Treatments Quiz 2 Flashcards
Eptifitabitide
MOA: inhibits platelet aggregation by reversibly binding to the platelet receptor glycoprotein (GP) IIb/IIIa of platelets. This blocks fibrinogen from binding and prevents platelet aggregation.
Given in acute MI
Nitroglycerine
MOA: orms free radical NO → activates guanylyl cyclase → increases cGMP → activates MLC phosphatase → dephosphorylation of MLC → smooth muscle relaxation → vasodilation (mostly veins) → decrease blood returning to heart → decrease preload → decrease stress on myo cardium.
Indications: Angina/MI
Ranitidine
MOA: H2 histamine antagonist on parietal cells
Histamine normally stimulates gastric acid secretion
Motivational Interview
Motivational Interviewing:
Conversation and Partnership
Plant seed in pts mind that they want to change/can change
Use open ended questions- if you had to change one thing to improve your health what would that be?
A- affirmation; reward/celebrate accomplishments
R- reflective listening
S- summarize; at end of office visit → summarize plan
Morphine
Agonist of mu receptors which decreases pain. Blocks influx of presynaptic calcium (preventing NT release) and increases permeability to postsynaptic potassium (hyperpolarization).
Also works on descending pain pathway via GABA.
Clopidrogel
Trade name: Plavix
Irreversibly blocks ADP receptors which prevents platelet aggregation.
Heparin
MOA: Potentiates activity of antithrombin III → inactivates thrombin → prevents conversion of fibrinogen to fibrin
Statins
MOA: Lower lipids by inhibiting HMG-CoA reductase (the rate limiting step in cholesterol synthesis).
Bare stents
Preferred in patients with a high risk of bleeding, inability to comply with antiplatelet therapy, or anticipated invasive surgical procedure in the next 12 months
Antiplatelet therapy is usually aspirin + clopidogrel (or ticlopidine - same MOA)
Drug-eluting stents
Stents coated w/ paclitaxel and sirolimus which inhibit local tissue growth.
Preferred to bare metal if the patient can tolerate and comply with the dual antiplatelet therapy and if the risk of restenosis is increased (left main disease, small vessels, long lesions, diabetes, multiple lesions)
Carotid massage
Massaging carotid sinuses and “tricks” them into sending a “high-pressure” alarm to the medullary control centers –> activates PNS –> decrease heart rate.
Used to treat atrial tachycardia.
Tube throacostomy
Very slow vacuum placed in the 4th or 5 intercostal space to treat a PTX.
Pleural tap
To remove blood or other fluids, a needle is inserted through the 9th intercostal space into the costodiaphragmatic recess.
It is important to place the needle or chest tube above the diaphragm and to avoid the liver and spleenn.
Rx for pleural effusion or hemothorax
