Pericarditis Medications: A Comprehensive Guide to Treatment Options

Pericarditis is an inflammation of the pericardium, the thin sac that surrounds the heart. The choice of medication depends largely on the underlying cause of the condition. Below is a detailed overview of the most common causes and their associated treatment options.

Infectious Pericarditis: Targeted Antibiotic and Antituberculous Therapy

Infectious pericarditis, often linked to tuberculosis, requires aggressive treatment with antitubercular drugs. A standard regimen typically includes three medications: Rifampin, Isoniazid, and Pyrazinamide. These drugs are administered in adequate doses and for a sufficient duration to ensure complete eradication of the infection and to prevent the development of drug resistance.

Idiopathic Pericarditis: Symptom Management with NSAIDs and Corticosteroids

When the cause of pericarditis is unknown, it is referred to as idiopathic pericarditis. In such cases, treatment often focuses on symptom relief. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are commonly prescribed to reduce pain and inflammation. In more severe or persistent cases, corticosteroids may be introduced to control the immune response and alleviate symptoms.

Purulent Pericarditis: Immediate Antibiotic Intervention

Purulent pericarditis, a form caused by bacterial infection, requires prompt administration of antibiotics. Intravenous (IV) antibiotics are often necessary in the early stages to combat the infection effectively. The specific antibiotic used will depend on the identified or suspected pathogen.

Uremic Pericarditis: Dialysis and Supportive Care

This type of pericarditis occurs in patients with severe kidney failure. The primary treatment is hemodialysis to remove toxins from the blood. In addition, medications such as indomethacin may be prescribed to manage inflammation and reduce discomfort.

Radiation-Induced Pericarditis: Corticosteroid Therapy

Pericarditis resulting from chest radiation therapy can be treated with corticosteroids like prednisone. These medications help reduce inflammation and manage symptoms, especially in cases where the condition becomes chronic or recurrent.

Post-Myocardial Infarction Pericarditis: Monitoring and Conservative Approach

Sometimes, pericarditis develops as a reaction following a heart attack. In many cases, this form—known as Dressler's syndrome—resolves on its own over time. During this period, close monitoring is recommended. Medication is usually not required unless symptoms become severe, in which case NSAIDs or other anti-inflammatory agents may be considered.