Cardio Pharm -- MI Flashcards
MONA therapies
morphine
oxygen
nitroglycerin
aspirin
morphine
MOA
binds opioid receptors in CNS, inhibiting of ascending pain pathways
alters response to pain, produces generalized CNS depression
morphine
SE
hypotension (caution with hypovolemia and circulatory shock pts)
respiratory depression (risk in elderly, debilitated pos, etc)
oxygen
indications
hypoxia (SpO2 <90%)
respiratory distress (heart failure)
oxygen CIs
hyperoxia
can cause vasoconstrictor effect on coronary artery
nitroglycerin
indications
treatment or prevention of angina pectoris
acute decompensated heart failure
perioperative HTN
nitroglycerin MOA
vasodilator effect
peripheral veins and arteries
reduces cardiac oxygen demand (decreases preload)
nitroglycerin SE and CI
SE: hypotension, headache (bradycardia, tachycardia, syncope, dizziness, nausea, committing, diaphoresis, dypsnea)
aspirin
MOA
recommend to be given ASAP with possible diagnosis of unstable angina or MI)
inhibits COX1 and COX2 and inactivates thromboxane A2
aspirin
SE
mostly dose related
extremely rare at low dosages
tinnitus
UGI events (ulcers)
aspirin CI
hypersensitivity to NSAID
asthma, rhinitis , nasal polyps
additional MI therapies
unfractionated Heparin
rTPA (Alteplase)
clopidegrel (Plavix)
unfractionated heparin
indications
anticoagulant during PCI/stent
ST elevation MI unstable angina (non STEMI)
unfractionated heparin
MOA
inactivates thrombin, prevents conversion of fibrinogen to fibrin
unfractionated heparin SE
thrombocytopenia
bleeding
unfractionated heparin
CI
severe thrombocytopenia
uncontrolled active bleeding
rTPA/alteplase
class
MOA
thrombolytic agent
begins local fibrinolysis by binding to fibrin in a clot and converting entrapped plasminogen to plasmin
rTPA
indications
acute ischemic stroke
ST Elevation
MI
PE
acute peripheral arterial occlusion
rTPA
SE
may impact hemostasis
bleeding
hemorrhage
rTPA
CI
active internal bleeding
history of recent CVA
head trauma
recent cranial or spinal surgery
intracranial conditions to increase bleeding
severe uncontrolled HTN
clopidogrel
brand, class
Plavix
anti-platelet aged
Plavix indications
unstable angina
myocardial infarction
stroke
peripheral arterial disease
Plavix
MOA
active metabolite irreversible blockage of ADP receptor to prevent activation of GP2b/3a
reduces platelet aggregation
works for 7-10 days
clopidogrel S/CI
bleeding
