The development of diseases of the cardiovascular system is slow and imperceptible in the early stages. In most cases, a person learns about his heart problems when the pathology is already progressing, as a result of which urgent hospitalization is necessary. Heart disease is dangerous because it occurs almost without symptoms. They are one of the main factors of mortality on earth. Even if the patient survives an attack of heart disease, he is unlikely to be able to return to a normal lifestyle, and therefore he needs to adapt to a new, more limited style. It is possible to prevent the development of serious complications of heart diseases by diagnosing them in time. Therefore, it is necessary to undergo preventive examinations in order to maintain the he alth of your heart.
Heart disease
There are several signs that may indicate the development of heart problems. If you notice such symptoms in yourself, you should immediately contact the clinic, where a thorough examination will help diagnose the disease and prevent possible complications.
The most common symptoms of the early stages of heart disease include increased fatigue and general weakness. They may be associated with stress or increased workload, but they can also be a signal for the development of heart failure. As a rule, fatigue does not go anywhere even after rest, and a feeling of oppression, a decrease in appetite, and a poor general condition of the body are added to it. The second symptom that can signal the development of pulmonary or heart failure is shortness of breath, and it can occur even when a person is in a state of absolute calm.
Severe fear, stress or prolonged physical activity in every he althy person can cause an increase in heart rate, and this is considered the norm. If tachycardia worries often and without any good reason, then we can talk about the presence of disorders in the state of the cardiovascular system. Other symptoms of heart disease include loss of balance or sudden dizziness, fainting, discomfort, and chest pain. Such signs give rise to a person to visit a doctor. And undergo a comprehensive examination of the cardiovascular system.
Coronal preparation
If a patient has been diagnosed with heart disease at a stage that does not require surgery, he is prescribed drug therapy. Drugs for heart disease help the patient cope with the symptoms of pathology and slow down its development. A person needs to be prepared for the fact that ifhe plans to prolong his life, he needs to change her image, in particular, give up bad habits, eat right, combine moderate exercise with rest.
Today there are many different drugs on the shelves of pharmacies, the action of which is aimed at combating heart problems. One of the most common medicines that are prescribed by doctors are Coronal tablets. Indications for the use of the drug may be as follows: coronary heart disease, arrhythmia, arterial hypertension, ventricular or supraventricular extrasystole, and others. Before starting a course of treatment with the drug, you should consult with your doctor. The drug "Coronal" has a fairly strong effect on the body, has a list of contraindications and can cause side effects. Available in coated tablets. The doctor can prescribe both Coronal and its analogues.
Pharmacology
The drug "Coronal" has antianginal, hypotensive and antiarrhythmic effects. This selective beta-blocker reduces the formation of cyclic AMP from ATP and is able to block the beta-adrenergic receptors of the heart. Also, the drug "Coronal" helps to reduce myocardial contractility and the frequency of heart contractions, its conduction and excitability.
The hypotensive effect of the drug is manifested in the fact that it helps to reduce the minute volume of blood. "Coronal" - tablets that restore the normal sensitivity of baroreceptors, inhibit the activity of the reninangiotensive system, affect the central nervous system. In patientswho suffer from arterial hypertension, the hypotensive effect is observed after 2-5 days after the start of use. After 1-2 months, a stable hypotensive therapeutic effect is noted.
The drug "Coronal", indications for the use of which have a fairly wide spectrum, has an antianginal effect. Tablets contribute to the lengthening of diastole, improve the perfusion of the heart muscle, reduce its oxygen demand by reducing heart rate. The antiarrhythmic effect of the drug is manifested in its ability to eliminate arrhythmogenic factors. Under its influence, atrioventricular conduction slows down and there is a decrease in the rate of excitation of the sinus and ectopic pacemakers.
The use of the drug in medium dosages has a less pronounced effect on peripheral arteries, bronchial smooth muscles, pancreas, skeletal muscles, carbohydrate metabolism. The drug does not retain sodium ions in the body, its absorption is about 80-90%.
Indications for use
Before taking Coronal, you need to consult a doctor who will give clear instructions regarding the dosage and frequency of administration. You can not start taking the drug on your own, there is a risk of harming your he alth, and with irreversible consequences.
