Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key


Play button


Play button




Click to flip

25 Cards in this Set

  • Front
  • Back
How do you treat unstable angina including NSTEMIs and Non STEMIs
Morphine 1-5 mg IV
Nitro 0.4 mg x 3 sublingual
Aspirin 325 mg x 1
Name the anticoagulants
which anticoagulants would you not give with a STEMI?
LMWH (lovenox) because it has a long half life
How do GP 2b/3a inhibitors work?
by stopping platelet aggregation
what is the dose for Nitro IV?
start at 10 mcg/min IV and titrate up
what are the side effects of nitro?
hypotension, headache, bradycardia
What is the dose of BB (metoprolol) IV?
IV metoprolol 5 mg iv every 5 minutes times three doses, then 50 mg po every 6 hours, and then q12h
What are the indications for ACE Inhibitors in ACS
Left ventricular dysfunction (EF less than 40) or diabetic or both

Start on oral form
what is the contraindication for metoprolol
HR less than 50;
also if acute COPD with edema
what part of the platelet does plavix work on?
ADP pathway
what part of the platelet does aspirin work on?
Cyclooxygenase pathway
which anticoagulant is used in patients with ACS going to Cath lab?
Clopidrogel (Plavix)
300 mg loading dose, then 75 mg po daily
what drug would a patient that got a stent be on and for how long?
Plavix for a minimum of 3 months
what are GPIs contraindications?
Active internal bleeding

Recent (< 6 weeks) GI or GU bleeding

History of CVA, or h/o any hemorrhagic CVA

Bleeding diathesis or evidence of active bleeding within previous 30 days

Oral anticoagulants (warfarin) within 7 days and PT > 1.2 x control or INR  1.2 seconds

Thrombocytopenia (<100,000 cells/uL) or coagulopathy (PT > 1.2 x control, INR  1.2 seconds, or PTT > 35 seconds)

Recent major surgery (< 6 wks), dental surgery or trauma

Intracranial neoplasm, AV malformation, or aneurysm
Severe uncontrolled HTN (BP > 200/110)

IV dextran before PCI, or intent to use during PCI
Pediatrics - less than 17 years old

Nursing or pregnant women
For Integrilin only: serum creatinine > 4 mg/dl
what are the options for treating a STEMI
PTCA (Percutaneous Transluminal Coronary Angiography)
STENT implantation or both
when do you give thrombolytics?
With STEMIs, preferably within 6 hours, after 12 no benefit just increased risk of bleeding
name some thrombolytics
Alteplase- (TPA) Double bolus and infusion

Reteplase- Bolus and infusion

Tenecteplase- Weight based just bolus 1 dose
what are the GP 2b/3a Inhibitors indications?
Treatment of ACS
what is the first and only glycoprotein Inhb. to have a 2b recommendation for the use of STEMIs
Abciximab (ReoPro®)

use with unstable angina with planned PCI

It also has a NSTEMI - IIA recommendation
which glycoprotein inhibitors can you use with NSTEMIs
what do you monitor in a pt on glycoprotein inhibitors
CBC- if platelets drop below 100k, stop drug; if <60k, stop all anticoagulants

Also monitor SCr
what other Medications are used in STEMIs
Unfractionated heparin- can be given with thrombolytics

Lovenox (enoxaparin)

ACE Inhibitors – Conserve cardiac muscle

Statins – Improve morbidity and mortality

Life – Style modifications
how do you treat STEMIs in the ER?
1. PCI- PTCA/stent
2. Thrombolytics (Alteplase-double bolus and infusion)
3. Unfractionated Heparin
4. ACE I-conserves cardiac muscle
5. Statins-improves M/M

Outside the ER:
MONA & Heparin
What's the first line Tx in relieving chest pain, reducing infarct size and LV stress?

IV metoprolol 5 mg every 5 min x 3; then 50 mg po Q6; then Q12
what's the clinical presentation of a STEMI?
C/P > 20 min
ST elevation
Positive enzymes