Professional Documents
Culture Documents
β-blockers
Anti-
arrhythmics
Antiplatelet
drugs & Anti-
coagulants
Inotropics
Nitrates - Analgesics Thrombo- ACE inhibitors/ARB’s
preload lytics - afterload
DRUGS USED IN MYOCARDIAL INFARCTION
• Immediate treatment:
1) Analgesics & antianxiety drugs: pain in MI → anxiety &
apprehension → sympathetic over activity →
deleterious to the heart
- Morphine 10mg / Pethidine 50mg IV relieves pain →
reduce anxiety, sympathetic over activity
- Diazepam can also be given for sedation & to anxiety
2) Thrombolytics: can limit the extent of damage &
mortality, should be started at the earliest (6-12hrs)
- Streptokinase 1.5 million units infusion over 1 hr or
- Urokinase / Alteplase 15mg bolus & 0.5mg/kg over
the next 90 mins
- Anistreplase is long acting, can be used as a single IV
injection
3) Antiplatelet drugs: 300mg soluble Aspirin given
orally immediately at the onset of symptoms →
mortality & the effect of thrombolysis. Aspirin
should be continued for a long term (75-150mg/
day) even after the patient recovers from MI.
Pts allergic to Aspirin given oral Clopidogrel
4) Anticoagulants: Heparin may be given to prevent
extension of thrombus & to prevent DVT
5) Oxygen: high flow should be given by inhalation
6) Vasodilators: Nitroglycerin / Sodium nitroprusside
may be used as IV infusion to cardiac workload &
mortality.
7) Other drugs:
i. β-blockers: IV Atenolol 5-10mg over 5mins/
Metoprolol 5mg over 2 mins given at the earliest
unless C/I. Limit the infarct size, incidence of
arrhythmias, mortality. Later oral β-blockers
ii. ACE inhibitors/ ARB’s: should be started within
24hrs, prevent ventricular remodelling &
progression of heart failure, continued for long
periods
iii. Inotropic drugs: Dobutamine/Dopamine may be
given to pumping action of heart
iv. Antiemetics: Pheniramine 25mg IV
v. Furosemide: cardiac preload
vi. Antiarrhythmics: depending on arrhythmia
LONG TERM TREATMENT
Certain drugs are recommended for prevention of
further ischemic events:-
• Stool softener to avoid straining at stools
• Long term administration of low dose aspirin,
β-blocker, ACE inhibitor useful in reducing long term
mortality
RISK FACTOR MANAGEMENT
• Smoking should be stopped
• Hyperlipidemia should be controlled
• Reduction of body weight
• Regular moderate exercises
• Adequate control of diabetes & hypertension
TREATMENT OF PERIPHERAL VACULAR DISEASES