Cardiovascular and cerebrovascular disease prevention and treatment of medication

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We all know that we have to take medicine to get sick, and we often listen to others, "It's three poisonous medicines." Medication is very scientific and accurate, and must not be careless. Recently, Lin Yang, director of the Pharmaceutical Department of Beijing Anzhen Hospital, Affiliated to the Capital Medical University, was guest guided by the Propaganda Department of the National Health and Health Commission, and the "Health Everyone Talk" live broadcast organized by the National Health and Health Commission and the Health China Government Affairs New Media Platform. "A reminder of intimate medication."

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Patients with coronary heart disease cannot stop the drug at will

01

Coronary heart disease patients need to take medicine after finishing surgery or coronary veins?

Director Lin Yang: Coronary heart disease is coronary atherosclerosis that causes the lumen to block and change the functionality of the coronary arteries, which cause heart disease caused by myocardial ischemia and hypoxia, also known as ischemic heart disease. Coronary heart disease has a high incidence and high mortality rate, which seriously endangers human health. The main treatment method of coronary heart disease is drug treatment. Coronary heart disease patients have a lot of medicines, and many patients have some misunderstandings or questions for medication.

Patients with coronary heart disease after some branches have relieved acute myocardial ischemia and the symptoms have disappeared. Therefore, they think that it is completely good, and I do n’t want to take medicine anymore. In fact, this is a big misunderstanding. This is because the pathogenic factor is not eradicated. Patients often have hyperlipidemia, and atherosclerotic plaques have not been removed. Therefore, lipid -lowering drugs such as statins are needed for a long time.

The implanted stent itself increases the risk of early or advanced thrombosis, so patients need to take anti -platelet drugs for a long time. None of these drugs can be discontinued at will.

02

What is the difference between anticoagulant drugs and antiplatelet drugs?

Director Lin Yang: anticoagulant drugs can play the role of inhibiting coagulation by inhibiting coagulation factors while preventing the formation of thrombosis, but cannot dissolve the thrombosis that has been formed. Anticoagulant drugs are mainly used for patients with atrial fibrillation, venous thrombosis, and artificial heart valve replacement.

Anti -plates are targets with platelet adhesion, activation, or gathering, and to a certain extent to prevent the aggregation of platelets through different mechanisms, thereby inhibiting thrombosis. The thrombosis formed by the arterial system is mainly formed through platelet activation and gathering. Therefore, antiplatelet drugs occupy a very important position in the treatment of arterial thrombosis such as coronary heart disease and cerebral thrombosis.

The mechanisms of these two types of medicines are completely different, and the diseases are different. Do not mix it.

How to avoid gastrointestinal bleeding caused by aspirin

03

The common adverse reactions of aspirin are gastrointestinal bleeding. How should patients avoid the adverse reactions of bleeding and use aspirin?

Director Lin Yang: Long -term use of aspirin may cause digestive tract damage, which is the result of the local effect and systemic effect of the drug. Aspirin causes high -risk factors for gastrointestinal bleeding: age ≥65 years old, a history of gastrointestinal ulcers or a history of bleeding, combined with Helicobacter pylori infection, smoking and drinking at any degree Combined with multiple antiplatelets or anticoagulant.

There is a layer of acid -resistant coat on the outside of Aspirin enteric -soluble tablets that can protect aspirin from being dissolved and released in an acidic environment in the gastric gastric. After the alkaline environment of Aspirin reaches the alkaline environment of the small intestine Stimulating effects and reducing the occurrence of adverse gastrointestinal tract. It is recommended to take an aspirin entericoline tablets when the empty stomach (1 hour before meal or 2 hours after meals). Taking an empty stomach can shorten the stay time of aspirin in the stomach, and then make it reach the small intestine smoothly.

It should be noted that if you are not taking aspirin enteric soluble slices, but an aspirin ordinary tablets, there is no protection mechanism above, then you should take it after meals (15-30 minutes after meals). At the same time, you can take aspirin at any time of the day, but it must be noted that it should be taken regularly at the same time every day.

The risk of gastrointestinal injury caused by aspirin increased significantly with the age and the increase in the dosage of the drug. Therefore, for people with high risk factors, remember not to increase the dosage of the drug at will. After taking the medicine, you should closely observe the signs of the signs.

