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NURS 572 Ch 52 MI
Pharm - MI - STEMI
Question | Answer |
---|---|
what are the first 6 drugs classes, in general order, to treat the acute phase (in pt) of MI (ASAP) | oxygen first ---morphine ---ASA ---reperfusion therapy (thrombolytics)---anticoagulants---nitrate/nitroglycerin |
What are the second 5 drug classes, in general, that are generally given within first 24 hours of in patient MI | BB---ACEI---statin, even if no dyslipedimia---anti-aldosterone ---antidysrhythmic |
what does morphine do? | decreases pain---decreases preload---decreased 02 demand |
what does ASA do | anti-platelet effect |
when should we admin reperfusion tx | ASAP - within 12-24 hours from onset of symptoms is generally the cut-off |
what drugs do we use for reperfusion tx | tPAs = tissue plasmin activators (thrombolytics)----may also use anti-platelet GIIb/IIIa inhibitors |
name 3 thrombolytics used for reperfusion tx | alteplase---reteplase---tenectaplase |
name 3 anti-platelet GpIIb/IIIa drugs that can alternatively be used in reperfusion tx | abcixamib---eptiFIBatide---tiroFIBan |
what thrombolytic given 2 bolus doses | reteplase |
what thrombolytic difficut to admin - initial load infusion, then second load | ateplase |
what thrombolytic admin single bolus | tenecteplase |
what are examples of anti-coagulants used | unfractioned heparin ----LMW heparins = enoxaprin, dalteprein, tinzaprin |
Drug regimen upon d/c - all to be given unless contraindicated to PREVENT 2nd MI | ASA/anti-platelt---BB---ACEI---statins |
why give ACEIs to prevent subsequent MI | decreases risk of HF complication |
why give statins to prevent subsequent MI | statins have a pleimorphic effect, so should be given even if pt has normal lipid levels |
what adjunctive tx do we want to optimize upond d/c of MI pt | control HTN---control dyslipidemia---control diabetes---diet/exercise/smoking |