Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Notes/Facts/Brand vs Generic > Acute Coronary Syndrome lec > Flashcards

Acute Coronary Syndrome lec Flashcards

1
Q
A

class:

Indications:

MOA:

Dosage forms:

Dosing:

Max dose:

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

Drug-Drug/Food interactions:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Class:
Indications:
Dosing:
MOA:
Contraindications:
Warnings:
Side effects:
Monitoring:
Note/Pearls:
Drug-Drug Interactions:

A

Oxygen supply and Oxygen Demand are not balanced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is an Acute Coronary Syndrome?

A

It is a global term that encompasses:
- Non-ST segment elevation ACS
- Unstable Angina
- Non-ST segment MI (NSTEMI)

  • ST segment elevation MI (STEMI)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the signs and symptoms of Acute Coronary Syndrome?

A
  • *chest pain
  • dyspnea “shortness of breath”
  • syncope or lightheadedness
  • diaphoresis “sweating”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do we diagnosis an ACS?

A

with an electrocardiogram (ECG)

also looking at cardiac enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

With Unstable Angina (UA)

Cardiac enzymes-
ECG Changes-
Blockage-

A

Cardiac enzymes- (negative)
ECG Changes- None or Transient = P-QRS-T - ST depression
Blockage- partial blockage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

With Non-ST segment elevation Myocardial Infarction (NSTEMI)

Cardiac enzymes-
ECG Changes-
Blockage-

A

Cardiac enzymes- (positive)
ECG Changes: None or Transient = P-QRS-T - ST depression
Blockage- partial blockage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

With ST-segment elevation Myocardial Infarction (STEMI)

Cardiac enzymes-
ECG Changes-
Blockage-

A

Cardiac enzymes- (positive)
ECG Changes- ST elevation
Blockage- complete blockage of a coronary artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

If someone is thought to be having an Acute Coronary Syndrome, the guidelines recommend we get an _____________

A

12-lead electrocardiogram within 10 minutes of their first medical contact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What enzymes are most sensitive/specific towards ACS?

A

Troponins (Troponin I and Troponin T)

  • these are detectable within 2-12 hours of an ACS and stay elevated for out to 2 weeks. (so they elevate quickly and stay elevated for a while)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Drug Treatment:

May involve medications alone (medical management)
or
Medications + (PCI) percutaneous coronary intervention

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What medications will we use in a patient with ACS?

A

remember MONA-GAP-BA

Morphine GPIIb/IIIa antagonists Beta blockers

Oxygen Anticoagulants ACE inhibitors

Nitrates P2Y12 inhibitors

Aspirin

MONA- these are usually started right away

GAP - these agents will be determined depending if patient is going for a PCI or not

BA - within the first 24 hours we want to consider

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the treatment for someone with NSTE-ACS?

**remember NSTE-ACS encompasses _____________

A

MONA-GAP-BA +/- PCI

(UA) Unstable Angina & NSTEMI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the treatment for someone with STEMI?

A

MONA-GAP-BA + PCI or fibrinolytic

PCI preferred

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When should the MONA drugs be given in someone having an ACS?

What is the clinical benefit of each?

What other additional information should be known for each?

A

M- Morphine provides pain relief and helps anxiety.

  Not for routine use; reserve for patients with unacceptable chest discomfort. Dose 2-5mg IV repeated at 5-to-30-minute intervals PRN. Monitor for hypotension, bradycardia, N/V, sedation and respiratory depression.

O- oxygen administer to patients with arterial oxygen saturation < 90% or respiratory distress

N- Nitrates: will dilate the coronary arteries, improve collateral blood flow and decrease preload/myocardial oxygen demand and afterload modestly. Also reducing chest pain. May consider IV infusion if patient is not improving.

A- Aspirin stops platelets from aggregating around atherosclerotic plaque. we want patient to chew a non-enteric coated aspirin. A couple baby aspirin or a 325mg chewable aspirin at the sign of chest pain.

Then a maintenance dose of aspirin 81-162mg daily continued indefinitely

DO NOT USE extended-release aspirin products. We want aspirin in blood stream fast!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When would we NOT consider IV nitroglycerin in someone with ACS?

