Brief Answer:
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Detailed Answer:
hi
mr XXXXXXX
have noted all your details
post angioplasty a patient is given
a dual antiplatelet combination
on which you are on i.e tab ecosprin and tab prasita ...tab prasita should be switched over to tablet clopidrogel 75mg twice daily ,usually prasita is preffred for first 6months after stenting
prasita thiugh have a higher efficacy yet chances of bleeding(haemorrhage are higher in prasita then clopigrel) ,so while shifting patient from prasita to clopigrel 300mg clopigrel is given as a stat dose and after that a continuation dose of 75mg twice or once is given depending on nature of your stent(bare metal or drug eluting etc)
you said you take atorva 40mg in morning ,sir atorvastatin inhibits the enzyme Hmg co A which assists the formation of cholestrol in body
as most of the cholestrol formation in body takes place during the night time hence atorvastatin is usully given at bed time not in the morning infact prasugrel should also be taken during bed time to improve its efficacy
for gastro problem you are taking sucral fate which prevents and heals the ulcers in stomach ..your endoscopy must have shown some ulcers as you are prescribed with sucralfate

if you feel gastritis ,heart burn ,gas problem you can also add
tab esomeprazole(neksium 40mg) twice daily empty stomach
it is a very safe proton pump inhibitor (decrese acid formation) and you will be much relieved

tablet rivotril will lessen your anxiety and is good for patients after stenting but as you got your stents done in 2014 and it has been more then 2years now,in case you are not having anxiety issues or sleeping problem you can taper this medicine off

falvedon mr is a trimetazidine and is a chronic antianginal as nikorandil both of them are given to prevent further attacks of angina
as you have not attached your angiography and angioplasty reports it is very difficult to comment on these two medicine as they have no direct role after stenting a patient but yes if there is diffuse blockage in some of your vessels or blockage which need not to be stented but have to be medically treated then these two are good

trimetazidine is also given to increase ejection fraction of the heart ..as your echo reports is not there ...i suppose that dr must have prescribed you trimetazidine as your ef must be low

-you should stop smoking if u r a smoker
-advised 45minutes of exercise daily if u walk it should be brisk
-stop ghee, coconut oil, butter, mustard substitute them with rice XXXXXXX olive, saffola oil
-use three oils alternating one with other every month
-add fibres to your diet
-you can live a perfectly normal life

advised :
stress thallium every year(to check patency of the stents )

thank you
feel free to ask
sorry cant mail you separately due to company policy

Dr rishu saxena
consultant cardiologist XXXXXXX hospital ,new XXXXXXX

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