{"id":6917,"date":"2023-08-16T14:54:38","date_gmt":"2023-08-16T13:54:38","guid":{"rendered":"https:\/\/www.healthy-heart.org\/zivot-se-srdecni-chorobou\/druhy-leku\/"},"modified":"2024-12-10T12:24:30","modified_gmt":"2024-12-10T12:24:30","slug":"druhy-leku","status":"publish","type":"page","link":"https:\/\/www.healthy-heart.org\/cs\/zivot-se-srdecni-chorobou\/druhy-leku\/","title":{"rendered":"Druhy l\u00e9k\u016f"},"content":{"rendered":"<h3><strong>L\u00e9ky na \u0159ed\u011bn\u00ed krve<\/strong><\/h3>\n<p>Po infarktu je nezbytn\u00e9 u\u017e\u00edvat antiagregancia (protidesti\u010dkov\u00e9 l\u00e9ky). Jsou to l\u00e9ky, kter\u00e9 zabra\u0148uj\u00ed tvorb\u011b nov\u00fdch sra\u017eenin v koron\u00e1rn\u00edch tepn\u00e1ch nebo ve stentu (trubici zaveden\u00e9 do ucpan\u00e9 tepny za \u00fa\u010delem obnoven\u00ed pr\u016ftoku krve). Obvykle se do\u017eivotn\u011b p\u0159edepisuje n\u00edzk\u00e1 d\u00e1vka aspirinu (75 a\u017e 100 mg\/den) a na n\u011bkolik m\u011bs\u00edc\u016f se p\u0159id\u00e1v\u00e1 inhibitor P2Y12 (tikagrelor, prasugrel nebo klopidogrel). Vzhledem k tomu, \u017ee prim\u00e1rn\u00ed funkc\u00ed antiagreganci\u00ed je potla\u010dit tvorbu sra\u017eenin, zvy\u0161uj\u00ed sice riziko krv\u00e1cen\u00ed, ale p\u0159\u00ednosy v\u00fdrazn\u011b p\u0159eva\u017euj\u00ed nad riziky. Je nesm\u00edrn\u011b d\u016fle\u017eit\u00e9 nep\u0159estat u\u017e\u00edvat tyto l\u00e9ky, a to ani na jedin\u00fd den, pokud to nedoporu\u010d\u00ed v\u00e1\u0161 kardiolog. Pokud m\u00e1te tak\u00e9 fibrilaci s\u00edn\u00ed, m\u016f\u017ee v\u00e1m kardiolog m\u00edsto protidesti\u010dkov\u00fdch l\u00e1tek p\u0159edepsat jin\u00fd l\u00e9k na \u0159ed\u011bn\u00ed krve (peror\u00e1ln\u00ed antikoagulancium).<\/p>\n<h3><strong>Inhibitory protonov\u00e9 pumpy<\/strong><\/h3>\n<p>Pokud m\u00e1te vysok\u00e9 riziko gastrointestin\u00e1ln\u00edho krv\u00e1cen\u00ed, m\u016f\u017ee v\u00e1m kardiolog nebo praktick\u00fd l\u00e9ka\u0159 p\u0159edepsat inhibitor protonov\u00e9 pumpy na ochranu \u017ealudku, po dobu kdy u\u017e\u00edv\u00e1te dva l\u00e9ky na \u0159ed\u011bn\u00ed krve.<\/p>\n<h3><strong>L\u00e9ky sni\u017euj\u00edc\u00ed hladinu cholesterolu<\/strong><\/h3>\n<p>Aby do\u0161lo ke zpomalen\u00ed progrese ateroskler\u00f3zy v tepn\u00e1ch, je t\u0159eba sn\u00ed\u017eit hladinu cholesterolu o 50 a v\u00edce procent, p\u0159i\u010dem\u017e c\u00edlov\u00e1 hodnota LDL cholesterolu mus\u00ed b\u00fdt ni\u017e\u0161\u00ed ne\u017e 55 mg\/dl (&lt;1,4 mmol\/l). L\u00e9kem prvn\u00ed volby jsou pro tento \u00fa\u010del statiny. Statiny sni\u017euj\u00ed produkci cholesterolu v j\u00e1trech, zmen\u0161uj\u00ed pl\u00e1ty v tepn\u00e1ch a sni\u017euj\u00ed riziko dal\u0161\u00edho infarktu. K mo\u017en\u00fdm vedlej\u0161\u00edm \u00fa\u010dink\u016f pat\u0159\u00ed bolest sval\u016f a zv\u00fd\u0161en\u00e9 