Patient
Information
Heart Medications Commonly
Used in Children
There are several types of medications that
are useful in congestive heart failure.
Lanoxin (digoxin) is the most common
heart medication used in children and adults.
It was originally an herbal remedy derived from the
foxglove plant. It
helps the heart beat more strongly and so is useful in congestive
heart failure, and it can also reduce or eliminate some abnormal
heart rhythms, such as supraventricular
tachycardia.
Digoxin is available as a tablet, or as a liquid (elixir)
for infants and children. Digoxin
is a very toxic medication if too much is taken, so very careful
attention must be paid to the doctor’s instructions, and the
bottle must always be kept out of the reach of children.
Digoxin toxicity can also occur if the kidneys are not
working properly, especially in a child who is dehydrated.
Signs of digoxin toxicity include poor feedings or
excessive gagging, vomiting, a slow or very irregular heart rate,
and (in older children), unusual visual effects such as seeing
colored halos around lights. It
is thought that Vincent van Gogh may have had this toxic effect
from having been treated with extracts of the foxglove plant.
Diuretics such as Lasix (furosemide)
are often used in children with congestive heart failure or high
blood pressure. This
class of medication causes the kidneys to produce more urine,
reducing the amount of fluid in the body and helping the heart
work more efficiently. Lasix
is available in tablets or in a liquid form for children.
Problems can occur with the use of diuretics if a child
stops taking fluids because of a stomach flu, for example, since
the medication will cause a child to urinate even if he or she is
already dehydrated. If
your child stops taking fluids, or is having a lot of vomiting or
diarrhea, be sure to check with your cardiologist whether it is a
good idea to continue giving this medication.
Also, many diuretics cause the body to lose too much
potassium (a type of salt), and a second medication, Aldactone (spironolactone)
or a potassium supplement, may be used as well.
Afterload Reducing Agents, which
include Captoten (captopril) and Vasotec (enalapril), cause the
arteries to relax, reducing the amount of work the heart has to
do. These medications
are useful in congestive heart failure, certain problems with
leaking valves (aortic regurgitation and mitral regurgitation) and
high blood pressure. Because
these medications can lower the blood pressure, some patients
become dizzy while taking them.
If this happens, lay down and drink some fluids, and check
with your cardiologist to see whether the dose of the medication
should be adjusted. Also,
some children taking these medications, particularly Captopril,
may develop a dry cough.
Beta-blockers, such as Inderal (propranolol)
and Tenormin (atenolol), slow the heart rate, lower the blood
pressure and reduce or eliminate some abnormal heart rhythms, such
as SVT. Beta-blockers
may also be prescribed in the case of severe congestive heart
failure (particularly carvedilol).
This class of medication can cause dizziness from low blood
pressure or slowing of the heart rate.
Also, beta-blockers can make asthma or wheezing worse.
There are many other medications that are
used in special circumstances for children with heart problems.
If you have questions, please ask your cardiologist.
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