Medications for the Treatment of Acute Coronary Syndrome
| Therapy | Recommendations for STEMI |
|---|---|
| Atorvastatin (Lipitor) | 40 to 80 mg per day |
| Morphine | 4 to 8 mg IV every five to 15 minutes as needed |
| Nitroglycerin | 0.4 mg sublingually every five minutes, up to three doses as blood pressure allows |
| 10 mcg per minute IV |
Similarly one may ask, do you give nitrates for STEMI?
NSTEMI and STEMI AHA/ACC guidelines recommend administration of sublingual or intravenous nitrates for management of angina, hypertension, acute pulmonary edema, or recurrent ischemia as a class I indication [5,7].
- The ideal treatment for all STEMIs is acute PCI or in some cases emergency CABGs.
- Primary PCI is preferred for reperfusion therapy in patients with STEMI if it can be performed within 90 minutes of first medical contact.
Correspondingly, how do you remember ACLS algorithms?
The best way to remember ACLS algorithms is by using the material you have studied in class to handle practical ACLS scenarios. It is advisable to use half of your study time to physically play out scenarios and go through the motions.
What are the 7 components of the BLS algorithm in order?
The key elements include: Prompt recognition of cardiac arrest; • Call for urgent medical assistance; • Early effective CPR with an emphasis on minimal disruptions to compressions; • Early defibrillation; • Early advanced life support; • Integrated post-cardiac arrest care.
What are the ACLS algorithms?
ACLS Algorithm Overview
- ACLS Algorithm #1: Cardiac Arrest. The most important and most frequently used ACLS algorithm is the cardiac arrest algorithm. …
- ACLS Algorithm #2: Bradycardia. …
- ACLS Algorithm #3: Tachycardia. …
- ACLS Algorithm #4: Acute Coronary Syndrome (ACS) …
- ACLS Algorithm #5: Suspected Stroke Algorithm.
What is CPR algorithm?
Start high-quality CPR (30 compressions to 2 breaths, 100-120 compressions per minute) Compress chest between 2 and 2.4 inches. Allow the chest to fully recoil. Continue CPR for 2 minutes or until AED is on the victim, powered up, and ready for use.
What is the best treatment for ST elevation MI?
Primary percutaneous coronary intervention (p-PCI) has become the treatment of choice for patients presenting with ST-segment elevation myocardial infarction (STEMI) when it can be performed expeditiously by an experienced team.
What is the initial drug therapy for ACS?
Morphine (or fentanyl) for pain control, oxygen, sublingual or intravenous (IV) nitroglycerin, soluble aspirin 162-325 mg, and clopidogrel with a 300- to 600-mg loading dose are given as initial treatment.
What is the primary goals of ACS algorithm?
The goal is to reperfuse myocardial tissue that is being damaged by a blockage. Reperfusion may involve the use of coronary angiography with balloon angioplasty and stenting otherwise known as PCI.
What is the time line for treating an ACS patient?
Time from onset of symptoms < 12 hours.
If the time from onset of symptoms is 12 hours or less, proceed with reperfusion therapy. If the time from onset is greater than 12 hours, treat as a troponin elevated or high-risk patient.
What is your goal for PCI when treating STEMI?
In the setting of acute ST-elevation myocardial infarction (STEMI), the primary goal of percutaneous coronary intervention (PCI) or fibrinolysis is to reestablish patency of the affected coronary artery and thereby improve perfusion of the myocardium.
When do you not give GTN to STEMI?
2013 AHA/ACC STEMI Guidelines:
“Nitrates should not be given to patients with hypotension, marked bradycardia or tachycardia, RV infarction, or 5’phosphodiesterase inhibitor use within the previous 24 to 48 hours.”
When is PCI recommended for STEMI?
Guidelines recommend primary percutaneous coronary intervention (PCI) in patients with ST-segment–elevation myocardial infarction (STEMI) presenting ≥12 hours of symptom onset in the presence of ongoing ischemia.
Why is heparin used in STEMI?
The most important is that the heparin-antithrombin complex cannot bind or inactivate thrombin bound within a clot [1]. Such clot-bound thrombin acts as an important thrombogenic stimulus at a site of coronary thrombosis, particularly after clot disruption by fibrinolytic agents [2].