(1) Nitrate drugs: This type of drugs mainly includes: nitroglycerin, isosorbide dinitrate (for heart pain), isosorbide 5-mononitrate, and long-acting nitroglycerin preparations (nitroglycerin ointment) or adhesive plaster patch), etc. Nitrates are routinely used in patients with stable angina. During an angina attack, you can take nitroglycerin sublingually or use nitroglycerin aerosol. For patients with acute myocardial infarction and unstable angina pectoris, intravenous administration is required first. After the condition stabilizes and symptoms improve, oral administration or skin patching can be performed. The medication can be discontinued after the pain symptoms completely disappear. Continuous use of nitrate drugs can cause drug resistance and decrease in effectiveness. Medications can be taken 8 to 12 hours apart to reduce drug resistance.
(2) Antithrombotic drugs include antiplatelet and anticoagulant drugs. Antiplatelet drugs mainly include aspirin, clopidogrel (Plavix), tirofiban, etc., which can inhibit platelet aggregation and prevent blood clots from forming and clogging blood vessels. Aspirin is the drug of choice, with a maintenance dose of 75 to 100 mg per day. All patients with coronary heart disease should take it long-term without contraindications. The side effect of aspirin is irritation to the gastrointestinal tract, so patients with gastrointestinal ulcers should use it with caution. After coronary intervention, oral clopidogrel should be taken daily, usually for six months to one year.
Anticoagulant drugs include unfractionated heparin, low molecular weight heparin, fantaparinux, bivalirudin, etc. It is usually used in the acute phase of unstable angina and myocardial infarction, as well as during interventional procedures.
(3) Fibrinolytic drugs Thrombolytic drugs mainly include streptokinase, urokinase, tissue plasminogen activator, etc., which can dissolve the thrombus that has formed in the coronary artery occlusion, open the blood vessels, and restore blood circulation. flow, used during acute myocardial infarction.
(4) Beta-blockers Beta-blockers not only have the effect of relieving angina pectoris, but also prevent arrhythmia. In the absence of obvious contraindications, beta-blockers are the first-line medication for coronary heart disease. Commonly used drugs include: metoprolol, atenolol, bisoprolol, carvedilol and arollol (Almar), which have alpha-receptor blocking effects, etc. The dose should be to reduce the heart rate to the target within the range. Contraindications and caution in using β-blockers include asthma, chronic bronchitis, and peripheral vascular disease.
(5) Calcium channel blockers can be used to treat stable angina and angina caused by coronary spasm. Commonly used drugs include: verapamil, nifedipine controlled-release agent, amlodipine, diltiazem, etc. The use of short-acting calcium channel blockers, such as nifedipine tablets, is not recommended.