Treatment
Table 12. Selected Routine Medical Therapies
Indications
Dose/Administration
Avoid/Caution
Nitroglycerin
• Ongoing chest pain
• Hypertension and
HF
• 0.4 mg sublingual every 5 min
≤3 doses as BP allows
• IV dosing to begin at
10 mcg/min; titrate to desired
BP effect
• Avoid in suspected
right ventricular (RV)
infarction
• Avoid with SBP
<90 mm Hg or if
SBP >30 mm Hg below
baseline
• Avoid if recent
(24-48 h) use of
5'-phosphodiesterase
inhibitors
• 2-4 L/min via nasal cannula
• Increase rate or change to face
mask as needed
• Caution with chronic
obstructive pulmonary
disease and CO2
retention
• 4-8 mg IV initially, with lower
doses in elderly
• 2-8 mg IV every 5-15 min if
needed
• Lethargic or moribund
patient
• Hypotension
• Bradycardia
• Known hypersensitivity
Oxygen
• Clinically
significant
hypoxemia (oxygen
saturation <90%)
• HF
• Dyspnea
Morphine
• Pain
• Anxiety
• Pulmonary edema
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