Management of ACS

Question 1

Best Anticoagulant

Answer 1

Ultrafiltrate Heparin

Question 2

3 ADP R Blocking Drugs to Inhibit Platelet Action (& strengths/benefits/downsides)

Answer 2

Ticagrelor - reversible
Prasugrel and Clopidogrel - irreversible. Also prodrugs that depend on CYP so muts can affect action. Prasurgel stronger but also get more bleeding that can kinda of cancel out overall mortality

Question 3

GP IIb/IIIa Inhibitors

Answer 3

Inhibit platelet aggregation

Question 4

Bleeding and Outcomes

Answer 4

Poorer outcomes NO SHIT

Question 5

NonSTEMI 2 Elements of Treatment

Answer 5

Antiplatelets/coags and maybe cath. More ischemic risk means more aggressive

Question 6

Primary Goal in STEMI

Answer 6

Rapid reperfusion

Question 7

Reperfusion Standard of Care

Answer 7

Aspirin + tPA (used to be SK). Within as soon possible, hopefully 90 min

Question 8

PCI vs. Thrombolysis for STEMI

Answer 8

PCI reduced mortality

Question 9

Location You Don’t Use PCI

Answer 9

Vessel unrelated to infarct

Question 10

Fibrinolytic Contraind (2)

Answer 10

Pts at risk of brain bleed

ST depression

Question 11

Statins

Answer 11

Treat everybody w/ an event with aggressive statin therapy

Question 12

ACEi

Answer 12

Treat HF/CHF/low EF pts/whatever w/ ACEis