For the elderly over 65 years old, especially when applying dual anti -platelet treatment, it is recommended that the dose of aspirin for a long time should not exceed 100 mg/day. For those over 80 years old, it is no longer recommended to use aspirin for first -level prevention. At the same time, smoking and alcohol should be quit and alcohol during the treatment of anti -platelet medicines to ensure sufficient sleep.

Only effective

04

Nitroglycerin is a common medicine for patients with coronary heart disease. Under what circumstances need to apply nitroglycerin?

Director Linyang: Nitroglycerin is a type of nitrate drug, which can reduce the amount of myocardial oxygen consumption and relieve the symptoms of angina pectoris; it can protect the heart by reducing the front and back of the heart; The amount, thereby narrowing the scope of cardiac infarction; it can reduce the incidence of heart failure and the incidence of ventricular fibrillation.

Nitroglycerin is generally used during the acute attack of angina pectoris. For patients with a history of myocardial infarction, they can also be taken before exercise or stool to prevent the onset of angina pectoris. In both cases, the method of nitroglycerin is different.

During the acute attack of angina pectoris, the patient was served under the tongue with half tablets or 1 tablet. It can be repeated once every 5 minutes until the symptoms are relieved. If the total amount of medication is 3 tablets in 15 minutes, and the chest pain is still not relieved or the pain is more intensified, you should seek medical treatment immediately. However, the nitroglycerin is prohibited when the acute myocardial infarction is low (systolic blood pressure ≤90 mm Hg). Therefore, in the case of conditions permit, the patient's blood pressure should be measured before using nitroglycerin. When preventing the use of nitroglycerin, it should be carried out 5 to 10 minutes before the mobility of angina pectoris (such as exercise and stool).

There are two main types of nitroglycerin preparations currently used for patients' daily self -rescue, namely tablets and qi mist. Proper use of nitroglycerin preparations is the key to ensuring that drugs can quickly play an emergency role.

Nitroglycerin tablets (underneath tongue tongue): Put these dosage nitroglycerin tablets under the tongue or the cheek mucosa, and do not chew, crush or swallow. Adults use half to 1 tablet at a time, which can be repeated every 5 minutes until the pain is relieved. If the total amount of 3 tablets in 15 minutes continues to exist, you should seek medical treatment immediately.

Nitrate glycerin spray (nitrate glycerin gas mist): Remove the hood when used, shake it, and the nozzle is facing up. Generally, 1 ~ 2 揿 is sprayed at the mucosa under the oral tongue, which is equivalent to 0.5 ~ 1mg of nitroglycerin. Remember to spray the medicinal solution directly to the lower mucosa, do not swallow it with saliva. When you use it for the first time or use it for more than 1 week before using it, you should first try to spray the air. If you can't spray, please confirm whether the use is correct or check whether the spray hole is blocked.

It should be noted that when using nitroglycerin for first aid, it is recommended to take as much as possible to avoid dizziness and falling.

The nitroglycerin tablets should be stored in the original packaging bottle. After each medication, a tight bottle cap must be covered to avoid loss of medicinal effects, and it must be saved in a cool place (avoiding light and not exceeding 20 degrees Celsius). When carrying nitroglycerin with you, you should also pay attention. Do not put the medicine in a personal clothes pocket, because nitroglycerin will be unstable at the temperature, and the drug will fail due to decomposition.

For unopened nitroglycerin, it can be used according to the shelf life on the pill. The nitroglycerin tablets after the bottle are generally invalidated for 3 to 6 months. When it contains nitroglycerin under the tongue, the patient will have a slight burning or numbness. If there is no feeling, it may indicate that nitroglycerin tablets have failed. It is recommended to replace it immediately.

The device of nitroglycerin gas fog is a pressure container. Such containers are strictly prohibited from heating, impact or piercing on the bottle. Nitroglycerin gas fog general also requires shading, saved in a cool place (avoiding light and the ambient temperature does not exceed 20 degrees Celsius). It should be noted that if the patient is flying out of the airplane, it is not allowed to bring the nitroglycerin gas fog to the plane or put it in the suitcase. In this case, it is recommended to carry nitrate slices or tongue tablets with you.

The medication time is particular

05

Elderly patients often need to take a variety of drugs. How to arrange the order of drugs? "Is taking antihypertensive drugs in the morning and taking lipid -lowering medicine at night"?

Director Lin Yang: The medication time of chronic disease drugs has a rough range. It has a certain reason for "taking antihypertensive drugs in the morning and taking lipids reduction medicine at night".

