This article is from "Nankai Sun Pharmacist", which is used for medical science popularization for reference. Summary of adverse reactions of commonly used anti-coronary heart disease angina drugs (very comprehensive, recommended collection).
Aspirin is a cyclooxygenase inhibitor with strong antiplatelet effect, mainly by making cyclooxygenase acetylation of platelets, reducing the synthesis of thromboxane A2, irreversibly inhibiting platelet aggregation induced by thromboxane A2, and can inhibit the platelet aggregation and release reaction caused by low concentration of collagen and thrombin, thereby inhibiting thrombosis, and is suitable for the prevention and treatment of coronary heart disease angina.
The following adverse reactions can be seen with regular consumption of aspirin:
1.Gastrointestinal reactions: nausea, vomiting, epigastric discomfort or pain (caused by direct stimulation of the gastric mucosa by aspirin) and other gastrointestinal reactions, with an incidence of 3%-9%, which can disappear after stopping the drug, and gastrointestinal bleeding or ulcers may occur when taken in long-term or large doses.
2.Central nervous system: reversible tinnitus, hearing loss, mostly after taking a certain course of treatment, when the blood concentration is too high.
3.Allergic reactions: incidence 02%, presenting with asthma, urticaria, angioedema, or shock. Most of them are susceptible people, and they have difficulty breathing quickly after taking the drug, and in severe cases, it can lead to death, which is called aspirin asthma. Some allergic reactions are a triad of aspirin allergy, asthma, and nasal polyps, often related to genetic and environmental factors.
4.Liver and kidney damage: related to the size of the dose, especially when the dose is too large, the damage is reversible, and it can be recovered after stopping the drug, but there are reports of necrosis of the renal papillary.
Clopidogrel is a platelet P2Y12 receptor antagonist, which inhibits adenosine diphosphate-mediated platelet aggregation, and can also block the platelet activation caused by adenosine diphosphate released by activated platelets and further inhibit platelet aggregation, which is suitable for the prevention and treatment of coronary heart disease angina.
The following adverse reactions can be seen with clopidogrel regularly:
1.Bleeding: With clopidogrel alone, the incidence of gastrointestinal bleeding and intracranial hemorrhage is similar to that of aspirin. When clopidogrel is combined with aspirin, the incidence of bleeding increases, mainly gastrointestinal bleeding and the increased risk of bleeding at the vascular puncture site.
2.Gastrointestinal reactions: abdominal pain, dyspepsia, gastritis, constipation, etc., occasionally mild diarrhea.
3.Rashes and other ** lesions.
4.Thrombocytopenia and leukopenia are rare (less common than ticlopidine), but if fever or other signs of infection develop after taking the drug, they must be tested accordingly to confirm the diagnosis and manage accordingly. Thrombotic thrombocytopenic purpura is very rare but can be life-threatening.
Statins are one of the most widely used anti-lipid drugs in clinical practice, and also have anti-atherosclerotic effects such as anti-inflammatory, antioxidant, reducing endothelin production, reducing tissue factor expression, protecting vascular endothelial function, stabilizing atherosclerotic plaques, inhibiting platelet aggregation, and anti-thrombosis, and are suitable for the prevention and treatment of coronary heart disease and stroke.
Statins are a very safe class of lipid-regulating drugs, and the incidence of clinically significant adverse reactions is very low, including nausea, flatulence, diarrhea, abdominal pain, dizziness, headache, insomnia, rash, etc. Statins can increase alanine aminotransferase and aspartate aminotransferase in a small number of patients but do not cause progressive liver disease, and statins should be contraindicated in patients with active and chronic liver disease. Statins can inhibit the reabsorption of protein in the proximal convoluted tubules, which can cause mild proteinuria, but do not cause pathological tubular injury, let alone develop chronic renal failure. The incidence of serious adverse effects of statins is low, with the most severe being myopathy, including rhabdomyolysis, which can lead to acute renal failure.
Nifedipine sustained-release tablets are commonly used in clinical practice as a first-line antihypertensive drug, which can also inhibit myocardial contraction, reduce myocardial function, reduce oxygen consumption, relieve angina, and have anti-atherosclerotic effects when taken for a long time. **Dose has little effect on sinus node and atrioventricular node function. It is mainly suitable for essential hypertension and angina, especially for elderly hypertension and vasospasmodic angina, but cannot be used for acute attacks of angina.
The transient but more common adverse effect of nifedipine extended-release tablets is swelling of the ankles, feet, and calves. Less common are dyspnea, cough, asthma, rapid heartbeat (due to increased sympathetic activity reflex after hypotensive downing), gingival hyperplasia, etc. Chest pain (which can occur about 30 minutes after taking the drug), syncope (caused by low blood pressure), cholelithiasis, allergic hepatitis, polyuria, etc. When dizziness, dizziness, facial flushing and heat sensation, headache, nausea and other reactions persist, attention should be paid and the drug should be discontinued if it cannot be tolerated.
Metoprolol extended-release tablets are also commonly used in clinical first-line antihypertensive drugs, which can also reduce myocardial contractility, slow down heart rate, reduce myocardial oxygen consumption, and can be used for angina pectoris and myocardial ischemia.
Adverse reactions of metoprolol extended-release tablets include:
1.Nervous system: Metoprolol is fat-soluble, easy to penetrate the central nervous system, and can cause fatigue, dizziness, depression, headache, insomnia, and dreaminess.
2.Cardiovascular: shortness of breath, bradycardia, extremity chills, Raynaud's phenomenon (acral ischemia, fingers and toes turn white, purple, and flushed), heart failure, atrioventricular block.
3.Respiratory: shortness of breath and asthma.
4.Gastrointestinal: diarrhea, nausea, stomach pain, constipation.
5.**Pruritus, which may worsen psoriasis.
Irbesartan is also a first-line antihypertensive drug, which can also reduce cardiac load, improve heart failure, prevent and treat vascular wall thickening and myocardial hypertrophy complicated by hypertension, protect kidney function, significantly reduce proteinuria, significantly delay the process of end-stage renal disease, and is suitable for patients with hypertension and coronary heart disease angina.
Adverse effects of irbesartan include:
1.Common: nausea, flushing, dizziness, musculoskeletal injuries, etc.
2.Less common: orthostatic hypotension, diarrhea, dyspepsia.
3.Rare: cough and allergic reactions (rash, urticaria, angioedema).