jatern\u00ed enzymy v krvi, ale obvykle jsou m\u00edrn\u00e9 a zvladateln\u00e9. Navzdory n\u011bkter\u00fdm negativn\u00edm zku\u0161enostem s l\u00e9\u010dbou statiny, kter\u00e9 se objevuj\u00ed ve zpr\u00e1v\u00e1ch, ukon\u010den\u00ed l\u00e9\u010dby statiny dramaticky zvy\u0161uje riziko dal\u0161\u00edho infarktu. V n\u011bkter\u00fdch p\u0159\u00edpadech m\u016f\u017ee v\u00e1\u0161 kardiolog k l\u00e9\u010db\u011b statiny p\u0159idat ezetimib, kter\u00fd br\u00e1n\u00ed vst\u0159eb\u00e1v\u00e1n\u00ed cholesterolu ve st\u0159ev\u011b a vede k dal\u0161\u00edmu sn\u00ed\u017een\u00ed hladiny cholesterolu. Pokud jsou va\u0161e hladiny cholesterolu velmi vysok\u00e9 nebo statin nesn\u00e1\u0161\u00edte, m\u016f\u017ee v\u00e1\u0161 kardiolog p\u0159idat kyselinu bempedovou, nov\u00fd l\u00e9k sni\u017euj\u00edc\u00ed produkci cholesterolu v j\u00e1trech, nebo injekce s inhibitorem PCSK9 \u010di Inclisiran, kter\u00e9 zvy\u0161uj\u00ed odbour\u00e1v\u00e1n\u00ed LDL cholesterolu v j\u00e1trech.<\/p>\n<h3><strong>Betablok\u00e1tory<\/strong><\/h3>\n<p>Betablok\u00e1tory chr\u00e1n\u00ed va\u0161e srdce p\u0159ed \u0161kodliv\u00fdmi \u00fa\u010dinky adrenalinu. Sni\u017euj\u00ed srde\u010dn\u00ed frekvenci, <a href=\"https:\/\/www.healthy-heart.org\/keep-your-heart-healthy\/blood-pressure\/\">krevn\u00ed tlak<\/a> a spot\u0159ebu kysl\u00edku srdcem. Pokud je schopnost va\u0161eho srdce pumpovat krev sn\u00ed\u017eena, pom\u00e1haj\u00ed zabr\u00e1nit dal\u0161\u00edmu zhor\u0161ov\u00e1n\u00ed. Pokud se srde\u010dn\u00ed frekvence p\u0159\u00edli\u0161 sn\u00ed\u017e\u00ed, m\u016f\u017eete poci\u0165ovat z\u00e1vra\u0165. Mezi b\u011b\u017en\u00e9 dal\u0161\u00ed ne\u017e\u00e1douc\u00ed \u00fa\u010dinky pat\u0159\u00ed bolest hlavy, studen\u00e9 ruce a nohy, \u00fanava a pot\u00ed\u017ee se sp\u00e1nkem. R\u016fzn\u00e9 betablok\u00e1tory maj\u00ed odli\u0161n\u00e9 vedlej\u0161\u00ed \u00fa\u010dinky, a proto se pora\u010fte se sv\u00fdm kardiologem, abyste na\u0161li ten, kter\u00fd je pro v\u00e1s ten prav\u00fd.<\/p>\n<h3><strong>ACE inhibitory a blok\u00e1tory receptor\u016f pro angiotenzin (ARB)<\/strong><\/h3>\n<p>Inhibitory angiotenzin-konvertuj\u00edc\u00edho enzymu (ACE) sni\u017euj\u00ed produkci angiotenzinu II, enzymu, kter\u00fd zu\u017euje krevn\u00ed c\u00e9vy, zat\u00edmco blok\u00e1tory receptor\u016f pro angiotenzin (ARB &#8211; sartany) inhibuj\u00ed jeho funkci. T\u00edm pom\u00e1haj\u00ed c\u00e9v\u00e1m roz\u0161\u00ed\u0159it se a uvolnit, zlep\u0161uj\u00ed pr\u016ftok krve a sni\u017euj\u00ed krevn\u00ed tlak. Krom\u011b toho tyto l\u00e9ky zlep\u0161uj\u00ed funkci srdce jako pumpy, pokud byla sn\u00ed\u017eena srde\u010dn\u00edm infarktem. Nej\u010dast\u011bj\u0161\u00edm vedlej\u0161\u00edm \u00fa\u010dinkem ACE inhibitor\u016f je such\u00fd ka\u0161el, v tom p\u0159\u00edpad\u011b m\u016f\u017ee p\u0159ej\u00edt na ARB (sartany). Pokud ji\u017e m\u00e1te norm\u00e1ln\u00ed krevn\u00ed tlak, budete pot\u0159ebovat sn\u00ed\u017eenou d\u00e1vku ACE inhibitoru nebo ARB.