STEMI Tratament

Question 1

Ingrij de urgenta

Answer 1

1. ECG
2. Opioide (Morfina 4-8mg i.v) /tranchilizante
3. O2 terapie
4. Nitroglicerina
5. Fibrinolitic (tPA)
6. Aspirina

Question 2

Tratament adjuvant in PCI primara

Answer 2

1. Aspirina 150-325mg P.O —> Dupa 300-600mg P.O
2. Clopidogrel 300-600mg P.O
3. Inhib GP2b/3a: Abciximab bolus I.V 0.25mg/kg–> 0.125mg/kg/min 12h
4. Heparina bolus iv 100UI/kg

Question 3

Indicatie PCI

Answer 3

Reperfuzie indicata la toti cu durere toracica <12hr
12-24hr daca pacient este stabil
>24hr nu este recomandata

Question 4

Trat fibrinolitic

Answer 4

1. Streptokinaza 1.5MU +- Heparina 24-48hr
2. Alteplase (tPA) 15mg iv + Heparina -//-
3. Reteplase (r-PA) 10U+10U + Heparina -//-
4. Tenecteplase (TNK-tPA) Bolus unic 30-50mg +Hep

Question 5

Medicatia in Faza acuta STEMI

Answer 5

1. Aspirina 75-100mg/zi
2. Clopidogrel 75mg/zi
3. BB p.o
4. IECA p.o

Question 6

Preventia secundara dupa IM

Answer 6

1. Aspirina 75-100mg/zi TOATA VIATA (clopidog75mg/zi)
2. Clopidorgrel 75mg/zi, 12luni dupa IM
3. +- ACO (FiA,Proteza valv, sau inloc ASA)
4. BB la toti
5. IECA
6. Statine
7. Vaccin antigripal