For long -term antihypertensive drugs, it is recommended to take early morning, because most people have the highest blood pressure in the morning in the morning, and taking antihypertensive drugs in the morning can reduce the morning peak of blood pressure. The rest of the night is a state of static breath. At this time, the blood pressure is relatively low. If you take antihypertensive drugs at night, hypotension will cause danger. Middle and short -acting antihypertensive drugs are generally used 2 to 3 times a day, which requires a balanced time all day.

Commonly used lipid regulatory drugs include statins and Bate. Blocking the liver synthesis cholesterol can be blocked. Because the synthesis of cholesterol is mainly performed at night, such drugs are best taken before going to bed at night. Bate -class drugs are mainly used to reduce the level of triglyceride. You only need to take it once a day and take the same as meals.

There are many types of hypoglycemic drugs, and all kinds of taking time are not the same. Patients should strictly use the doctor's advice.

06

In the age of a person, it is not good to remember, and it is inevitable to forget to take medicine. What if you forget to take the medicine on time? Should I make up for it in time?

Director Lin Yang: Should you take it in time after leaking the medicine, and the specific situation should be analyzed. For example, the hypoglycemic medicine Fuguli sugar needs to be taken before meal, and immediately eats after taking the medicine. Because its mechanism is to delay the absorption of carbohydrates in the intestine, if you think of the omissions in the meal, you can take it immediately. If you eat it after eating, the hypoglycemic effect will weaken. For another example, anticoagulant drug Huafarin can only take once a day, and take the medicine every day. After leakage, you can make up for it within 4 hours. Do not take it for more than 4 hours. Normal dose take medicine and cannot double the medicine.

Some people forget to take medicine, and some people may repeat the medicine. Before taking the medicine, you must read the instructions carefully, read the pharmaceutical ingredients, and avoid repeated medication. Especially the Chinese patent medicine, the ingredients may be the same, and several drugs should be paid special attention when taking at the same time. If it is a general drug, it will not be too much dangerous to take over or twice.

Commonly used drugs such as antibacterial drugs, cold medicines and antipyretics are mostly used when the disease occurs, so wrong medicines often occur. The total treatment principles of these types of drugs after excessive use are: first, pay attention to the adverse reactions at that time to avoid accidental damage; the other is to drink plenty of water and promote the metabolism of drugs; Gastric lavage or vomiting. Medical business card

Lin Yang, chief pharmacist, doctoral, professor, doctoral supervisor, general pharmacist of Beijing Hospital Management Center, Deputy Director of the Department of Clinical Research and Popular Diseases of Capital Medical University, Director of Pharmaceutical Department of Beijing Anzhen Hospital Affiliated to Capital Medical University, research type Director of the ward, director of the Office of the Drug Clinical Test Institution, and the head of the Phase I Clinical Research Office. He is also the chairman of the Chinese Pharmacist Association Clinical Test Drug Management Committee, deputy chairman of the Pharmacy Professional Committee of the Chinese Female Physician Association, chairman of the Chairman of the Pharmaceutical Comprehensive Evaluation Special Committee, Chairman of the Professional Committee of the Beijing Pharmaceutical Society, and Beijing Integrated Medicine Medical The president of the Association Integration Pharmaceutical Branch, etc. "Chinese Pharmaceutical", "China Clinical Pharmaceutical Magazine", "Chinese Pharmacy", "Chinese Pharmacy", "Chinese New Pharmaceuticals and Clinical Magazine" and other magazine editors, the head of the "13th Five -Year Plan" of the Ministry of Science and Technology Create a major special project leader, the national key research and development plan "Precision Medicine Research "The person in charge of the special special sub -project has presided over the National Natural Science Foundation of China and the Beijing Natural Science Foundation of China. Published more than 100 research papers.

"Health Everyone" Introduction

In order to implement the "Opinions of the State Council on the Implementation of Healthy China Actions", promote the popularization of health knowledge, give full play to the technical support of experts, and provide scientific health science knowledge for the people. The first batch of members of the National Health Popularization Expert Library. In order to mobilize experts to actively participate in science popularization activities and form a series of brands, the Expert Library Management Office will carry out "Health Everyone -National Health Science Popularization Expert Series Live Campaign", which will be implemented by healthy Chinese government affairs platforms. Create a boutique science science column, and promote it through the new media matrix of healthy Chinese government affairs to expand the spread of authoritative science popularization content.

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Planning: Fang Tong

Text: Wang Jianying

Edit: Wang Jianying

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