Uncomplicated acute myocardial infarction. Methods of nonlytic management.

Therapy for acute myocardial infarction has its most compelling effect when the patient is seen early in the course of illness. In this article, the authors discuss the status of nonlytic medications during the acute phase of Q-wave infarction and also examine the role of risk modification and stratification in long-term survival of the patient.

Efficacy and safety of intravenous diltiazem for treatment of atrial fibrillation and atrial flutter. The Diltiazem-Atrial Fibrillation/Flutter Study Group.

This study evaluates the effectiveness and safety of intravenous diltiazem for the treatment of atrial fibrillation and atrial flutter. A double-blind, parallel, randomized, placebo-controlled protocol was used, and 6 large, urban hospitals, both university-affiliated and private, participated. The study involved 113 patients with atrial fibrillation or flutter, a ventricular rate greater than or equal to 120 beats/min and systolic blood pressure greater than or equal to 90 mm Hg without severe heart failure.

Efficacy of esmolol in the treatment and transfer of patients with supraventricular tachyarrhythmias to alternate oral antiarrhythmic agents.

The efficacy and safety of esmolol, a titratable intravenous beta-adrenergic blocking agent with a short elimination half-life (t 1/2 = 9.0 min) was evaluated in a multicenter open-label study for the treatment of supraventricular tachyarrhythmias (heart rate greater than 100 bpm). The study also investigated the feasibility of transferring patients from esmolol to alternate oral antiarrhythmic agents without loss of therapeutic response.

Esmolol hydrochloride: an ultrashort-acting, beta-adrenergic blocking agent.

The chemistry, pharmacology, pharmacokinetics, hemodynamic and electrophysiologic effects, clinical efficacy, adverse effects, drug interactions, compatibility and stability, dosage, and administration of esmolol hydrochloride are reviewed. Esmolol produces competitive blockade of beta receptors in both animals and humans. It does not possess membrane-stabilizing, intrinsic sympathomimetic, or alpha-adrenergic blocking activity.