ZFA (Stuttgart) 2006; 82(3): 124-128
DOI: 10.1055/s-2006-921560
Übersicht

© Georg Thieme Verlag Stuttgart · New York

Aktuelle kardiologische Pharmakotherapie

Current Cardiological PharmacotherapyA. van de Loo1 , W. Niebling1
  • 1Zentrum für Innere Medizin/Kardiologie, Marienkrankenhaus Hamburg
Further Information

Publication History

Publication Date:
15 March 2006 (online)

Zusammenfassung

Die Einführung neuer Medikamente und eine Vielzahl von aktuellen Studien macht es schwierig, deren Relevanz zu bewerten und in der klinischen Praxis umzusetzen. Im folgenden Text sollen drei wichtige Themen vertieft werden: 1. Die Thrombozytenhemmung ist eines der wichtigsten Therapieprinzipien der modernen Pharmakotherapie geworden. Die Kombinationstherapie aus ASS und Clopidogrel nach Stentimplantation wird für verschiedene klinische Situationen erklärt. Nach welchen Kriterien soll man eine Primärprophylaxe mit ASS einleiten? 2. Aldosteronantagonisten spielen heute kaum noch als Diuretika eine Rolle. Dagegen haben sie einen neuen, gut begründeten Stellenwert in der Herzinsuffizienzbehandlung. Wie dosiert man hier richtig? Welche Indikationen sind gesichert? Welche neuen Substanzen kommen zum Einsatz? 3. In der Therapie der chronischen Herzinsuffizienz sind die ACE-Hemmer fest etabliert. Unsicherheit besteht bezüglich der möglichen Kombination mit Angiotensin-Rezeptorantagonisten: Wie ist das Rationale zu verstehen? Wie sollte man dosieren? Welche Komplikationen sind zu erwarten? Welche Kontrollen sind notwendig?

Abstract

The recent introduction of numerous medications in cardiovascular pharmakotherapie makes it difficult to assess their relevance in daily clinical practice. Three relevant topics will be discussed in this article: 1. Inhibition of platelet aggregation has become a predominant strategy in modern cardiovascular pharmacotherapy. The evidence for combined treatment with ASS and clopidogrel is explained for various clinical settings. What are relevant criteria for platelet inhibition in primary prophylactic treatment? 2. The improving knowledge on pathophysiology of chronic heart failure led to a revival of aldosterone antagonism. Which patients benefit from new agents like eplerenone? What is the scientific background? 3. ACE inhibitors are established agents for heart failure treatment. Why is the combination with angitensin receptor blockers advocated in some cases? What doses are recommended? Are there relevant complications to expect? How can we treat and control patients safely?

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Priv.-Doz. Dr. med. A. van de Loo

Marienkrankenhaus · Zentrum Innere Medizin/Kardiologie

Alfredstr. 9

22087 Hamburg

Email: vandeloo.innere@marienkrankenhaus.org

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