Emergency Medications for Myocardial Infarction 2001.12.22

Emergency Medications for Myocardial Infarction 2001.12.22

1. Nitroglycerin at 5–10 µg/min, isosorbide dinitrate at 40 µg/min. During the acute phase, continuous intravenous infusion of nitroglycerin at 1 mg once daily is recommended, diluted in 250 mL of 5% glucose solution. If the infusion is completed within 2 hours, it generally meets the requirement of 5–10 µg/min.

2. Urokinase at 1.5 million units once daily, administered via intravenous drip in 100 mL of 5% glucose solution. The medication can be repeated every 4–5 hours until coronary artery patency is achieved. During this period, blood samples should be taken every 2 hours to test prothrombin time and thrombin time.

3. Heparin at 5,000 units mixed with 50–100 mL of normal saline, administered via intravenous drip or bolus injection. Typically, after the bolus injection, maintenance is at 1,000 units/hour. Recently, low-molecular-weight heparin has become popular (enoxaparin 20 mg, 0.2 mL subcutaneously, once daily).

4. For severe hypertension, sodium nitroprusside at 10–30 mg can be added to 250 mL of 5% glucose solution for intravenous drip, once daily.

5. Oral administration of aspirin, propranolol, and captopril.