In the drug "Coronal" indications for use are most often limited to arterial hypertension and coronary heart disease. The daily dose of the drug is 5 mg. The main active substance of the drug "Coronal" is bisoprolol. Maximum dailythe norm can reach 20 milligrams, and for patients with impaired normal functioning of the liver - 10 milligrams. The dose of the drug in all cases is adjusted individually, taking into account the therapeutic efficacy and heart rate. It is necessary to reduce the dose of the drug "Coronal" gradually, you can not stop the course of taking it suddenly. This is especially true for patients with angina pectoris (CHD).
Contraindications
There is a list of cases in which it is better to stop using Coronal. Indications for use in heart disease cannot be the only factor in starting a course of treatment. The doctor must carefully and comprehensively examine the patient for the safety of the latter.
The drug is contraindicated in patients with decompensated CHF, acute heart failure, cardiogenic shock, cardiomegaly, Prinzmetal's angina, SSU syndrome, atrioventricular block II-III stage, sinoatrial block. Do not take Coronal for patients who have individual hypersensitivity to the drug. It is not recommended to prescribe it to women during lactation, as well as to combine it with the use of MAO inhibitors.
In extreme cases, but very carefully, the drug is used to treat patients with myasthenia gravis, intermittent claudication, Raynaud's syndrome, liver failure, CHF, pheochromocytoma, metabolic acidosis, bronchial asthma, pulmonary emphysema, diabetes mellitus. Contraindications for use may be depression, psoriasis, thyrotoxicosis, childhood and old age,pregnancy. Justify taking the drug "Coronal" (reviews of doctors agree on this) during pregnancy can only be the case when the benefit to the mother is many times higher than the risk to the child.
Overdose
The patient must strictly follow the instructions of a specialist, because an overdose can cause dangerous symptoms. Among the common signs that are caused by an overdose of Coronal are bronchospasm, heart failure, arterial hypotension, and bradycardia. Intoxication causes a strong cardiodepressive effect, which prevails over a decrease in contractility and a decrease in the frequency of heart contractions. The patient may develop respiratory distress caused by bronchospasm.
If a patient has an unnatural reaction to a drug, you must immediately take measures to neutralize them. The first thing to do is to carry out a gastric lavage, followed by the intake of enterosorbents (activated charcoal). You also need to drink a laxative (sodium sulfate). You can eliminate the symptoms of intoxication by administering atropine (0.5-2.0 mg) intravenously. Also in such cases, glucagon 1-5 mg is used. If bronchospasm occurs, a bronchodilator should be used (aerosol Salbutamol or Fenoterol).
Side effects
Coronal can cause side effects affecting the entire body. At risk are:
- cardiovascular system;
- nervous system;
- breathingsystem;
- gastrointestinal tract;
- genitourinary system;
- visual apparatus;
- skin, muscles, joints.
On the part of the cardiovascular system, complications such as paresthesia, conduction disturbances, bradycardia, orthostatic hypertension, and low blood pressure can occasionally be observed. Patients with Raynaud's or intermittent claudication have worsening symptoms.
The drug Coronal can also cause side effects from the nervous system, namely: mental changes, vivid dreams, sleep disturbance, dizziness, headache, fatigue. Very rarely, but still the Coronal agent can affect the visual apparatus. Reviews of such cases are accrued, but as a result of exposure to the drug, vision may deteriorate, tear production may decrease, up to the development of conjunctivitis.
Symptoms such as bronchospasm, shortness of breath, rhinitis and nasal congestion can disturb those patients who suffer from bronchial asthma. In isolated cases, the hepatotoxic effect of bisoprolol occurs, which is determined by nausea, diarrhea, constipation and abdominal pain.
Among other side effects caused by the action of the Coronal drug, patient reviews note the following: increased sweating, itching and redness of the skin, arthropathy, cramps and muscle pain. Rarely worried about dysuria and erectile dysfunction caused by the action of the drug "Coronal". Drug analogues can also cause side effects onorganism. Therefore, in each individual case, it is imperative to consult a doctor and follow his instructions.
Special Instructions
In addition to contraindications and side effects, there are a number of cases when the drug should be used extremely carefully and certainly under the supervision of a doctor. This primarily applies to conditions such as congestive heart failure, diabetes mellitus, depression, myasthenia gravis, psoriasis, thyrotoxicosis, abnormal liver or kidney function, metabolic acidosis, fasting, Prinzmetal's angina.
In chronic obstructive airway diseases, Coronal, analogues and other beta-blockers can be taken, but only in combination with bronchodilators and in minimal doses. With pheochromocytoma, the agent must be taken simultaneously with the blockade of alpha-adrenergic receptors. Dosage should be determined after investigation of liver and kidney disorders.
