406 pharm - wk 1 Flashcards
initial treatment for acute MI
oxygen 1st
-morphine
-aspirin (chewed)
-nitroglycerin
-beta blockers
-thrombolytic agent (if eligible)
morphine can
decrease pain which decreases stress on heart & also dilates + helps preserve ischemic tissue
what is the thrombolytic eligibility requirements
-within 4-6 hours of the beginning of the MI
-no recent homographic stroke or brain bleed
when can we give nitroglycerin IV
if pt BP can withstand it
if a patient HR cannot withstand a beta blocker, what can we give
a beta 1 selective
aspirin
suppresses platelet aggregation + decreases mortality
beta blockers
reduce HR & contractility + reduces pain, infarct size & mortality
nitroglycerin
reduces preload & afterload and limits infarct size
does not reduce mortality
what class is alteplase (tPA)
fibrinolutic therapy
alteplase (tPA) MOA
dissolves clot by converting plasminogen into plasmin
alteplase (tPA) SE
bleeding
alteplase (tPA) indication
stemi
alteplase (tPA) nursing considerations
-most effective but needs to be given within 30 to 70 minutes for best work
-always given w/ heparin & antiplatelet therapy (clopidogrel)
nitroglycerine SE
hypotension
headache
flushing
what drug cannot be administered w/ nitroglycerine
sildenafil d/t severe hypotension
