MI pharm

Question 1

initial treatment for acute MI

Answer 1

Oxygen
Morphine *
Aspirin
Nitroglycerin
Beta-blocker (if no contradictions)**
Thrombolytic agent ***

Question 2

reason for oxygen

Answer 2

Increase 02 delivery to ischemic myocardium

Question 3

reason for Aspirin

Answer 3

Suppresses platelet aggregation.
note: Decreases mortality, Chew first dose.

Question 4

reason for morphine

Answer 4

Decreases pain, Reduces preload and afterload.
Note: Helps preserve ischemic tissue.

Question 5

reason for Beta Blockers

Answer 5

Reduce HR and contractility (reduce oxygen demand).
note: Reduces pain, infarct size, and mortality

Question 6

reason for nitroglycerin

Answer 6

Reduces preload and afterload, limits infarct size.
Note: Does not reduce mortality.

Question 7

Alteplase (tPA)

Answer 7

STEMI: Fibrinolytic therapy
MOA: Dissolves clot by converting plasminogen into plasmin.
Advantages? Most effective
Disadvantages? Works best within 30 – 70 minutes
Main adverse effect? bleeding.
Always given with: Heparin and antiplatelet therapy- clopidogrel

Question 8

Nitroglycerine

Answer 8

SE: Hypotension, headache, flushing.
Severe hypotension: Particularly with other nitrates.
Do not administer with sildenafil (ViagraR)- Risk of severe hypotension.