A new pharmaceutical package designed to give heart attack victims a chance at survival when out of range of medical help is currently awaiting final FDA approval. The 3 X 6-in. CardioCare Kit, a plastic package manufactured by World Travel Meds (Salt Lake City), contains four individually packaged oral drugs. Three of the drugs are packaged in blister strips, while the fourth—nitroglycerin—is contained in a single-dose bottle.

The medications can be self-administered by victims of myocardial infarction who are too far from civilization to get help. When properly used, the kit can give victims 24 hours to reach a hospital. “It’s basically the standard emergency room protocol for a heart attack,” says Angus Mackie, who helped design the kit with his brother, William Mackie, MD. “It has already saved four lives.”

The kits are targeted to hikers, hunters, cross-country skiers, pilots, and extreme adventurers that are alone in the wilderness and hours away from civilization, according to Mackie. They provide step-by-step instructions on administering four oral drugs: 81 mg of aspirin; 0.4 mg of nitroglycerin; 75 mg of clopidogrel; and 50 mg of metoprolol. The first dose, the aspirin, is used to soften up the victim’s arteries and thin the blood. The next drug, nitroglycerin, is used to relieve pain and lessen the severity of the heart attack. Following that, the victim administers four doses of another blood thinner (clopidogrel) approximately 30 minutes after the initial chest pain. Finally, a dosage of beta blockers (metoprolol) is included to prevent full cardiac arrest from occurring. The aspirin, which is packaged in a chewable form, works within 10–15 minutes. The nitroglycerin dose is instantaneous, becoming effective within one minute, and the blood thinner, clopidrogrel, works in about 30 minutes, according to Mackie.

Still, there are several roadblocks to the widespread use of the kits, he says. At the present time, the kits are not fully FDA-approved, even though three of the medications contained in the package are. “Right now, we’re driving toward making this a single SKU, and we want to get into pharmaceutical distribution,” he adds. “At some point, we would like to get the kit fully approved in its current form, to distribute it on a wider basis.”

Currently, those who wish to order the heart attack kit must fill out an on-line consultation form. A licensed physician approves each applicant, and then allows a pharmacist affiliated with World Travel Meds to prescribe the kit and send it by mail. “That is slowing us somewhat, since only 22 states have the proper mail-order licenses,” says Mackie. “We hope that this will change in the near future."

The company’s team of physicians has also developed a high-altitude sickness kit and travel diarrhea kit. It is great to see that healthcare practitioners appreciate the power of packaging.