Your doctor has prescribed medications for you that must be taken exactly according to  instructions. The medications will be effective only if you take them exactly as prescribed and this will also help your doctor develop a dosage regimen that will give you the most benefits with the least side effects.

Do not hesitate to ask questions or discuss side effects about your medication with your doctor or pharmacist and make sure you give and receive clear information.  

How do medications work?

Medications are intended to relieve symptoms or to cure, control, prevent or diagnose disease. After they have been at work in the body for a certain period of time they are gradually eliminated in different ways. (through the lungs, urine, bowel for example) The same drug may act differently in different people especially if they are very young, old or ill. When, how, and in what period of time a drug is eliminated from the body depends both upon the drug itself and the individual taking it.

This is why dosage schedules are different for each drug and sometimes vary between individuals taking the same drug.

All medications have desirable and undesirable effects and many do not mix with each other or with certain foods. The potential for unwanted effects can be minimized if you have reliable information. Your doctor and pharmacist are the best sources. Information received from friends, relatives, newspaper or magazine articles and other non-medical sources should not be used to alter your regimen without checking with your doctor.  

What you need to know about any medication you take

                                    The name

                                    what it is for

                                    what it looks like (shape colour)

                                    how much to take

                                    – when to take it (before, after or with meals)

                                    how often to take (once a day, three times a day)

                                    how to take it (with or without food, on an empty stomach)

                                    side effects

It may often be difficult to remember exactly when to take medication & how much to take, especially if you are  taking more than one drug.

         Organize a system to help you remember with the use of memory aids, for example

                                    – a calendar

                                    – chart method

                                    – lists

                                    – sectioned pill boxes

                                    – special vials®colour coded

       ask your pharmacist to assist you in developing a system.

Points to note about Your Medication

1)    Ask what to do if you happen to miss taking the medication at the required time.

2)    Know how long you are supposed to take the drug and when your prescription should be filled (give proper notice if you need refills).

3)    Know where and how the drug should be stored (usually in a cool, dry place).

4)    Do not adjust the dose without directions to do so.

5)    Check with your doctor or pharmacist before taking non-prescribed drugs.

6)    Don’t share or borrow prescriptions. Your prescription is designed for you.

7)    Shop at one pharmacy, get to know your pharmacist; this way continuity of your therapy can be maintained.

8)    Take your medication with you on outings, when traveling make sure you have sufficient quantity.

9)    Always have a list of your medications with you with proper identification, & dosages, show the list to any medical personnel who will be treating you (i.e.: doctors, dentists, pharmacists, nurse)

10)  Side effects may occur from certain drugs. Most of these will subside within a short period of time. Discuss these side effects with your doctor or pharmacist.

11)  Certain medications can cause sexual dysfunction. If you are experiencing this, speak to your doctor, as there are alternative medications that may be prescribed.


How to Take Nitroglycerin  

¨    Nitroglycerin relieves anginal pain by temporarily dilating veins and arteries. This brings more blood and oxygen to the heart so it does not have to work as hard.

· when you have anginal pain, sit or lie down, and place one tablet (or give one spray) under tongue. Let this dissolve completely

                   – hold the saliva in your mouth for 1 or 2 minutes before swallowing

                   – don’t stand up for a few minutes, you may become dizzy

· you may feel  headache or flushed, don’t worry, these effects are only temporary

· take up to 3 tablets (or sprays) — one every 5 minutes if necessary

· if pain remains after 3 doses, call 911, get emergency assistance

· nitro is not habit-forming

· keep tablets in original container (dark), they will lose their strength if exposed to light, moisture, heat or if older than 3 months, replace outdated tablets

· fresh tablets and spray produce a slight burning sensation under your tongue

       Always have a supply of tablets with you when you go out. Keep a bottle (or spray) in you car, at work or home.

Nitroglycerin is available in different strengths.  If you are in a situation where you have forgotten your supply, you may use the supply of  another person, but realize that the effect may vary if the strength is different.  Likewise you may find that you need to lend your supply to someone else in an emergency.  Caution the other person that the effect may be different and stay nearby to help them summon help if the medication is ineffective.


Certain classes of medication are used in patients with coronary artery disease to prevent further trouble in the future.  These are known as secondary prophylactic drugs, that is, drugs used to prevent worsening of disease that is already present.  Mainly, these drugs are used in heart attack patients but some also have a role in those who have angina only.  The drugs are listed below by class and their action explained.  ALL OF THESE CLASSES OF DRUG HAVE BEEN PROVEN TO SAVE LIVES.

1.    “BLOOD THINNERS”:  ASA, aspirin, clopidogrel (PLAVIX), ticlopidine (TICLID), and warfarin (COUMADIN) are the drugs used for this purpose with aspirin being by far the most common.  Aspirin works by making the platelets in the blood less sticky and thereby reduces the chance that a blood clot will form in one of your coronary arteries.  It is used in virtually all patients unless they are allergic or intolerant.  It reduces death rates in acute heart attack and prevents subsequent events as well.  PLAVIX and  TICLID are similar to ASA, although PLAVIX appears to be safer.  COUMADIN is a more powerful blood thinner and may be used in special circumstances.  Usually, we ask you to avoid ASA if you are on COUMADIN although there are some specific exceptions to this rule.

2.    BETA BLOCKERS:      There are dozens of choices but all generic names end in “LOL”. Propranolol, metoprolol, sotalol, acebutolol, atenolol are a few of the available drugs and many have more than one “trade name”.  It is easy to get confused by the names but it is important for you to know whether or not you are on a beta blocker.  The purpose of these drugs is to prevent recurrent heart attack.  They are also useful in controlling the symptoms of angina and preventing some rhythm disturbances.  Almost all heart attack patients should be on one of these drugs.  People with asthma may not be able to take them and certain patients with diabetes should also avoid these drugs.

3.         ACE INHIBITORS:  Like the beta blockers, there are many of these drugs on the market.  The generic names end in “PRIL”.  Captopril, enalapril, lisinopril, cilazapril and ramipril are a few of the available drugs and many have multiple trade names.  The purpose of these drugs is to help the heart heal after a heart attack and prevent the slow deterioration in heart function that can otherwise occur over time.  In so doing these drugs prevent death and the development of heart failure.  They are usually used in patients who have more than a little damage to the heart from their heart attack - those with “mild” heart attacks therefore may not need these drugs.  The drugs are sometimes not used if patients have kidney disease.

4.    THE “STATINS”:          This class of drug ends in “STATIN” and all are designed to significantly lower the cholesterol.  They are remarkably effective and well tolerated drugs.  Recent evidence shows that their use prevents recurrent heart attack and death in all patient groups including women and the elderly.  Lovastatin (MEVACOR), simvastatin (ZOCOR), pravastatin (PRAVACHOL), atorvastatin (LIPITOR), fluvastatin (LESCOL) and cerivastatin (BAYCOL) are the preparations currently available in Canada.