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CORONARY ARTERY BYPASS SURGERY: EDUCATION AND MEDICATION
There are a few drugs commonly used in treatment after coronary artery bypass surgery and there are many less commonly used.
Aspirin
Most patients take aspirin after bypass surgery and remain taking it in small doses for the rest of their lives. The dose is usually in the range of 60-150 mg per day. Commonly half a soluble aspirin tablet is taken daily or every second day.
Aspirin helps to stop platelet aggregation which can lead to blood clotting. If you take aspirin, you are much less likely to have subsequent episodes of graft occlusion or coronary artery occlusion. However, even a small dose can sometimes cause indigestion or worsen a peptic ulcer.
Aspirin increases the tendency to bleeding, which may be observed if you cut yourself, and it may make you bleed more than you normally would.
Diuretics
Diuretic or fluid tablets, which have many different names, are used to remove the excess fluid which may be retained for a time after the operation. Fluid retention can cause shortness of breath or swelling of the ankles. Diuretics may also be used to control the swelling in the leg after the removal of veins for grafting. More commonly, however, diuretics are used to control blood pressure before the operation and may need to be resumed afterwards.
Some diuretics cause you to have an urgent need to pass urine. If that happens, it is often desirable to change to a less dramatic type of diuretic which causes you to pass urine in smaller quantities over more hours.
Digoxin (lanoxin)
This drug is commonly used to control palpitations after the operation. If so, it can be stopped after some weeks or months. Or it may be used to control your pulse rate if you have a permanent pulse irregularity called atrial fibrillation. It may also be used if you have had past heart attacks or if you have a tendency to some degree of heart failure with fluid retention and breathlessness.
Ace inhibitor drugs
These drugs (Captopril, Enalopril and others) are used to control blood pressure or to suppress the tendency to heart failure. They may be used alone or in combination with diuretics.
Their major side effect is a tickling cough. This usually does not cause much discomfort, but sometimes it is sufficient to justify withdrawal of the drug.
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