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PAR2021 Cardiology > Week 3 > Flashcards

Week 3 Flashcards

1
Q

What does of Aspirin do you give to a patient with ACS?

A

300mg
Single dose
Orally

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2
Q

What is the dose of GTN given to suspected ACS patients

A

300mcg SL is not previously had or elderly/fragile

600mcg SL if had before

+ 50mg patch (0.4mg/hr)

Every 5 mins

No limit

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3
Q

What is aspirin?

A

Anti platelet aggregator, inhibiting thrombus formation

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4
Q

How long does aspirin last?

A

Life of the platelet

7-10 days

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5
Q

How long can onset of anti-platelet effects to start of aspirin

A

45 minutes

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6
Q

What are the contraindications of aspirin?

A
  • Hypersensitivity
  • Actively bleeding peptic ulcer
  • Bleeding disorders
  • Suspected dissecting aortic aneurysm
  • chest pain associated with a psychostimulant overdose with BP >160
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7
Q

What are the precautions of aspirin?

A
  • Peptic ulcer
  • Asthma
  • Patient on anticoagulants
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8
Q

Why is asthma a precaution for aspirin?

A

It can be a tigger for drug induced asthma

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9
Q

What does GTN do?

A

Vaso-dilator

  • may reduce coronary artery spasm
  • Stops nitrates that stimulate Ca2+ release, on smooth muscle in vascular walls
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10
Q

What effect does GTN have on preload and afterload?

A

Will reduce them both
- Reduces work rate of heart

  • Reduce myocardial oxygen consumption
  • relieve ischaemia
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11
Q

What are the contraindications for GTN?

A
  • Known hypersensitivity
  • Systolic BP <110 - Tablet
  • SBP <90 - Patch
  • Sildenafil Citrate (Viagra) or Vardenafil (Levitra) in previous 24 hours
  • Tadalafil (Cialis) in previous 4 days
  • HR >150
    HR <50 (excluding autonomic dysreflexia)
  • VT
  • Inferior STEMI with SBP <160
  • RV MI
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12
Q

What are the precautions of GTN?

A
  • No previous administration
  • Elderly patients
  • Recent MI
  • Concurrent use with other tocolytics
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13
Q

What are some side effects of GTN?

A
  • Tachycardia
  • Hypotension
  • Headache
  • Skin flushing (vasodilation)
  • Bradycardia
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14
Q

When do you use oxygen?

A
  • Only when SpO2 <92

- Shock/hypo-perfusion

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15
Q

What is the does of Ondansetron?

A

8mg IV

4mg Oral

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16
Q

Why do we give ondansetron to ACS patients?

A

Prevent vomiting which will increase BP and stress on heart.

17
Q

Where is lead 1 of a 12 lead ECG placed

A

4th intercostal space right of sternum

18
Q

Where is lead 2 of a 12 lead ECG placed

A

4th intercostal space left of sternum

19
Q

Where is lead 4 of a 12 lead ECG placed

A

5th intercostal space left mid clavicular line

20
Q

Where is lead 6 of a 12 lead ECG placed

A

left mid auxillary line

on same pane as V4

21
Q

What is the goal of STEMI management?

A

minimise ongoing damage and re-perfuse myocardial tissue

22
Q

What are the methods of STEMI management?

A
  • Thrombolysis
  • Primary PCI
  • Rescue PCI
23
Q

What does PCI stand for?

A

Percutaneous coronary intervention

24
Q

What are the benefits of PCI?

A
  • Primary PCI offers lower risk of bleeding
  • Has higher chance of recanalisation
  • Significantly lower chance of re infarction compared to thrombolysis
25
Q

What is the ideal door to balloon time to increase mortality?

A

< 120 mins

26
Q

What does Heparin do?

A

Inhibits coagulation

27
Q

What are the contraindications for Heparin?

A
  • Hypersensitivity
  • Active bleeding
  • Oral anti coagulants
  • Bleeding disorders
  • History of Heparin-induced Thrombocytopaenia
  • Severe hepatic impairment/disease, including oesophageal variances
  • Recent trauma or surgery (<3 weeks)
28
Q

What is tPA?- Activates

A

Tissue Plasminogen Activator

  • activates fibrin specific plasma protein (plasminogen) to become plasmin
  • Plasmin is able to break down fibrin
29
Q

What timelines determine differential treatments in ACS?

A

> 30 mins to hospital - Thrombolysis

<30 mins - pPCI

PAR2021 Cardiology (12 decks)

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