Lullmann Color Atlas of Pharmacology 2000 Thieme

The antiplatelet agent, ASA, is administered at the first suspected signs of infarction. Pain due to ischemia is treated predominantly with antianginal drugs (e.g., nitrates). In case this treatment fails (no effect within 30 min, administration of morphine, if needed in combination with an antiemetic to prevent morphine-induced vomiting, is indicated. If ECG signs of myocardial infarction are absent, the patient is stabilized by antianginal therapy (nitrates, p-blockers) and given ASA and heparin.

When the diagnosis has been confirmed by electrocardiography, attempts are started to dissolve the thrombus pharmacologically (thrombo-lytic therapy: alteplase or streptoki-nase) or to remove the obstruction by mechanical means (balloon dilation or angioplasty). Heparin is given to prevent a possible vascular reocclusion, i.e., to safeguard the patency of the affected vessel. Regardless of the outcome of thrombolytic therapy or balloon dilation, a p-blocker is administered to suppress imminent arrhythmias, unless it is contraindicated. Treatment of life-threatening ventricular arrhythmias calls for an antiarrhythmic of the class of Na+-channel blockers, e.g., lidocaine. To improve long-term prognosis, use is made of a p-blocker ( | incidence of re-infarction and acute cardiac mortality) and an ACE inhibitor (prevention of ventricular enlargement after myocar-dial infarction) (A).

If needed: antiarrhythmic: e.g., lidocaine

Antiplatelet drugs, thrombolytic agent, heparin

Preload reduction: nitrate

Sympathetic ® nervous system

Sympathetic ® nervous system

If needed: antiarrhythmic: e.g., lidocaine

Excitability 1

Your Heart and Nutrition

Your Heart and Nutrition

Prevention is better than a cure. Learn how to cherish your heart by taking the necessary means to keep it pumping healthily and steadily through your life.

Get My Free Ebook


Post a comment