There are many types of cardiovascular diseases, and there are also a large number of corresponding treatment drugs. When patients are faced with many drugs, it is easy to have a difficult problem: when should this drug be taken? Today, the author hereby summarizes the best medication time for some commonly used cardiovascular drugs, hoping to help everyone.
1
antiplatelet drugs< /span>
01. Aspirin
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1) When to take the medicine?
Aspirin is completely absorbed through the gastrointestinal tract after oral administration. It is rapidly degraded to the main metabolite salicylic acid after absorption. The peak times of aspirin and salicylic acid plasma concentrations were 10-20 minutes and 20-120 minutes, respectively.
The currently commonly used aspirin enteric-coated tablets are acid-resistant, insoluble in acidic gastric juice but in alkaline intestinal juice. Dissolving, aspirin enteric-coated tablets have a delayed absorption of 3 to 6 hours compared to ordinary tablets.
The antiplatelet effect of aspirin lasts 7 to 10 days (ie, the entire life cycle of platelets period), and is irreversible. So,Theoretically, it doesn’t make any difference when you take your aspirin each day.
2) Before and after meals?
Ordinary aspirinorally will cause strong irritation to the gastric mucosa and easily cause gastric Mucosal damage, induced gastric bleeding. Therefore, aspirinis more suitable to be taken after meals.
But aspirin enteric-coated tablets are different, in the fasting state, the pH value in the stomach is around 1-2 , is a strong acid environment, aspirin enteric-coated tablets do not dissolve; after reaching the duodenum, it begins to dissolve in the alkaline environment of the intestinal tract, so it will not directly stimulate and damage the gastric mucosa.
If taken after meals, it may increase the retention time of the drug in the stomach, resulting in some drugs and enteric-coated films separation, thereby irritating the gastric mucosa; in addition, food dilutes the strong acid environment in the stomach, causing the drug to dissolve in the stomach, increasing the risk of gastric adverse reactions. Therefore,aspirin enteric-coated tablets are best taken before meals.
Summary:Aspirin usage is daily Morning and evening, before and after meals According to the tablet technology, ordinary aspirin is applied after meals, and aspirin enteric-coated tablets are applied before meals.
02. Clopidogrel
Clopidogrel itself is irreversibly bound to platelets. to remove the effect. Thereforeregular use of clopidogrelno time period. It can be taken at a fixed timeabout time, and the diet has little effect on it.
It should be noted that omeprazole or esomeprazole and clopidogrel are co-administered or separated Taking it for 12 hours will lead to a decrease in the blood concentration of clopidogrel, so it is recommended that the above two drugs should be taken at intervals.
03. Ticagrelor
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is a new type of P2Y12 receptor antagonist, which is a non-prodrug and can act directly without being activated by liver metabolism. , strong and reversible anti-platelet effect. Compared with clopidogrel, ticagrelor has a shorter onset time, only 0.5 to 4 hours. The average half-life is 7.2 hours, and the active metabolite is 9 hours. According to the half-life, it is recommended to use it once a day in the morning and evening. It is not affected by diet.
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lipid-lowering drugs
The most important lipid-lowering drugs are statins, including atorvastatin, rosuvastatin, and fluvastatin. Statins, simvastatin, etc. These drugs work by inhibiting HMG-CoA reductase, blocking the synthesis of cholesterol in the liver, and can reduce the concentration of serum total cholesterol and low-density lipoprotein cholesterol.
Because statins mainly inhibit the rate-limiting enzyme of cholesterol synthesis, and this enzyme has the strongest activity at night, and general statins The drug has a short half-life, so generally needs to be taken at bedtime.
andatorvastatin, rosuvastatin< span>andpitavastatinlong half-life and good lipid-lowering effect,can be taken at any fixed time of day.
Another common lipid-lowering drug isfibrates. Typically used to lower triglycerides, it is recommendedwith meals.
3
hypertensive drugs
Human blood pressure has obvious circadian fluctuation characteristics. Most people have “dipper blood pressure”, that is, nighttime blood pressure drops by more than 10% to 20% compared with daytime blood pressure; on the contrary, if the waveform of nighttime blood pressure drop becomes shallower, the average nighttime blood pressure drop is less than 10% compared with daytime blood pressure, or there is no obvious nighttime valley, or even Nocturnal blood pressure higher than daytime blood pressure is called “non-dipper blood pressure”.
Generally, antihypertensive drugs take effect 30 minutes after taking, and reach a peak in 2 to 3 hours, then oral antihypertensive drugs The time will depend on the whole-day blood pressure waveform..
patients with dipper blood pressureblood pressure generally peaks at 9-11 am and 16-18 pm. Then it is recommended to take the medicine at 7:00 in the morning and 14:00 in the afternoon, the time when the effect of the medicine reaches its peak coincides with the fluctuation of blood pressure, which effectively reduces blood pressure.
patients with non-dipper blood pressure should be based on the curve formed by ambulatory blood pressure monitoring , Take the drug about two hours before the peak blood pressure, effectively lowering blood pressure.
Note that most antihypertensive drugs are currently in the form of controlled or sustained release, For such drugsit is recommended to take the drug in the morning to stably control blood pressure throughout the day. Alpha blockerssuch as terazosin can cause orthostatic hypotension, so usually taken at bedtime< span>.
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Digitalis span>
Digitalis drugs are important drugs for the treatment of heart failure, but their own toxicity cannot be ignored.
The peak plasma concentration of digoxin in the morning was slightly lower, but the bioavailability and efficacy were the highest. Blood was collected from 14:00 to 16:00 in the afternoon, which showed that the peak blood concentration was high and the bioavailability was low. Digitalis drug sensitivity peaks at night, and if it is used in conventional doses, it is prone to toxic reactions.
Therefore, it is recommended to take digoxin in the morning, which can not only improve the efficacy, but also can reduce its toxic effects.
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antianginal drugs< /strong>
The rate of angina attacks is highest in the morning due to sympathetic activation in the morning. Therefore, anti-angina drugs such ascalcium antagonists, nitrates, and beta-blockers are generally recommended to be taken in the morning to dilate coronary arteries and improve The effect of myocardial ischemia was significantly higher than that in the afternoon.
Note: Certain antianginal drugs, such as amlodipine, work It is gentle and has a long duration of action. It takes 6 to 12 hours for the blood drug to reach its peak.Can be administered before going to bed, so that the blood drug peak will appear in the early morning to combat angina pectoris .
Typesetting: lySubmission Cooperation: [email protected]Source of title image: Zhanku Hailuo