ACS and AMI - Therapy

Question 1

Describe the mechanism of action of thrombolytic therapy

Answer 1

• Serine proteases: convert plasminogen to plasmin

- Plasmin: lyses clot by breaking down fibrin meshwork

Question 2

Describe the contraindications to thrombolytic therapy

Answer 2

• Prior ICH
• Known cranial malignancies
• Ischaemic stroke within 3 months
• Suspected aortic dissection
• Active bleeding or bleeding diathesis
• Significant closed head/facial trauma within 3 months

Question 3

Describe the regimen to treat ACS if there is no evidence of STEMI

Answer 3

• Aspirin
• Clopidogrel/ticagrelor
• LMWH
• IV nitrate
• Analgesia
• Beta blockers

Question 4

Describe the regimen to reduce the risk from NSTEMI

Answer 4

• PCI or CBAG
• Aspirin
• Clopidogrel/ticagrelor
• LMWH
• Fondaparinux
• GIIb/IIIa receptor blockers
• Statins
• Beta blockers