MONAS

Question 1

Morphine (MOA, indication, CI, dosing)

Answer 1

MOA: binds to opioid receptors in the CNS, inhibiting ascending pain pathways; cause histamine release

Indication: Pain
Dose:
CI: SBP<100; allergy

Question 2

Oxygen (MOA, indication)

Answer 2

MOA: limit ischemic injury
Indication: SOB, HF, Ox < 94%

Question 3

NTG (MOA, Indication, Dose)

Answer 3

MOA: forms free NO (nitric oxide), resulting in increase of cGMP in smooth muscle
Indication: chest pain
Dose: 0.4 mg SL q5 min
CI: SBP<90, HR<50, PDE INHIBITOR (sildenafil)—> prolongs the action of cGMP by preventing the degradation of cGMP increasing their levels in smooth muscle cells

Question 4

Aspirin (MOA, Indication, Dose)

Answer 4

MOA: irreversibly inhibits COX, and reduces platelet thromboxane (TXA2) which results in decrease formation of prostaglandins, decreasing platelet aggregation and thrombus formation
Indication: UA/STEMI/NSTEMI
Dose: 162-325 mg PO x1

Question 5

Heparin

Answer 5

MOA: binds to ATIII, inactivates thrombin and inhibits Factor II and X; prevents conversion of fibrinogen to fibrin
indication: hospitalized ACS patients
Dose: 5000 units, followed by continuous infusion of 12-18 units/kg/hr (max 1000 units/hr)

CI: ATIII deficiency

60 units/kg (max 4000) followed by 12 units/kg/hr (max 1000)

Question 6

Statin (atorvastatin)- MOA, indication, dose

Answer 6

MOA: inhibit HMG-CoA reductase, which forces liver to increase cholesterol uptake from blood via LDL receptor ; slows down production of cholesterol in your body, decreasing the amount of cholesterol that may build up in the walls of the arteries
Indication: UA/STEMI/NSTEMI
Dose: 80mg PO x 1