Definition
Pericarditis is an inflammatory disease that affects the pericardium, that is, it affects the membrane whose job it is to wrap, support and protect the heart.
Pericarditis can occur both in acute form (characterized by rapid development) and in chronic form (characterized by a slower development).
Causes
The factors triggering pericarditis can be multiple but, in some cases, the cause is unknown and there is therefore talk of idiopathic pericarditis.
Among the main causes triggering pericarditis, we mention viral, bacterial or fungal infections, autoimmune diseases (in particular, rheumatoid arthritis, systemic lupus erythematosus and scleroderma), renal failure, tumors (especially metastatic ones), thoracic radiotherapy, chest trauma and heart attack.
Symptoms
The classic symptom of pericarditis is chest pain very similar to that which can be experienced during a heart attack. Other symptoms that may occur in individuals with pericarditis are palpitations, tachypnea, asthenia, dysphagia and hiccups.
If the pericarditis is of infectious origin, fever, sweating and chills may also appear.
Information on Pericarditis - Drugs and Pericarditis Care is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Pericarditis - Drugs and Pericarditis Treatment.
drugs
The drugs most used in the treatment of pericarditis are non-steroidal anti-inflammatory drugs (thanks to their analgesic and anti-inflammatory properties) and colchicine, followed by opioid analgesics and corticosteroids.
The additional pharmacological treatments that can be undertaken vary according to the cause causing the pericarditis. For example, if the disease is caused by an infection (viral, bacterial or fungal), the most suitable drugs will be used to counteract the microorganisms responsible for its onset.
Surgery, on the other hand, is reserved only for very severe cases of pericarditis accompanied by complications.
NSAIDs
NSAIDs are among the first-line drugs used in the treatment of pericarditis. They are used by virtue of their anti-inflammatory properties (they ignite the pericardium) and, at the same time, analgesics.
The most common non-steroidal anti-inflammatory drugs used in the treatment of pericarditis are:
- Ibuprofen (Brufen ®, Moment ®, Nurofen ®, Arfen ®, Actigrip fever and pain ®, Vicks fever and pain ®): ibuprofen is available in different pharmaceutical formulations suitable for different routes of administration. When administered orally, the dose of medication used should not exceed 1, 200-1, 800 mg of active ingredient per day. The exact dosage of medicine must be established by the doctor on an individual basis, depending on the intensity of the pain and according to the condition of each patient.
- Acetylsalicylic acid (Aspirin ®, Alkaeffer ®): acetylsalicylic acid is available for oral and parenteral administration.
When administered orally, the dose of medication usually used in adults ranges from 325 mg to 1, 000 mg, to be taken 2-3 times a day.
If acetylsalicylic acid is administered parenterally, however, the dose usually used in adults is 500-1, 000 mg, to be administered intravenously or intramuscularly, every 6, 8, or 12 hours.
However, the exact amount of drug to be taken and the route of administration must be established by the doctor.
Colchicine
Colchicine (Colchicina Lirca ®) is a drug that is normally used in gout therapy. However, its usefulness has also been demonstrated for the treatment of pericarditis.
Colchicine can be used to treat this disease because it is able to exert a very powerful anti-inflammatory action, acting directly on the cells of the immune system that trigger inflammation.
Colchicine is effective both in reducing symptoms and preventing relapses and can be given as monotherapy, or in combination with NSAIDs.
The dose of drug to be administered for the treatment of pericarditis must be established by the doctor.
Corticosteroids
Steroidal anti-inflammatory drugs are not a first-line treatment for pericarditis and are used only if treatment with NSAIDs and / or colchicine has not been successful. This is due to the serious side effects that corticosteroids can cause, especially when used for long periods of time.
Methylprednisolone (Urbason ®, Medrol ®, Solu-Medrol ®) are among the steroidal anti-inflammatories that can be used to treat pericarditis. When administered orally, the dose used can range from 4 mg to 48 mg of active ingredient per day. The initial amount of drug to be administered must be established by the doctor, depending on the severity of the inflammation and the patient's condition. Subsequently, the dose can be modified and adjusted according to the response of the patient to the therapy.
Opioid analgesics
Similarly to what happens for corticosteroids, treatment with opioid analgesics is also not among the first-line treatment for pericarditis, due to the side effects that these drugs can cause (including tolerance and physical and mental dependence). Their use is, in fact, reserved for cases of pericarditis characterized by very intense pain.
Among the opioid analgesics that can be used, we recall:
- Tramadol (Contramal ®): tramadol is available for oral, rectal or parenteral administration. Usually, the initial dose administered is 50-100 mg, depending on the severity of the pain afflicting the patient. However, if it is deemed necessary, the doctor may decide to increase the amount of tramadol administered.
In any case, the maximum dose of 400 mg of drug per day should not be exceeded.
- Codeine (Codamol ®, Co-Efferalgan ®, Tachidol ®): for the treatment of pain, codeine is administered orally and is often found in pharmaceutical formulations in combination with paracetamol. The dose of codeine that must be administered will be established by the doctor, depending on the intensity of the pain that afflicts the patient and according to his age.
Antibiotics, antivirals and antifungals
Antibiotic, antiviral or antifungal therapy is implemented only when pericarditis is caused by bacteria, viruses or fungi, respectively. In this regard, it is very important to identify the pathogen that supports the infection, so as to prescribe the patient the specific treatment best suited to counteract that particular type of microorganism.
