Acute coronary syndromes/MI treatment

Question 1

what is involved in the initial treatment of ACS

Answer 1

morphine, O2, nitrates, aspirin, ticagrelor

Question 2

what pneumonic is used for initial treatment of ACS

Answer 2

MONA T

Question 3

when is O2 necessary in initial treatment of ACS

Answer 3

if hypoxic

Question 4

when are nitrates needed in initial treatment of ACS

Answer 4

if patient is hypertensive or in acute left ventricular failure(LVF)

Question 5

in the definitive management of ACS, what is the first line treatment for STEMI patients

Answer 5

PCI, if it can be delivered within 120 mins of first medical contact

Question 6

in the definitive management of ACS, what is the second line treatment for STEMI patients

Answer 6

thrombolysis with tissue plasminogen activator(.e.g alteplase)

Question 7

in the definitive treatment of ACS, what treatment do all NSTEMI/ unstable angina patients receive

Answer 7

continuing antiplatelet therapy, anticoagulation, GTN spray if chest pain, beta blocker unless contraindicated

Question 8

what anticoagulation agent is used in NSTEMI/unstable angina definitive treatment

Answer 8

fondaparinux

Question 9

what treatment may be given to NSTEMI/unstable angina patients if they are high risk or have recurrent symptoms

Answer 9

inpatient coronary angiography, and possibly tirofaban(an antiplatelet)

Question 10

what allows low risk NSTEMI/unstable angina patients to leave hospital

Answer 10

negative troponin test and regular follow-ups