Additional medicines

Medications that are given as an additional measure (which doctors may call adjunctive therapy) include:

Beta-blockers

Beta-blockers are medicines that inhibit certain receptors (beta-receptorsA type of receptor within cells, by which substances such as adrenaline and noradrenaline exert their actions.) in the nervous system. They are given to people who have had a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. to relieve chest pain, reduce the risk of abnormal heart rhythms, and improve their chance of survival.

Some people take long-term beta-blockerOne of a group of drugs that block beta-receptors to slow the heart rate, or constrict the airways and arteries. therapy. However, these drugs should not be given to people who have heart failureFailure of the heart to pump adequately. or a very slow heart rate. [1]

Beta-blockers are thought to reduce the size of the infarctDeath of a piece of tissue owing to obstruction of its blood supply. (the area of dead heart muscleTissue made up of cells that can contract to bring about movement.) after a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. and lower the risk of another heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction.. They also improve survival rates when given long term.[2]

Beta-blockers reduce the oxygen demands of heart muscleTissue made up of cells that can contract to bring about movement., and lower the work of the heart muscleTissue made up of cells that can contract to bring about movement. by lowering the heart rate. The drugs are usually started early after someone has had a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction..[3]

Continuous treatment with an oral beta-blockerOne of a group of drugs that block beta-receptors to slow the heart rate, or constrict the airways and arteries. has been shown to improve survival rates in the long term. Unfortunately, many people do not tolerate beta-blockersA group of drugs that block beta-receptors to slow the heart rate, or constrict the airways and arteries. because of a low heart rate, low blood pressure or asthma.[1]

Nitrates

Nitrates can be taken under the tongue or orally, or may be injected intravenously.[1]

Nitrates are thought to reduce the size of the infarctDeath of a piece of tissue owing to obstruction of its blood supply. (the damaged area of the heart) and reduce the oxygen demand of the heart, so improving outcome after a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction.. They also dilate the coronaryRelating to the arteries supplying the heart itself. arteries, and so may increase the bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. flow to the heart muscleTissue made up of cells that can contract to bring about movement..[2,3]

ACE inhibitors

ACE inhibitors are sometimes given within 24 hours of a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. to people who have symptoms of heart failureFailure of the heart to pump adequately.. They should not be taken by people who have low bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. pressure.[2,3]

Long-term treatment with an ACE inhibitorAbbreviation for angiotensin converting enzyme inhibitor - one of a class of drugs used to treat cardiovascular conditions. can improve someone's survival rate  after a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. and reduce his or her need for later hospitalisation. Some people who cannot take ACE inhibitors may be given angiotensin receptor blockersA group of drugs used to treat high blood pressure. instead.[1]

References: 
  1. Boon NA, Colledge NR and Walker BR. Davidson's Principles and Practice of Medicine. Churchill Livingstone Elsevier. 2006; 20th edition.
  2. Diagnosis and management of ST elevation myocardial infarctionDeath of an area of heart muscle due to poor blood supply.: a review of the recent literature and practice guidelines.  Hahn SA and Chandler C. The Mount Sinai Journal of Medicine 2006;73:469-81.
  3. Unstable anginaA central chest pain caused by insufficient oxygen supply to the heart. and non-ST-segment myocardial infarctionDeath of an area of heart muscle due to poor blood supply.: an evidence-based approach to management. Kou V and Nassisi D. The Mount Sinai Journal of Medicine 2006;73(1):449-68.