Cardiac Ischemia

Question 1

Cardiac Ischemia
Indications

Answer 1

Suspected cardiac ischemia

Question 2

Cardiac Ischemia
ASA
Conditions
Age?
LOA?
Other?

Answer 2

Age: ≥ 18 years
LOA: Unaltered
Other: ability to chew and swallow

Question 3

Cardiac Ischemia
Nitroglycerin
Conditions
Age?
LOA?
HR?
SBP?
Other?

Answer 3

Age: ≥ 18 years
LOA: Unaltered
HR: 60 - 159
SBP: Normotension
Other: Prior history of nitroglycerin OR IV access obtained

Question 4

Cardiac Ischemia
Morphine
Age?
LOA?
SBP?
Other?

Answer 4

Age: ≥ 18 years
LOA: Unaltered
SBP: Normotension
Other: Severe Pain

Question 5

ASA
Contraindications

Answer 5

1. Allergy or sensitivity to NSAIDs
2. If asthmatic, no prior use of ASA
3. Current Active Bleeding
4. CVA or TBI in previous 24 hours

Question 6

Nitroglycerin
Contraindications

Answer 6

1. Allergy or sensitivity to nitrates
2. Phosphodiesterase inhibitor use within the previous 48 hours
3. SBP drops 1/3 of initial value
4. 12 Lead ECG compatible with Right Ventricular MI (ii,iii, aVF with V4R)

Question 7

ASA
Route - PO
Dose?
Max. Single Dose?
Dosing Interval?
Max # of Doses?

Answer 7

Dose: 160 - 162mg
Max. Single Dose: 162mg
Dosing Interval: N/A
Max # of Doses: 1

Question 8

Nitroglycerin
Route - SL
NON-STEMI
Dose?
Max. Single Dose?
Dosing Interval?
Max # of doses?

Answer 8

Dose: 0.4mg
Max. Single Dose: 0.4mg
Dosing Interval: 5 mins
Max # of doses: 6

Question 9

Nitroglycerin
Route - SL
STEMI
Dose?
Max. Single Dose?
Dosing Interval?
Max # of doses?

Answer 9

Dose: 0.4mg
Max. Single Dose: 0.4mg
Dosing Interval: 5 mins
Max # of doses: 3

Question 10

Morphine
Route - IV
when considered?
Dose?
Max. Single Dose?
Dosing Interval?
Max # of Doses?

Answer 10

when considered: after 3rd nitroglycerin or if nitroglycerin is contraindicated
Dose: 2mg
Max. Single Dose: 2mg
Dosing Interval: 5min
Max # of Doses: 5

Question 11

A patient with cardiac ischemia and CHF (pulmonary edema) would fall under which directive for nitroglycerin?

Answer 11

Follow Cardiac Ischemia Dosage for nitroglycerin

MI or ischemia usually exacerbates CHF

Question 12

Common ending for phosphodiesterase inhibitors?

Answer 12

-afil

Viagara, Levitra, Cialis
Sildenafil, Tadalafil, Verdenafil, Udenafil, Avanafil, Lodenafil, Mirodenafil, Acetildenafil, Aildenafil, Benzamidenafil