121 Cardiac Ischemia

Question 1

What are the INDICATIONS for the CARDIAC ISCHEMIA medical directive?

Answer 1

Suspected Cardiac Ischemia

Question 2

What are the CONDITIONS for Nitroglycerin in the CARDIAC ISCHEMIA medical directive?

Answer 2

18 years old
Unaltered
HR: 60-159
BP: normotensive
IV / Hx

Question 3

What are the CONTRAINDICATION for Nitroglycerin in the CARDIAC ISCHEMIA medical directive?

Answer 3

Allergy or sensitivity
Phosphodiasterase Inhibitor use
SBP drop by 1/3
12 Lead compatible with RVMI

Question 4

What is the initial dose Nitroglycerin in the CARDIAC ISCHEMIA medical directive?

Answer 4

0.3/ 0.4 mg

Question 5

How MANY doses are given of Nitroglycerin in the CARDIAC ISCHEMIA medical directive?

Answer 5

STEMI 3
Non-Stemi 6

Question 6

What is the MAX dose for Nitroglycerin in the CARDIAC ISCHEMIA medical directive?

Question 7

What is the interval between doses for Nitroglycerin in the CARDIAC ISCHEMIA medical directive?

Answer 7

5 minutes

Question 8

What is the route of administration for Nitroglycerin in the CARDIAC ISCHEMIA medical directive?

Answer 8

SL

Question 9

What are the CONTRAINDICATIONS for ASA in the CARDIAC ISCHEMIA medical directive?

Answer 9

Allergy
If asthmatic, prior use
Current active bleeding
CVA/ TBI in past 24 hours

Question 10

What are the CONDITIONS for ASA in the CARDIAC ISCHEMIA medical directive?

Answer 10

18 years
unaltered
able to chew and swallow

Question 11

What is the dose ASA in the CARDIAC ISCHEMIA medical directive?

Answer 11

160-162mg

Question 12

How MANY doses are given of ASA in the CARDIAC ISCHEMIA medical directive?

Answer 12

1

Question 13

What is the route of administration for ASA in the CARDIAC ISCHEMIA medical directive?

Answer 13

PO

Question 14

How does Nitroglycerin work?

Answer 14

MOI:
relaxes vasculature
causes venodilation and vasodilation
decreases preload and afterload
decreased heart oxygen demand
increases circulation to ischemic tissue

Question 15

How does ASA work?

Answer 15

MOI:
-inhibits COX1 which blocks formation of thromboxane A2
-Decreases prostaglandins
-Inhibit COX2 (inflammation/ pain)

Question 16

Which leads are the Inferior Leads

Question 17

Which leads are the Lateral Leads

Question 18

Which Leads are the Septal Leads

Question 19

Which Leads are the Anterior Leads

Question 20

Which Leads show the LAD

Question 21

Which Leads show the LCX

Question 22

Which leads show the RCA

Question 23

How much ASA is too much

Answer 23

Over 1500mg

Question 24

ASA drug class

Answer 24

ASA is an NSAID, antipyretic, platelet inhibitor, analgesic

Question 25

Nitro drug class

Answer 25

Nitroglycerin is an anti-anginal medication

Question 26

What does thromboxane A2 do?

Answer 26

Platellet aggregator/vasocontrictor

Question 27

How does ASA reduce fever

Answer 27

Inhibit prostaglandin E1 in the hypothalamus Causes vasodilation at the skin

Question 28

What does COX 2 do?

Answer 28

Cause inflammation and pain

Question 29

What are the CONTRAINDICATIONS for Morphine in the CARDIAC ISCHEMIA medical directive?

Answer 29

Allergy Labour SBP drop by 1/3

Question 30

What are the CONDITIONS for Morphine in the CARDIAC ISCHEMIA medical directive?

Answer 30

18 years unaltered normotensive severe pain

Question 31

What is the initial dose Morphine in the CARDIAC ISCHEMIA medical directive?

Answer 31

2mg

Question 32

How MANY doses are given of Morphine in the CARDIAC ISCHEMIA medical directive?

Answer 32

5

Question 33

What is the MAX dose for Morphine in the CARDIAC ISCHEMIA medical directive?

Answer 33

10mg

Question 34

What is the interval between doses for Morphine in the CARDIAC ISCHEMIA medical directive?

Answer 34

5 minutes

Question 35

What is the route of administration for Morphine in the CARDIAC ISCHEMIA medical directive?

Answer 35

Only IV

Question 36

What class of drug is morphine?

Answer 36

opioid

Question 37

How does morphine work?

Answer 37

Binds at opioid receptor in CNS Causes venodilation and decreased preload Increases pain threshold and alters perception