Arterial hypertension can be treated with the drug only under regular medical supervision. Decreased adrenergic counterregulation and anaphylactic reactions exacerbate reactions in patients taking beta-blockers. In elderly patients, hypersensitivity may occur even with the usual dose of the drug, so constant monitoring is also needed here.
If it is necessary to carry out a planned surgical intervention, then the use of the drug is canceled 48 hours before the operation, and this is not done immediately, butgradually. If the patient has indications for use of Coronal, he needs to be very careful in activities that require a high speed of physical and mental reactions (working at height, servicing cars, working with dangerous mechanisms, driving a car, etc.).
Drug Interactions
When taking Coronal (tablets) at the same time as other medicines, precautions must be taken. In particular, this applies to combinations with MAO inhibitors, since after cessation there is an increase in blood pressure. Combining beta-blockers with allergen extracts for skin tests and with allergens used for immunotherapy, there is a risk of provoking severe allergic reactions.
When using antiarrhythmic drugs of classes I and III (Disopyramide, Sotalol, Quinidine, Amiodarone, Lidocaine), you also need to be careful. With the simultaneous use of antihypertensive drugs and Coronal tablets, the latter can potentiate the effects of the former. If you use this drug in combination with "Guafatsin", "Digitalis", "Clonidine", "Reserpine", then this can lead to a slowdown in the conduction of electrical impulses through the conduction system of the heart.
The therapeutic efficacy of Coronal may be reduced by exposure to sympathomimetic agents (antitussive drugs, nasal or eye drops). Liver enzyme activators provoke a reduction in the biological half-life of beta-adrenoreceptor. Simultaneous use of antiarrhythmic drugs and calcium channel blockers of the Nifedipine and Verapamil groups can cause the development of bradycardia, heart failure or conduction disturbances.
Simultaneous treatment with Coronal and Clonidine can cause the development of a hypertensive crisis. If there are indications for taking Coronal in patients with diabetes mellitus, it is strongly recommended to regularly monitor blood glucose levels. This is due to the fact that beta-blockers can potentiate the action of antidiabetic drugs and insulin, masking signs of hypoglycemia.
Drug reviews
Doctors prescribe Coronal to patients with heart disease. But does this drug work for everyone? Analyzing reviews about it, we can make a general conclusion that the effect of the drug on the patient's body depends on each individual case. Those who had the good fortune not to experience side effects speak very positively about Coronal. Reviews of patients who have experienced the consequences of using the drug are not so rosy. However, problems can be avoided. Before taking "Coronal" (tablets), the instructions for it should be re-read carefully and several times, because inattention can also be harmful to he alth.
The first thing that patients notice is a decrease in heart rate, a slight decrease in blood pressure, an improvement in the general condition of the patient. After a fewmonths of use, doctors recommend reducing the dose, because the pulse and pressure have already reached the norm and there is no need to lower them even more. Also, patients note that if you follow all the instructions of the attending physician, then you should not be afraid of unpleasant consequences from the use of the drug. But those who independently decided to change the daily dose or did not warn the doctor about the use of other drugs faced complications, which in some cases required hospitalization of the patient. And therefore, do not forget that there is an instruction for use in each package of Coronal tablets.
Analogues
The drug "Coronal" has a wide range of analogues - medicines that contain the same active substances. All of them differ in price, country of production, mechanism of action, contraindications, the presence or absence of side effects.
Like any medicine, Coronal also has its scope of application. Its analogues are similar in that their active substance is bisoprolol. The most common are drugs of domestic production. Their advantage is considered to be low price (compared to imported ones) and high efficiency. In particular, the following drugs can be noted: Aritel, Aritel Cor, Biprol, Bisoprolol, Bisoprolol-Prana, Niperten. They are available at every pharmacy kiosk, and their price ranges from 30 to 100 rubles per package.
Import analogues of Coronal are also presented in a large assortment: Bidop (Hungary), Biol (Slovenia),Bisogamma (Germany), Bisocard (Poland), Bisomor (India), Bisoprolol-Lugal (Ukraine), Bisoprolol-Teva (Israel) and others. The German medicine "Concor" is especially popular among imported drugs. Its price is 4 times higher than the cost of the drug "Coronal" and is about 180 rubles. In general, imported drugs in pharmacy kiosks are offered at prices ranging from 300 to 600 rubles per pack.
