$Unique_ID{BRK01047}
$Pretitle{}
$Title{Why Are So Many Drugs Used to Treat One Illness?}
$Subject{heart failure medications treatment Circulatory CHF pumping pumps
Edema water retention Diuretics cardiac glycosides Digoxin digitalis
Vasodilator blood vessels vessel hydralazine nitroglycerin angiotensin
converting enzyme ACE inhibitors medication treatments medicine medicines
Vasodilators hydrochlorothiazide bumetanide triamterene captopril lisinopril
enalapril}
$Volume{R-3}
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Copyright (c) 1991-92,1993   Tribune Media Services, Inc.


Why Are So Many Drugs Used to Treat One Illness?


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QUESTION:  Dad's medicine cabinet seems stocked with an abundant supply of
medications to treat his congestive heart failure.  It is frightening.  Can
you explain why so many drugs are used to treat one illness?

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ANSWER:  Your father could be suffering from one (or more) of several specific
conditions which can be contributing to his heart failure (CHF).  Each of the
conditions may need treatment with one (or more) different medicines.  All
drugs prescribed for CHF are aimed at trying to correct deficiencies in the
heart's pumping action.  Also, if your father has been ill for a long while,
his condition may have changed from time to time which could have required
changes in one or more of his medications.
     To try to answer your question more fully, let's briefly discuss the
heart, CHF and some medications frequently used to treat it.
     Our hearts not only act as pumps which feed the body's cells, they also
help other organs eliminate certain wasted fluids.  Certain types of CHF can
be caused when our kidneys--for whatever reason--cannot eliminate enough
water.  Edema (water retention) can occur in the lungs and other parts of the
body, such as the ankle.  In such cases, the heart can be seriously overworked
as it tries to help the kidneys relieve fluid congestion.  Diuretics often are
prescribed in treating patients suffering such conditions.  Diuretics promote
water excretion which, in turn, eases demand on the heart.  There are
different classes of diuretics, each with various actions.  It is possible
that your father may have taken hydrochlorothiazide, bumetanide, triamterene,
or others from more than one class as his physician endeavored to develop the
best course of therapy for him.
     Another group of drugs is prescribed in treating a CHF condition that
occurs when something is wrong with the heart's muscle itself.  These are the
cardiac glycosides which have been used for more than 200 years.  Digoxin
probably is the most widely known of that group, but many people still call
drugs in this group "digitalis".
     Vasodilator drugs are prescribed to cause blood vessels to expand when
there is need for increased blood flow.  In this group there are drugs which
cause vessel expansion in one, or a few, selected parts of the body and others
which act on virtually every blood vessel.  So your father might take one type
of these at some point, and another as his illness changes.  Among
vasodilators that he may have been prescribed are:  hydralazine, nitroglycerin
preparations, prazosin, and/or others.
     Another class of medications useful in treating failure are the
angiotensin converting enzyme (ACE) inhibitors, such as captopril, lisinopril
and enalapril.
     So you see, there may have been great need for quite a number of drugs,
with a wide variety of action, to help your father.  Reviewing this with you
may have given a better perception of the difficulties doctors face in
providing their patients with the specific, individualized care necessary to
control chronic and difficult to treat diseases.  However, you may put this
information to good use.  Collect all the medications that are currently in
that medicine cabinet, and review the medications your father is currently
taking with his physician.  It is a great way of making sure that a
complicated schedule is being properly adhered to, and that no necessary
medications are still lying around.

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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician.  Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.