Medications for Congenital Heart Disease: What Every Parent Should Know
While this blog post has been reviewed by clinical experts, it does not substitute for personalized advice from your healthcare providers. Be sure to talk to your doctor if you have any questions or concerns.
Congenital heart disease is a daunting diagnosis for any parent. But, with the right treatment plan in place, your child can lead a happy and healthy life. Medication will play an important part in that, so here is some insight to hopefully help decrease the overwhelming amount of medical info coming your way in the years to come.
We’ll cover common types of medications used to treat congenital heart disease, what parents should know about their use, and potential side effects to watch out for.
Types of Medications for Congenital Heart Disease
It’s important for parents and caregivers of children with congenital heart disease to understand the types of medications their child is taking and how they work in managing their condition.
Here are a few of the major categories of medications your child may be prescribed:
Diuretics
WHAT THEY DO:
Diuretics help reduce excess fluid in the body by promoting urine production. They block the reabsorption of sodium and chloride in the kidneys, which leads to increased urine output. This can relieve swelling and shortness of breath caused by fluid buildup in the lungs or other parts of the body.
POTENTIAL SIDE EFFECTS:
While diuretics can be effective in managing symptoms such as edema and hypertension, possible side effects include electrolyte imbalances, dehydration, and hypotension.
POTENTIAL CONTRAINDICATIONS:
It’s important to note that certain other medications may interact with diuretics or affect their efficacy. For example, angiotensin II receptor blockers (ARBs) may enhance the effectiveness of certain diuretics while antibiotics or antiarrhythmic drugs may interfere with their absorption or elimination.
ACE Inhibitors
WHAT THEY DO:
ACE inhibitors block the angiotensin-converting enzyme (ACE) which causes narrowing of blood vessels. Blocking this enzyme helps relax blood vessels so there is a wider opening for better blood flow. This will lower blood pressure, making it easier for the heart to pump.
COMMON NAMES:
Some common brand name ACE inhibitor drugs available to patients with CHD include lisinopril, ramipril and enalapril.
POTENTIAL SIDE EFFECTS:
Potential adverse reactions include coughing, dizziness, kidney problems, and low blood pressure.
Cardiac Glycosides
WHAT THEY DO:
Cardiac glycosides improve cardiac function in children with CHD. They act by controlling numerous functions of the cardiovascular system, including to help slow down the heartbeat and increase the strength of each contraction.
COMMON NAMES:
Digoxin is the most commonly used cardiac glycoside.
POTENTIAL SIDE EFFECTS:
Its potential adverse reactions include irregular heartbeat, nausea or vomiting, but these side effects can often be managed by adjusting the dose or frequency of administration.
Antiarrhythmic Drugs
WHAT THEY DO:
Antiarrhythmic drugs are used to help prevent or treat abnormal heart rhythms, such as atrial fibrillation and ventricular tachycardia.
COMMON NAMES:
There are different types of antiarrhythmic drugs, each with a unique mechanism of action. The most common antiarrhythmic drugs for children with congenital heart disease (CHD) include beta-blockers (see above) and sodium channel blockers.
POTENTIAL SIDE EFFECTS:
It is important to note that there may be possible risks associated with using antiarrhythmics in children with CHD, ironically including an increased risk of arrhythmia. They can also interact with other medications, such as angiotensin II receptor blockers and antibiotics.
Anticoagulants
WHAT THEY DO:
Anticoagulant therapy is important for preventing blood clots in children with congenital heart disease. These medications work by thinning the blood to reduce the risk of blockages that can cause serious complications.
COMMON NAMES:
Aspirin, heparin or low molecular weight heparins (LMWHs), and warfarin are commonly used anticoagulants.
Aspirin helps prevent blood clots by reducing the stickiness of platelets.
Heparin or low molecular weight heparins (LMWHs) are typically administered through an IV in a hospital setting, and work quickly to keep blood from clotting. LMWHs are often preferred because they have fewer side effects than regular heparin.
Children taking warfarin will need frequent lab tests to ensure their dose is correct.
POTENTIAL SIDE EFFECTS:
While anticoagulants can be lifesaving, they do come with possible adverse effects such as bleeding or bruising easily. Any signs of bleeding should be reported immediately so that adjustments can be made if necessary. Long-term use of anticoagulants can affect regular blood tests and may require diet restrictions to prevent complications.
Other Types of Medications
A few other types of medications your child may receive to ease their CHD:
- Calcium channel blockers relax and dilate arteries in addition to reducing contractility which reduces blood pressure.
- Inotropic agents such as dobutamine or milrinone can also help to improve heart function by increasing blood flow through the body.
- B-type natriuretic peptide (BNP) is a hormone produced by the heart that helps to regulate blood pressure and fluid balance. Medications like nesiritide can mimic this hormone’s effects and help reduce symptoms.
- Aldosterone antagonists block a hormone called aldosterone, which plays a role in regulating salt and water balance in the body. By inhibiting aldosterone, these medications can reduce fluid retention and improve heart function.
- Vasodilators: These medicines relax blood vessels and lower blood pressure, which can improve blood flow to the kidneys and reduce fluid buildup.
Precautions to Follow
It is important to understand that not all medications are safe for every patient. Below are some precautions you should take when administering medications to children with CHD.
- Follow the doctor’s instructions
Always follow instructions regarding the dosage, frequency, and duration of medications. Never adjust the dose or stop the medication without consulting a doctor. - Keep a record
Keep track of all the medications prescribed, including the name, dose, and frequency. (Need an encouraging place to track your child’s meds? Conquering CHD has a journal for that!) - Monitor for complications and side effects
We shared some common side effects above, but above all, report any unusual symptoms to your child’s doctor. - Be careful with interactions
Some medications can interact with each other, causing adverse effects. For example, angiotensin II receptor blockers (ARBs) and angiotensin-converting enzyme (ACE) inhibitors should not be taken together as they can increase the risk of side effects. It is important to inform the doctor of all medications, including over-the-counter drugs and supplements, that your child is taking. - Understand the risks
Every medication comes with some risks. It is important to understand the benefits and risks of each medication prescribed for the child’s CHD. Ask the doctor to explain the risks and benefits of each medication.
Managing your child’s CHD requires a team effort between you and your child’s medical providers. At times, the CHD medications will feel overwhelming, but by learning what you can about each medication and communicating well with your child’s doctor, you’ll be taking action toward the best possible outcome for your child.
Related Article: 9 Things to Monitor When Taking Medication for Congenital Heart Disease (CHD)