and anxiety.

By reducing the activity of nervous processes in the brain, the load on the heart is reduced, and the patient’s general condition improves.

List of prescribed tablets

Afobazole tablets contain the component of the same name. Prescribed 1 tablet 2 times a day for 10-12 days. Not used during pregnancy, lactase deficiency, or allergies to the composition. The product costs about 350 rubles.

Tenoten in tablet form contains antibodies to a brain-specific protein. You should take 2-3 tablets per day, dissolving until dissolved. Course duration is from 1 to 3 weeks. Do not prescribe tablets if the components are intolerant. Price – from 250 rub.

Herbs and nutritional supplements

Patients quite often use alternative methods in the treatment of chronic heart failure. As a rule, the use of traditional medicine is ineffective. In addition, many of them can cause harm to the patient.

It is worth mentioning the interaction between St. John's wort (often used for depression) and cardiac glycosides. St. John's wort significantly reduces the effectiveness of these drugs.

We recommend reading the article about folk remedies for heart failure. From it you will learn about the disease and its symptoms, the effectiveness of treatment with herbs and berries (digitalis, hawthorn, viburnum, rowan and rose hips), the need to take vitamins and microelements.

Fish Oil Supplements

Studies have shown that fish oil supplements can improve survival in patients with heart failure. The product contains omega-3 polyunsaturated fatty acids, as well as other healthy fats.

However, there is some research evidence, although not conclusive, that fish oil supplements may be harmful for patients with an implanted cardiac defibrillator.

Coenzyme Q10 (CoQ10) and vitamin E

There is evidence from clinical studies that CoQ10 is effective for heart failure, especially when used in combination with vitamin E. However, more recent studies have shown that CoQ10 and vitamin E do not help the heart. In fact, vitamin E supplements may increase the risk of heart failure, especially in patients with diabetes and vascular disease.

Vitamin E for chronic heart failure

Other vitamins and supplements

A wide variety of vitamins (thiamine, B6 and C), minerals (calcium, magnesium, zinc, manganese, copper, selenium) are contained in food supplements (carnitine, creatine), which are proposed to treat CHF. Hawthorn is a herbal medicine used for heart failure in folk medicine. But none of them have been seriously studied. There is no evidence that a specific vitamin or supplement can treat heart failure. A healthy diet can provide a variety of vitamins and microelements.

It is always a good idea to consult with your healthcare professional before you decide to use an herbal remedy or dietary supplement.

Other means

Additionally, patients are prescribed potassium and magnesium preparations, which compensate for the deficiency of components, improve myocardial function and ease the load on the muscle.

List of prescribed drugs

• Asparkam used in tablet form. Contains magnesium and potassium. The patient should take 2 tablets per day for 2 weeks. Price – from 100 rub.

• Panangin is an analogue of Asparkam in composition and action. The patient is prescribed 1-2 tablets per day, the course lasts 14-21 days. Price – from 150 rub.

The drugs are contraindicated if the level of potassium and magnesium in the blood increases, or if you are allergic to the components of the composition.

Tablets that help get rid of the symptoms of heart failure are actively used to treat patients of different genders and ages. They bring good results and allow the patient to lead a normal lifestyle.

Article design: Vladimir the Great