Bernstein, Arthur; Rothfeld, Edwin L.; Robins, Bernard; Cohen, Frederick; Simon, Franklin
November 1963
Angiology;Nov1963, Vol. 14 Issue 11, p559
Academic Journal
1. Shock in myocardial infarction must be vigorously combatted by increasing cardiac output and coronary blood flow if these patients are to be salvaged. 2. Inotropic, vasoconstrictor vasopressors such as norepinephrine and metaraminol are effective but have the disadvantage of the need for careful tigration, slough at sites of extravascular infiltration and arrhythmia production. 3. Pure vasoconstrictors such as methoxamine are probably best not used in the treatment of cardiogenic shock since they increase cardiac work. 4. Mephentermine sulphate is an inotropic vasopressor which is not a peripheral arterial constrictor, but is a venoconstrictor. It thereby increases cardiac efficiency. It is also antiarrhythmic. 5. Mephentermine was used to treat 80 cases of severe cardiogenic shock. In 61 cases, (76 per cent), there was an initial adequate rise in blood pressure with an ultimate survival rate of 43 per cent of the group. 6. Mephentermine was given in doses of 60 mg intravenously or intramuscularly or both followed by an intravenous drip of 600 to 1200 mg in 500 cc of 5 per cent glucose in distilled water with no evidence of slough, rash, excess rise of blood pressure or undue cerebral stimulation. Precise titration of dose was not needed and tachyphylaxis did not occur using this regime.


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