HEART ATTACK – MYOCARDIAL INFARCT

The drug trinitrin is widely used to treat angina and it may even help in the diagnosis.

These tablets are placed in the mouth and sucked or chewed but not swallowed. The drug is absorbed through the mucous membrane of the mouth directly into the blood stream and works immediately. Should a clot form on an atheromatous plaque in one of the coronary arteries, it will block the artery. This is a coronary occlusion.

If the heart muscle supplied by that artery is deprived totally of its blood supply, death of the muscle will occur — a myocardial infarct.

Ischaema is the term given to impaired blood supply of any tissue. Myocardial ischaema may be temporary, as in angina, or prolonged, as in coronary occlusion.

The pain from an occlusion is of the same type as angina but is not produced by exertion and is unrelieved by rest. The pain may persist for hours and only be relieved by giving strong pain-relieving drugs like morphine and its derivatives.

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PREGNANCY RISKS – INTRODUCTION

Pregnant women and their doctors often read about the hazards to the foetus of taking any drug during pregnancy.

The anti-morning sickness tablet, marketed in Australia as Debendox, came under notice because of a court case in America. It must be stressed that this drug had been used widely in Australia for more than 20 years and there is no evidence that it increases the risk of foetal abnormalities.

Just because a woman who has taken a drug during early pregnancy has a child with an abnormality does not prove cause and effect.

Congenital abnormalities occur in one in 40 births and, so, are common.

Because of the costs involved in defending this drug in the courts, the makers have withdrawn it from the market.

Of even more importance is: what should epileptic women do when they become pregnant? Most are taking at least one, sometimes two, drugs to control their epilepsy.

Some recent reports have indicated that there is an increased incidence of foetal abnormalities in the children of these women, particularly the risk of hare lip or cleft palate.

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