IHD Treatment Guideline


This is a sample prescription for the intern doctors for the treatment of IHD (STEMI and Non-STEMI). The Brand Names of the drugs mentioned below are from different drug manufacturers of Bangladesh.

Guideline Admission Release
Limit physical activities at least for 12 hours Absolute bed rest
Diet: restrict sodium intake Diet: Soft and liquid
Oxygen in patients with respiratory distress and oxygen saturation ≤94% O2 inhalation 4L/min

stat and SOS

Tab. Aspirin 150-325 mg PO administered as soon as possible on admission.

Tab. Clopidogrel 300 mg stat and followed by 150 mg daily for 1 week and 75 mg daily thereafter.


4 tabs stat by crushing

then 0+1+0 (a/m)


0+1+0 (খাবার পর)      – চলবে

Tab. Nitroglycerine 0.3-0.6 mg sublingual Tab. TROCER 2.6 SR2



2 puffs S/L stat and SOS


জিহ্বার নিচে দুই চাপ নিবেন

Continuous treatment with an oral β-blocker reduces long-term mortality Tab. METOPROL XL 50mg3

½+0+ ½

Tab. BETALOC 25mg3

1+0+1                      – চলবে

Tab. ANGINOX 20mg4

1+0+1 (a/m)

Irrespective of serum cholesterol concentrations, all patients should receive statin therapy after acute coronary syndrome Tab. ANZITOR 20mg5


Tab. ANZITOR 10mg5

0+0+1                     – চলবে

If no hypotension or contraindications and uncomplicated MI given Tab. Enalapril 5 mg 2 times a day PO Tab. RAMORIL 2.5mg6


Tab. RAMORIL 2.5mg6

0+0+1                     – চলবে

Tab. NEXUM 20

1+0+1 (b/m)

Tab. NEXUM 20

1+0+1 (খাবার আধা ঘণ্টা পুর্বে)

–  ১৫ দিন

Sedation with a benzodiazepine agent may help if anxiety is present Tab. EPICLON 0.5mg7


Tab. EPICLON 0.5mg7

0+0+1                     – ১৫ দিন

Inj. Enoxaparin 1 mg/kg subcutaneously 12 hourly for 3-5 days Inj. CLEXANE 60mg

1 PFS S/C around the umbilicus BD

If severe pain:

Morphine 15mg diluted with 14mℓ of water for injection or sodium chloride 0.9%. Give 1mℓ/min IV until pain relieved. (Initially, morphine sulphate 5–10 mg)

If within 6 hours of onset of pain and ST segment elevation above baseline or new LBBB on ECG.

Streptokinase 1.5 million IU diluted in 100mℓ dextrose 5% or sodium chloride 0.9% IV over 30–60 minutes.

Inj. STK9 1.5 million IU

Dissolved in 100 cc N/S IV @ 100 microdrops/min



1 LOPIREL PLUS – Incepta Aspirin + Clopidogrel

75mg + 75mg

2 TROCER 2.6 SR – Incepta


Glyceryl Trinitrate (nitroglycerine)
3 METOPROL XL – Beximco (50/100mg)

BETALOC – Drug Int. (25/50 mg)

Metoprolol Tartrate ( blocker). Avoid in pregnancy, asthma, COPD, peripheral vascular disease, heart failure (pulmonary oedema), hypotension (systolic BP < 105 mmHg) or bradycardia (heart rate < 65/min).


4 ANGINOX 20mg – General Pharma Trimetazidine Dihydrochloride (anti-anginal & anti-ischemic drug)
5 ANZITOR – Square (10/20/40mg)


Atorvastatin (statin, anti-anginal & anti-ischemic drug)
6 RAMORIL – Incepta (1.5/2.5/5/10mg)


Ramipril (ACEi)
7 EPICLON – General (0.5/1/2mg)


Clonazepam (Benzodiazepine hypnotic, adjunct anti-epileptic)
8 CLEXANE – Sanofi (20/40/60/80mg)

CLOTINEX – Square (40/60/80mg)



Enoxaparin (anti-coagulant)
9 STK– Incepta (4500/-)

STREPTASE– Sanofi Aventis (3464/-)

S-KINASE – Popular (3000/-)


Streptokinase (fibrinolytics)




Guideline Admission Release
Cessation of smoking Cessation of smoking ধূমপান সম্পূর্ণ বন্ধ।
Initiate or maintain lifestyle modifi cation–weight-control, increased physical activity, alcohol moderation, sodium reduction, and emphasis on increased consumption of fresh fruits, vegetables, and low-fat diary products. পাতে লবণ খাবেন না।
Patient should avoid non steroidal anti-inflammatory drugs like ibuprofen and diclofenac, as they may precipitate angina.
Coronary angiography should be considered with a view to revascularisation in all patients at moderate or high risk





  1. Standard treatment guidelines of the Kingdom of Swaziland. Swaziland: Ministry of Health; 2012.
  2. Primary Care 101 Guideline 2013/14: The National Department of Health Private Bag x828 Pretoria 0001; 2013.
  3. Papadakis MA, McPhee SJ, Rabow MW. CURRENT Medical Diagnosis and Treatment 2017: McGraw-Hill Education; 2016.
  4. Walker BR, Colledge NR, Ralston S, Penman ID. Davidson’s Principles and Practice of Medicine: Churchill Livingstone/Elsevier; 2014.


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