Which of the following is not listed as ACS acute tx?

• A. Vitamin K
• B. Oxygen
• C. Metoprolol
• D. Nitrates

Answer: (A)

In acute ACS, the focus is on rapidly relieving ischemia and preventing further thrombosis. Oxygen is given if the patient is hypoxemic to improve oxygen delivery to the heart. Nitrates help relieve chest pain and reduce preload, decreasing myocardial oxygen demand. A beta-blocker like metoprolol is used to lower heart rate and contractility, again reducing oxygen demand and work on the heart.

Vitamin K, on the other hand, is used to reverse warfarin anticoagulation or to treat vitamin K deficiency; it does not address the acute ischemia or thrombosis driving ACS. Therefore it is not part of the ACS acute treatment plan.