121 Cardiac Ischemia Flashcards
What are the INDICATIONS for the CARDIAC ISCHEMIA medical directive?
Suspected Cardiac Ischemia
What are the CONDITIONS for Nitroglycerin in the CARDIAC ISCHEMIA medical directive?
18 years old
Unaltered
HR: 60-159
BP: normotensive
IV / Hx
What are the CONTRAINDICATION for Nitroglycerin in the CARDIAC ISCHEMIA medical directive?
Allergy or sensitivity
Phosphodiasterase Inhibitor use
SBP drop by 1/3
12 Lead compatible with RVMI
What is the initial dose Nitroglycerin in the CARDIAC ISCHEMIA medical directive?
0.3/ 0.4 mg
How MANY doses are given of Nitroglycerin in the CARDIAC ISCHEMIA medical directive?
STEMI 3
Non-Stemi 6
What is the MAX dose for Nitroglycerin in the CARDIAC ISCHEMIA medical directive?
What is the interval between doses for Nitroglycerin in the CARDIAC ISCHEMIA medical directive?
5 minutes
What is the route of administration for Nitroglycerin in the CARDIAC ISCHEMIA medical directive?
SL
What are the CONTRAINDICATIONS for ASA in the CARDIAC ISCHEMIA medical directive?
Allergy
If asthmatic, prior use
Current active bleeding
CVA/ TBI in past 24 hours
What are the CONDITIONS for ASA in the CARDIAC ISCHEMIA medical directive?
18 years
unaltered
able to chew and swallow
What is the dose ASA in the CARDIAC ISCHEMIA medical directive?
160-162mg
How MANY doses are given of ASA in the CARDIAC ISCHEMIA medical directive?
1
What is the route of administration for ASA in the CARDIAC ISCHEMIA medical directive?
PO
How does Nitroglycerin work?
MOI:
relaxes vasculature
causes venodilation and vasodilation
decreases preload and afterload
decreased heart oxygen demand
increases circulation to ischemic tissue
How does ASA work?
MOI:
-inhibits COX1 which blocks formation of thromboxane A2
-Decreases prostaglandins
-Inhibit COX2 (inflammation/ pain)
Which leads are the Inferior Leads
Which leads are the Lateral Leads
Which Leads are the Septal Leads
Which Leads are the Anterior Leads
Which Leads show the LAD
Which Leads show the LCX
Which leads show the RCA
How much ASA is too much
Over 1500mg
ASA drug class
ASA is an NSAID, antipyretic, platelet inhibitor, analgesic
Nitro drug class
Nitroglycerin is an anti-anginal medication
What does thromboxane A2 do?
Platellet aggregator/vasocontrictor
How does ASA reduce fever
Inhibit prostaglandin E1 in the hypothalamus
Causes vasodilation at the skin
What does COX 2 do?
Cause inflammation and pain
What are the CONTRAINDICATIONS for Morphine in the CARDIAC ISCHEMIA medical directive?
Allergy
Labour SBP drop by 1/3
What are the CONDITIONS for Morphine in the CARDIAC ISCHEMIA medical directive?
18 years
unaltered
normotensive
severe pain
What is the initial dose Morphine in the CARDIAC ISCHEMIA medical directive?
2mg
How MANY doses are given of Morphine in the CARDIAC ISCHEMIA medical directive?
5
What is the MAX dose for Morphine in the CARDIAC ISCHEMIA medical directive?
10mg
What is the interval between doses for Morphine in the CARDIAC ISCHEMIA medical directive?
5 minutes
What is the route of administration for Morphine in the CARDIAC ISCHEMIA medical directive?
Only IV
What class of drug is morphine?
opioid
How does morphine work?
Binds at opioid receptor in CNS
Causes venodilation and decreased preload
Increases pain threshold and alters perception