MI Pharm (Exam 1) Flashcards
First thing we do when our patients have a MI
Give them O2 (prevent tissue death)
Morphine
Aspirin
Nitro
Beta-Blocker
Thrombolytic Agent
Morphine MI
Helps dilate blood vessels and increase blood flow
Decrease Preload and Afterload
Decrease pain
Helps preserve ischemic tissues
Aspirin MI
Chew to get into system quickly
Trying make platelets less sticky
Decreases mortality
Nitroglycerin MI
Dilate veins
Reduces preload and afterload and limit infarct size
Can give IV if they can maintain BP
Beta Blocker MI
Reduce HR and contractility
Reduces pain, infarct size, and mortality
Give if heart rate and blood pressure are WDL
When should we give thrombolytic agent for MI?
Give within 4-6 hours of start of chest pain
Make sure no contraindications like stroke or brain bleed
How to remember STEMI pharmacotherapy
Morhpine
Oxegyn
Asa
Nitro
Beta blocker
Alteplase: Class
Fibrinolytic therapy
Alteplase: MOA
Dissolves clot by converting plasminogen into plasmin
Alteplase: Advantages and Disadvantages
Adv: Really effective
Dis: Works best within 30-70 min
Alteplase: Adverse Effect
Bleeding
Contraindicated if history of bleeding in brain
Alteplase: NSG consideration
Always give with Heparin and Clopidogrel (antiplatelet)
Nitroglycerin: Side effects
Hypotension
Headache
Flushing
Do not give nitroglycerine with what other drug?
Sildenafil (severe hypotension)
Reperfusion Injury
Rapid restoration of blood flow and O2 to the myocardium can cause myocardial stunning (leading to heart failure)
Reperfusion Injury: Caused by
Oxidized free radicals generated by WBC’s and the cellular response to restored blood flow
What do we monitor for in reperfusion injury?
Reperfusion dysrhythmias
Vtach and VFib
STEMI drugs that decrease mortality
Aspirin
Beta blocker
Survival rate for treated patients with acute MI are
90-95%
Approximately 50% of individual who suffer an MI are
younger than 65
Persons with diabetes and those older than 65 often suffer
Silent asymptomatic MI’s
