ACUTE CORONARY SYNDROMES (STEMI, NON-STEMI, ETC) Flashcards
COMPARING UA, NSTEMI, STEMI
SYMPTOMS
CHEST PAIN
COMPARING UA, NSTEMI, STEMI
CARDIAC ENZYMES
POSITIVE IN STEMI AND NSTEMI
COMPARING UA, NSTEMI, STEMI
ECG CHANGES
ST ELEVATION IN STEMI
NONE OR TRANSIENT IN UA AND NSTEMI
COMPARING UA, NSTEMI, STEMI
BLOCKAGE
COMPLETE IN STEMI
PARTIAL IN UA AND NSTEMI
HOW IS NSTEMI TYPICALLY TREATED
USUALLY MEDICATIONS ALONE
“MEDICAL MANAGEMENT”
OR USING PCI
HOW IS STEMI TYPICALLY TREATED
PCI
IF PCI DELATED, FIBRINOLYTICS
DRUG TREATMENT FOR ACS
MONA-GAP-BA
MORPINE
OXYGEN
NITRATES
ASA
*
GPIIb/IIIa ANTAGONISTS
ANTICOAGULANTS
P2Y12 INHIBITORS
*
BETA BLOCKERS
ACEi
WHAT IS THE TREATMENT FOR NSTE-ACS
MONA-GAP-BA +/- PCI
WHAT IS THE TREATMENT FOR STEMI
MONA-GAP-BA + PCI OR FIBRINOLYTICS
WHAT ARE THE GPIIb/IIIa AGENTS
ABCIXIMAB
EPTIFIBATIDE
TIROFIBAN
WHAT ARE THE ANTICOAG AGENTS
LMWH, UFH, BIVALIRUDIN
WHAT ARE THE P2Y12 INHIBITORS
CLOPIDOGREL
PRASUGREL
TICAGRELOR
HOW SOON SHOULD BB BE GIVEN DURING ACS
WITHIN 24 HOURS
↑ LONG TERM SURVIVAL
HOW SOON SHOULD ACEi BE GIVEN DURING ACS
ORAL ONLY
WITHIN 24 HOURS IF LVEF < 40% AND THOSE WITH HTN, GM, STABLE CKD
PRASUGREL BOXED WARNING
DO NOT INITIATE IF CABG LIKELY
STOP AT LEAST 7 DAYS PRIOR TO ELECTIVE SURGERY
TICAGRELOR AND ASA CONSIDERATIONS
ASA DOSE SHOULD NOT EXCEED 100 MG AS MAINTENANCE DOSE
TICAGRELOR BOXED WARNINGS
AVOID IF CABG LIKELY
STOP 5 DAYS BEFORE ANY SURGERY
CANGRELOR FORMULATION
INJECTION
REOPRO
ABCIXIMAB
TERGRILLIN
EPTIFIBATIDE
WHEN ARE FIBRINOLYTICS USED
ONLY FOR STEMI
HOW SOON SHOULD PCI OCCUR
WITHIN 90 MINUTES (OPTIMAL DOOR-TO-BALOON TIME)
OR
WITHIN 120 MINUTES OF FIRST MEDICAL CONTACT
HOW SOON SHOULD FIBRINOLYTIC BE STARTED
IF PCI NOT POSSIBLE IN THE RECOMMENDED TIME FRAME, FIRBINOLYTICS SHOULD BE INITIATED WITHIN 30 MINUTES OF HOSPITAL ARRIVAL
WHEN IS FIBRINOLYTICS CONTRAINDICATED
ACTIVE INTERNAL BLEEDING
HISTORY OF RECENT STROLE
SEVERE UNCONTROLLED HTN (NOT RESPONDING TO EMERGENCY THERAPY)
SECONDARY PREVENTION
HOW LONG IS ASA INDICATED AT WHAT DOSE
81 MG DAILY
INDEFINITELY
SECONDARY PREVENTION
P2Y12 INHIBITOR AGENT AND DURATION
IF RECEIVED FIBRINOLYTICS, TICAGRELOR OR CLOPIDOGREL FOR ≥ 12 MONTHS
PCI-TREATED: ANY P2Y12 FOR ≥ 12 MONTHS
SECONDARY PREVENTION
NITROGLYCERIN DURATION
INDEFINITELY (PRN FOR ANGINA)
SECONDARY PREVENTION
BETA BLOCKERS DURATION
3 YEARS AT LEAST
IF HF OR NEEDED FOR HTN, INDEFINITELY
SECONDARY PREVENTION
ALDOSTERONE ANTAGONIST DURATION
INDEFINITELY IF EF<40% AND EITHER SYMPTOMATIC HF OR DM RECEIVING RTARGET DOSES OF ACEi AND BB
SECONDARY PREVENTION
ALDOSTERONE ANTAGONIST CONTRAINDICATION
SIGNIFICANT RENAL IMPAIRMENT
HYPERKALEMIA
SECONDARY PREVENTION
STATIN DURATION AND INTENSITY
INDEFINITELY AT HIGH INTENSITY
IF OLDER THE 75, MODERATE OR HIGH
WHICH NSAID IS KNOWN TO HAVE THE LOWEST CARDIAC RISK
NAPROXEN