<\/p>\n<h3><strong>MRA<\/strong><\/h3>\n<p>Pokud se po infarktu sn\u00ed\u017e\u00ed funkce srdce p\u0159e\u010derp\u00e1vat krev, lze spolu s betablok\u00e1tory a ACE inhibitory pou\u017e\u00edt antagonisty mineralokortikoidn\u00edch receptor\u016f (MRA) v\u010detn\u011b spironolaktonu a eplerenonu. MRA jsou slab\u00e1 diuretika a pom\u00e1haj\u00ed t\u011blu odstra\u0148ovat p\u0159ebyte\u010dn\u00e9 tekutiny. Tak\u00e9 sni\u017euj\u00ed krevn\u00ed tlak. Mo\u017en\u00e9 vedlej\u0161\u00ed \u00fa\u010dinky spironolaktonu jsou zv\u00fd\u0161en\u00e1 hladina drasl\u00edku v s\u00e9ru a gynekomastie (zv\u011bt\u0161en\u00ed prsou u mu\u017ee). V tom p\u0159\u00edpad\u011b by m\u011bla b\u00fdt zm\u011bn\u011bna l\u00e9\u010dba na eplerenon, kter\u00fd tento vedlej\u0161\u00ed \u00fa\u010dinek nezp\u016fsobuje.<\/p>\n<p>V z\u00e1vislosti na va\u0161ich jin\u00fdch zdravotn\u00edch obt\u00ed\u017e\u00edch, nap\u0159. <a href=\"https:\/\/www.healthy-heart.org\/keep-your-heart-healthy\/diabetes\/\">cukrovce<\/a>, onemocn\u011bn\u00ed ledvin nebo obezit\u011b, v\u00e1m mohou b\u00fdt p\u0159edeps\u00e1ny dal\u0161\u00ed l\u00e9ky.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>L\u00e9ky na \u0159ed\u011bn\u00ed krve Po infarktu je nezbytn\u00e9 u\u017e\u00edvat antiagregancia (protidesti\u010dkov\u00e9 l\u00e9ky). Jsou to l\u00e9ky, kter\u00e9 zabra\u0148uj\u00ed tvorb\u011b nov\u00fdch sra\u017eenin v koron\u00e1rn\u00edch tepn\u00e1ch nebo ve stentu (trubici zaveden\u00e9 do ucpan\u00e9 tepny za \u00fa\u010delem obnoven\u00ed pr\u016ftoku krve). Obvykle se do\u017eivotn\u011b p\u0159edepisuje n\u00edzk\u00e1 d\u00e1vka aspirinu (75 a\u017e 100 mg\/den) a na n\u011bkolik m\u011bs\u00edc\u016f se p\u0159id\u00e1v\u00e1 inhibitor P2Y12 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":6921,"parent":6898,"menu_order":2,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"categories":[146],"tags":[],"class_list":["post-6917","page","type-page","status-publish","has-post-thumbnail","hentry","category-zivot-se-srdecni-chorobou"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Typy l\u00e9k\u016f - Healthy-Heart.org<\/title>\n<meta name=\"description\" content=\"Zjist\u011bte v\u00edce o typech l\u00e9k\u016f a jejich vedlej\u0161\u00edch \u00fa\u010dinc\u00edch u pacient\u016f trp\u00edc\u00edch kardiovaskul\u00e1rn\u00edm onemocn\u011bn\u00edm.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.healthy-heart.org\/cs\/zivot-se-srdecni-chorobou\/druhy-leku\/\" \/>\n<meta property=\"og:locale\" content=\"cs_CZ\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Typy l\u00e9k\u016f - 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