In a Patient with chest pain since 1 hour and ST depression in V1, V 2, and V4 leads, which of the following drug should be avoided? (AIIMS May 2009)
During an attack of angina pectoris, 50% of patients with normal findings after resting ECG show abnormalities.
1. A 1-mm or greater depression of the ST segment below the baseline, is the most characteristic change.
2. Nitrates should first be given sublingually or by buccal spray if the patient is experiencing ischemic pain. If pain persists after three doses given 5 min apart, intravenous nitroglycerin is recommended.
3. β-ADRENERGIC BLOCKADE These agents are the other mainstay of anti-ischemic treatment. Intravenous beta blockade followed by oral beta blockade targeted to a heart rate of 50 to 60 beats/min is recommended.
4. Additional medical therapy includes (ACEI) and (statins) for long-term secondary prevention.
5. If pain persists despite intravenous nitroglycerin and beta blockade, morphine sulfate, 1 to 5 mg intravenously, can be administered every 5 to 30 min as needed.
6. Antithrombotic Therapy This is the other main component of treatment for UA/NSTEMI. Initial treatment should begin with the platelet cyclooxygenase inhibitor aspirin.
7. Thrombolytic therapy is given in ST elevation MI. It is not given in unstable angina.