The first-line drug for acute myocardial infarction in dental emergency is: (PSC - Lumbini 2083)

 # The first-line drug for acute myocardial infarction in dental emergency is: (PSC - Lumbini 2083)

 A. Nitroglycerin

B. Aspirin

C. Atorvastatin

D. Metoprolol

The correct answer is B. Aspirin.

In a dental emergency setting, the pharmacological priority for an acute myocardial infarction (AMI) is halting the expansion of the coronary thrombus:

Aspirin: This is the definitive first-line therapeutic drug for a suspected AMI. Standard protocol mandates the immediate administration of 160–325 mg of non-enteric-coated, chewable aspirin. It acts as a rapid antiplatelet agent by irreversibly inhibiting the cyclooxygenase-1 (COX-1) enzyme, blocking the synthesis of thromboxane A2. This prevents further platelet aggregation and is the primary chairside intervention proven to reduce patient mortality.   

Nitroglycerin: While sublingual Nitroglycerin (0.4 mg) is the first-line emergency drug for angina pectoris, it is not the primary disease-modifying drug for an established infarction. During an AMI, it provides symptomatic pain relief by acting as a vasodilator that reduces venous return (preload) and myocardial oxygen demand, but it does not stop the underlying thrombotic event.   

Atorvastatin & Metoprolol: These are critical hospital-administered medications utilized following an MI, but they are not acute, first-line emergency drugs kept in a standard clinical emergency armamentarium.