The use of P-blockers in NSTE ACS is similar to STE ACS in that oral P-blockers should be initiated within 24 hours of hospital admission to all patients in the absence of contraindications. Benefits of P-blockers in this patient group are assumed to be similar to those seen in patients with STE ACS. P-Blockers are continued indefinitely. The prescription of a P-blocker at hospital discharge used to be reported as a quality measure.

Calcium Channel Blockers

As described in the previous section, calcium channel blockers should not be administered to most patients with ACS. Their role is a second-line treatment for patients with certain contraindications to P-blockers and those with continued ischemia despite P-blocker and nitrate therapy. Administration of either amlodipine, diltiazem, or verapamil is preferred.

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