Russek, Henry I.
January 1967
Angiology;Jan1967, Vol. 18 Issue 1, p15
Academic Journal
In myocardial infarction, in spite of the major advances in diagnosis and therapy, it must still be recognized that under proper supervision a large proportion of cases will run their course from beginning to end with little or no need for medication. Since hazards exist even with skillful use of therapeutic measures by competent physicians, overtreatment arising from the application of �routine� programs should be discouraged. It is only by adherence to the important principle of treating each patient individually that the dangers of indiscriminate therapy may be avoided. The use of potentially dangerous agents in acute coronary occlusion without clear indication is not justified. It is the physician's responsibility to be as aware of the hazards as of the triumphs of modern therapy and to utilize such knowledge in the choice of specific measures for the individual case. In angina pectoris, the therapeutic role of the physician is by no means secondary to that of drug treatment. Nevertheless, the employment of long-acting nitrates, in particular, isosorbide dinitrate sublingually or pentaerythritol tetranitrate orally, in conjunction with careful counseling, represents a distinct advance in the prophylactic therapy of angina pectoris. The prudent use of these long-acting drugs requires a knowledge not only of dosage, time of onset, and duration of action in relation to route of administration but also of the pattern of anginal episodes and drug tolerance in the individual case. Failure to utilize available benefits may deprive the patient with angina pectoris of considerable comfort, assurance, and productivity.


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