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Management of Myocardial Infarction – Anti Platelet Agents and Nitroglycerine

A MyocardiaI Infarction is a state of medical emergency that needs immediate medical attention. The treatment of MI is intended to prevent as much damage to myocardium as possible. The therapies are designed for preventing further complications. The most common agents  used for the management of MI include Oxygen, aspirin, and nitroglycerin. They are administered immediately as the patient arrives in the emergency department. The morphine is  used in the cases where the nitroglycerin is not effective but  it may lead to increase in mortality in the setting of NSTEMI.

Among the anti-platelet agents used, the Aspirin has been found to reduce the mortality significantly. In case a person can tolerate the aspirin, it can be taken quickly. The aspirin also exerts antiplatelet effect that inhibits the formation of further blood clots that block the arteries. The aspirin can be administered by  chewing so that it can be absorbed quickly. In addition to it, the dissolved soluble preparations and sublingual administration are also used. As per the U.S. guidelines, the recommended dosage of aspirin is 162–325 mg and Australian guidelines prescribe a dose of 150–300 mg.

Additional antiplatelet agents like clopidogrel are also used and the dosage varies as per the further treatment methods. For example, 300 mg of clopidogrel is administered orally for those patients that are receiving thrombolysis and 600 mg of clopidogrel is administerted orally in case where there is angioplasty is anticipated.

Nitroglycerin – Glyceryl trinitrate (nitroglycerin) is administered sublingually and it can also be taken Buccally if available. The Glyceryl Trinitrate acts as a donor of Nitrous oxide to smooth muscles cells that are adjacent to the coronary artery endothelium and thereby resulting in increased vasodilation and coronary blood flow. It cannot be taken if the patient has taken certain inhibitors like Viagra, Cialis, and Levitra in the last 12 hours because this combination may drastically drop the blood pressure.

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