First of all, it is necessary to ascertain the specific nature of the abnormalities that affect the patient. Chest pains may result from a variety of complications, which demand different approaches and treatments. It is also essential to understand the overall condition of the patient to determine whether he is in danger in the short and long term. A variety of tests can contribute to the determination of the patient’s overall condition.
Cocaine is associated with adverse effects on one’s health and may cause cardiac conditions. Aronson (2016) claims that dyspnea, chest pain, syncope, dizziness, and palpitation are frequent but do not generally lead to acute ischemia. Angina is among the conditions that may arise from the drug’s usage, and it may become stable over the years. As such, it is possible to assert that cocaine has caused the patient’s illness.
Initially, the patient should undergo a baseline electrocardiogram, which helps determine the specific nature of the condition. Kaski (2016) notes that while it will usually show no abnormalities, the results may help establish a diagnosis immediately and suggests also using blood tests, baseline echocardiograms, and cardiac magnetic resonance imaging. These tests can help medical professionals diagnose angina accurately and determine its scope.
Angina’s primary threat is its ability to put pressure on the heart and lead to more severe issues. As such, treatment goals for the condition include reducing the severity of symptoms and lowering the risk of heart attacks, or preventing them entirely. Continued cocaine usage puts the patient at risk of developing further complications, so convincing them to abandon the habit will be an essential part of care.
The patient should try to avoid taxing his heart, especially in situations where angina symptoms manifest. As such, he should avoid intense physical labor if it results in symptoms and takes the time to rest frequently in general. With regards to meals, he should avoid large meals and foods that are high in calories and challenging to process. Most of all, the patient should avoid combining the potential causes of his issues, not working shortly after eating, and abandoning his drug habit.
Angina results from blood clots obstructing its proper flow in the chest area, and so, medication tends to focus on improving blood flow. The author would recommend using ranolazine, as it is a specialized drug that aims to address most or all symptoms and causes of the condition at once, alongside calcium channel blockers. It should be more productive and less harmful in other aspects than more generalized medicine variants such as aspirin or beta-blockers, and it can be taken alongside them.
The goal of the treatment is to minimize the patient’s angina symptoms and minimize the likelihood of a heart attack. As such, the care provider should monitor his angina incidents and observe their frequency, with fewer occasions meaning greater success. Additionally, if the testing discovers any other complications, the treatment should address them, as well. They will have other methods of monitoring, depending on their nature.
Ranolazine has several interactions with food, and one should be careful when taking it. “Ranolazine and alcohol/food” (2019) highlights the need to take ranolazine consistently with or without food, avoid grapefruit or its juice, and not use it with high blood levels of food. Overall, these considerations do not restrict the patient’s diet severely, but he should remember them because of the potential side effects and their association with the heart.
The drug has some side effects that may lead to a change of treatment if they manifest. “Ranolazine side effects” (2019) highlights dizziness, headaches, and nausea as the most common medically relevant symptoms. There is a variety of more severe complications that may manifest in continued use if these initial indicators are ignored. As such, an immediate change of treatment will be necessary to preserve the patient’s well-being.
If the first-line therapy fails, a replacement will be necessary, one that considers cocaine usage. Beta-blockers may exacerbate specific parts of the condition for users of the drug, and so, they should be not be used. Calcium channel blocker therapy should continue with the addition of aspirin and nitroglycerin. The treatment should be useful and have minimal adverse effects, though a reaction is still possible.
With the use of ranolazine, the patient would have to learn the specifics of using the drug and altering his lifestyle. In particular, the medical provider should instruct him on the dangers of taking medicine improperly. The elimination of the cocaine habit is another critical aspect of the education, as it is unlikely that the patient’s condition improves if he retains it. With this knowledge, he should be able to minimize the dangers of his condition.
Most medications that affect the heart are restricted and not sold over the counter due to the dangers of their excessive usage. Aspirin is a notable exception, as it is a ubiquitous drug that has proven mostly safe over the years. As such, the patient will have to rely on it if he wants some form of medicinal relief without a prescription. Otherwise, he will have to use alternative medicine remedies for cardiac issues such as yoga.
Aronson, J. K. (ed.). (2016). Meyler’s side effects of drugs: The international encyclopedia of adverse drug reactions and interactions (16th ed.). Waltham, MA: Elsevier.
Kaski, J. C. (2016). Essentials in stable angina pectoris. Cham, Switzerland: Springer.
Ranolazine and alcohol/food interactions. (2019). Web.
Ranolazine side effects. (2019). Web.