mac lipstick Intravenous diltiazem treatment of un

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Intravenous diltiazem treatment of unstable angina pectoris

Abstract Objective To observe the intravenous diltiazem treatment of unstable angina pectoris efficacy, safety and adverse reactions. Methods 35 patients with unstable angina patients, the first dose of 10 mg intravenous injection, and then to 60μg/min infusion, gradually increase the maximum dose 300μg/min continuous infusion for 48 h and observed the onset of angina, electrocardiogram, blood pressure and heart rate. Results within 48 h after treatment compared with the baseline, the average reduction in the number of angina pectoris,[link widoczny dla zalogowanych], ischemic ECG significantly improved the performance,[link widoczny dla zalogowanych], blood pressure, heart rate, sinus bradycardia occurred in 2 cases, hypotension in 1 case, after reduction recovery. Conclusions Short-term intravenous diltiazem Good Excel full and effective.  Key words diltiazem; unstable angina  unstable angina (unstable angina pectoris, UAP) is the range of stable angina pectoris and acute myocardial infarction between one of a cardiovascular event, its clinical manifestation, disease progressed rapidly, with acute risk of myocardial infarction or sudden death, so the correct diagnosis and prompt effective treatment can greatly improve the prognosis. In this study, intravenous diltiazem treatment of UAP in clinical efficacy and safety.  1  1.1 data and methods study from October 2007 to June 2008 in Jilin Province People's Hospital of Cardiology, 35 cases of hospitalized patients, including 27 males and 8 females, aged 40 to 76 years, mean (60.5 ± 8.4) years of age, inclusion criteria consistent with WHO's clinical classification of unstable angina criteria: angina at rest of which 5 cases, 3 cases of early onset exertion angina, worsening exertion angina pectoris in 15 cases, post-infarction angina pectoris in 2 cases, mixed angina in 10 cases, 18 cases had primary hypertension, hyperlipidemia in 20 cases, 15 cases of type 2 diabetes, smokers 20 cases. Exclusion criteria: ① renal failure; ② diabetic ketosis; ③ acute myocardial infarction; ④ second degree and second degree atrioventricular block; ⑤ heart rate <55 times / min; ⑥ cardiac function III level and above; ⑦ blood pressure less than 90/60 mm Hg (1 mm Hg = 0.133 KPa).  1.2  1.2.1 Method of treatment for selected patients with angina attack is injection of diltiazem (Tanabe Pharmaceutical Co. Ltd. in Tianjin, Herbesser) the first dose 10 mg intravenous Note (20 ml normal saline diluted slow intravenous injection 10 min), subsequently to 60 μg / min intravenous drip medication whether angina were observed during the attack, while blood pressure, heart rate and adverse drug reactions. If symptoms of angina attacks and no adverse reactions, 10μg per 5 min gradually increasing increments to 150 μg / min to maintain; if we continue to attack, and gradually increase the amount (3 ~ 5 min per dose 10 μg) to 300 μg / min (maximum dose) to maintain the effective dose of intravenous 48 h, such as the reduction of adverse reactions were observed. After intravenous administration of the effective reform of oral sustained-release tablets of diltiazem (Tanabe Pharmaceutical Co., Ltd. Tianjin,[link widoczny dla zalogowanych], Herbesser), the condition of patients during drug combination antiplatelet agent, β blockers, statins, and low molecular weight heparin treatment.  1.2.2 Clinical Assessment of land diltiazem intravenous medication 48 h before and during angina attack frequency and longest duration of ST-T changes in ECG, blood pressure, heart rate, myocardial oxygen consumption index (arterial contraction the product of pressure and heart rate, SBP × HR) and adverse drug reactions.  1.3 measurement data statistically to the mean ± standard deviation (x ± s) that were analyzed statistically using analysis of variance. P <0.05 for the difference was statistically significant.  2 results  2.1 Clinical intravenous diltiazem 28 cases markedly effective in 5 cases, total effective rate was 94%, 2 cases, 6%, compared with the baseline, drug 48 h, reducing the average number of patients with angina, attack duration, the difference was significant (P <0.01).  2.2 ECG changes before and after treatment after treatment before treatment and 24 h and 48 h respectively on the 12-lead ECG, ST segment depression lead to the total number of (NST) and the total amount of ST segment depression ( ΣST) that the scope and extent of myocardial ischemia, 24 h after the beginning of treatment and 48 hNST and ΣST significantly decreased compared with before treatment, 48 h than 24 h NST, ΣST further decreased,[link widoczny dla zalogowanych], the difference was not statistically significant . Before and after treatment  2.3 Blood pressure, heart rate, and SBP × HR changes. After medication, heart rate slowed to varying degrees,[link widoczny dla zalogowanych], no significant change, 1 h after treatment significantly decreased systolic blood pressure, P <0.05, myocardial oxygen consumption index (SBP × HR) decreased significantly.  2.4 adverse events occurred in 2 cases of sinus bradycardia (heart rate 46 to 50 times / min), 1 patient had transient hypotension (85/50 mm Hg), diltiazem were improved after the reduction. Course of medication without angina aggravated or worsening cardiac function.
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