It seems, to me anyway, today we are prescribing more and more drugs just to counteract the effects of other drugs.
The cases in which that is true are fairly rare in my experience, though it certainly happens. We try very hard when possible
to not use additional medications to treat the side effects of others.
Now I am going to put you on the spot here a little, if you don't mind. I have congestive heart failure due to atrial fribrillation. What medications, in your limited knowledge of just that, what would you prescribe.
I treat both these conditions a lot, I'm quite familiar with them.
But before going on, let me make one thing clear. In my response I am not offering any kind of specific assessment of your medical condition, your medical care, or the appropriateness of your medications. All I'm saying should be regarded as general, and to come up with a rational care plan for you would require a lot of knowledge (including a physical exam and a detailed history) that I have not obtained.
So, with that disclaimer, let me answer this way. If congestive heart failure is being attributed ONLY to a-fib, this is from one of two factors. Number one, in a-fib, your atria do not contract effectively, so about 10% of the blood that normally enters the ventricles does not. This decreases the "cardiac output". Second, in a-fib, the heart cannot control its intrinsic pacemaking, so the heart always beats irregularly and it can go way too fast or way too slow. If it's too slow, then your cardiac output will diminish. If it's too rapid, then the left ventricle doesn't have enough relaxation time to fully fill. When cardiac output goes down, the kidneys erroneously think that you're dehydrated because they're not receiving enough blood flow from the heart -- so the kidneys hold onto every last drop of fluid and this can accumulate in the lungs. Voila, that's congestive heart failure.
So the mainstay of treating CHF due to a-fib would be controlling the heart rate -- either with drugs that slow the rate if it's too fast, or with a pacemaker if it's too slow. You can also use a diuretic (like furosemide, aka Lasix) to get the body to pee out more fluid.
Treating the underlying a-fib with rhythm-controlling drugs (i.e. things that put you into a normal sinus rhythm) are sometimes used, but they are more toxic and long term outcomes aren't necessarily improved.
Now, CHF may be multifactorial. For instance, a history of hypertension can also lead to CHF, or a history of heart attacks, or a history of valvular heart disease. So is the a-fib the only
cause of your CHF, or is it part of a whole spectrum? All good questions for your doc.
I am taking seven different medications. What are they?
1) A drug to control your heart rate, probably a beta blocker like metoprolol (Toprol or Lopressor) or atenolol (Tenormin). The generics all end in "-olol".
* alternatives would be diltiazem (cardizem) or digoxin (lanoxin), some people are on a combination
* some people take amiodarone to control the arrhythmia itself rather than the rate, but this is less common
2) Warfarin (Coumadin) to prevent the fibrillating atria from generating blood clots
3) Lasix (furosemide) to prevent fluid accumulation
5) A cholesterol-lowering medication (Lipitor, Zocor, Crestor, Pravachol, etc)
Can't guess the rest. I'd need more information that you need not supply. The aspirin and the cholesterol-lowering medication would be mainly for the prevention of a heart attack, because smoking is a major risk factor.
---------- Post added at 09:47 PM ---------- Previous post was at 09:45 PM ----------
why dont you look on the internet? that's what i always do.
Use either WebMD.com or eMedicine.com. Definitely the most consistently reliable info for laypeople.
i was having an episode of atrial fibrillation here and a doctor prescribed a pill which when i looked it up said it was so potent and dangerous that it was only given to people when everything else failed and they were admitted in a hospital where they could be observed carefully because of the danger involved.
There are some of those. We have a lot of safe medications for A-fib, though.