Cardio Pharm -- MI

Question 1

MONA therapies

Answer 1

morphine
oxygen
nitroglycerin
aspirin

Question 2

morphine

MOA

Answer 2

binds opioid receptors in CNS, inhibiting of ascending pain pathways

alters response to pain, produces generalized CNS depression

Question 3

morphine

SE

Answer 3

hypotension (caution with hypovolemia and circulatory shock pts)

respiratory depression (risk in elderly, debilitated pos, etc)

Question 4

oxygen

indications

Answer 4

hypoxia (SpO2 <90%)

respiratory distress (heart failure)

Question 5

oxygen CIs

Answer 5

hyperoxia

can cause vasoconstrictor effect on coronary artery

Question 6

nitroglycerin

indications

Answer 6

treatment or prevention of angina pectoris

acute decompensated heart failure

perioperative HTN

Question 7

nitroglycerin MOA

Answer 7

vasodilator effect

peripheral veins and arteries

reduces cardiac oxygen demand (decreases preload)

Question 8

nitroglycerin SE and CI

Answer 8

SE: hypotension, headache (bradycardia, tachycardia, syncope, dizziness, nausea, committing, diaphoresis, dypsnea)

Question 9

aspirin

MOA

Answer 9

recommend to be given ASAP with possible diagnosis of unstable angina or MI)

inhibits COX1 and COX2 and inactivates thromboxane A2

Question 10

aspirin

SE

Answer 10

mostly dose related

extremely rare at low dosages

tinnitus

UGI events (ulcers)

Question 11

aspirin CI

Answer 11

hypersensitivity to NSAID

asthma, rhinitis , nasal polyps

Question 12

additional MI therapies

Answer 12

unfractionated Heparin
rTPA (Alteplase)
clopidegrel (Plavix)

Question 13

unfractionated heparin

indications

Answer 13

anticoagulant during PCI/stent

ST elevation MI 
unstable angina (non STEMI)

Question 14

unfractionated heparin

MOA

Answer 14

inactivates thrombin, prevents conversion of fibrinogen to fibrin

Question 15

unfractionated heparin SE

Answer 15

thrombocytopenia

bleeding

Question 16

unfractionated heparin

CI

Answer 16

severe thrombocytopenia

uncontrolled active bleeding

Question 17

rTPA/alteplase

class

MOA

Answer 17

thrombolytic agent

begins local fibrinolysis by binding to fibrin in a clot and converting entrapped plasminogen to plasmin

Question 18

rTPA

indications

Answer 18

acute ischemic stroke

ST Elevation

MI

PE

acute peripheral arterial occlusion

Question 19

rTPA

SE

Answer 19

may impact hemostasis
bleeding
hemorrhage

Question 20

rTPA

CI

Answer 20

active internal bleeding

history of recent CVA

head trauma

recent cranial or spinal surgery

intracranial conditions to increase bleeding

severe uncontrolled HTN

Question 21

clopidogrel

brand, class

Answer 21

Plavix

anti-platelet aged

Question 22

Plavix indications

Answer 22

unstable angina

myocardial infarction

stroke

peripheral arterial disease

Question 23

Plavix

MOA

Answer 23

active metabolite irreversible blockage of ADP receptor to prevent activation of GP2b/3a

reduces platelet aggregation

works for 7-10 days

Question 24

clopidogrel S/CI

Answer 24

bleeding