A

if SBP is < 90mmHg, HR < 50bpm or patient

Contraindicated with PDE-5 inhibitors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When should the GAP drugs be given in someone having an ACS?

What is the clinical benefit of each?

What other additional information should be known for each?

A

Choice of these drugs will be given as it relates to the plan/needs of the patient

G- GPIIb/IIIa receptor antagonists
-are for patient going for PCI or being medically managed. If used, then are used along with an anticoagulant.
- they block fibrinogen from binding to GPIIb/IIIa receptor that is on platelets. similar to aspirin in that they affect platelet aggregation.

A-Anticoagulants
- the agents here are the LMWH (enoxaparin) and UFH and bivalirudin
(preferred in STEMI)
- inhibit clotting factors and can reduce infarct size

P- P2Y12 inhibitors
- agents include clopidogrel/prasugrel/ticagrelor
-these inhibit the P2Y12 receptor also on platelets, which is another way of affecting platelet aggregation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What ways are we targeting platelet aggregation with drug treatment in someone with ACS?

A

aspirin
GPIIb/IIIa receptor antagonists
P2Y12 inhibitors

19
Q

When should the BA drugs be given in someone having an ACS?

What is the clinical benefit of each?

What other additional information should be known for each?

A

Once patient has stabilized, gone to cath lab. Give within 24 hours, have continue as an outpatient.

B- Beta-1 selective blocker without ISA

A- ACE inhibitor

20
Q

class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

21
Q

For this setting (ACS) especially, we want to AVOID _____________. There is increased risk of mortality. No oral or even IV formulations.

Should also AVOID IR ______________. Also associated with increased mortality.

A

NSAIDs

ex. like IV ketorolac

nifedipine

22
Q

Plavix

class:
Indications:
MOA:
Dosage forms:
Dosing:
Boxed Warnings:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

clopidogrel

class: antiplatelet, P2Y12 inhibitors (antagonist)

Indications: For ACS or as secondary prevention in patients with a Hx of MI, stroke or PAD.

MOA: irreversibly binds to the platelet ADP P2Y12 receptor, preventing ADP -mediated activation on the GPIIb/IIIa receptor complex. This inhibits platelet aggregation and clot formation.

Dosage forms: oral tablet
generic 75mg tablet & 300mg tablet

Dosing:
LD: 300-600mg PO (600mg for PCI)
MD: 75mg daily by mouth

  • if patient > 75 years old and fibrinolytic therapy administered for STEMI, omit loading dose and start at 75mg daily

Boxed Warnings:
Effectiveness depends on the conversion to an active metabolite. Poor metabolizers of CYP2C19 exhibit higher cardiovascular events than patients with normal CYP2C19 function. Consider alternative in patients identified as poor metabolizers.

Contraindications:
Active serious bleeding (GI bleed, intracranial hemorrhage)

Warnings:
-Bleeding risk (stop 5 days prior to elective surgery) Do Not Use with omeprazole or esomeprazole.
-Premature discontinuation increases risk for thrombosis
-(TTP) thrombotic thrombocytopenic purpura

Side Effects:
Generally well tolerated, unless bleeding occurs

Monitoring:

Pearls/Notes:
Prodrug “gets metabolized to active metabolite by CYP2C19”

Drug-Drug/Food interactions: Avoid omeprazole & esomeprazole.

clopidogrel increases the effects of repaglinide, which can cause hypoglycemia. Avoid using this combination.

Others: Topotecan, Urokinase, abrocitinib

23
Q

Effient

class:
Indications:
MOA:
Dosage forms:
Dosing:
Max dose:
Boxed Warnings:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

prasugrel

class: antiplatelet, P2Y12 inhibitors (antagonist)

Indications: **Only For ACS managed with PCI

MOA: is a prodrug that is metabolized to its active form, allowing it to irreversibly bind to & block the P2Y12 component of the ADP receptors on platelets. This prevents activation of GPIIb/IIIa receptor complex, thereby reducing platelet activation and aggregation.

Dosage forms: 5mg & 10mg oral tablets

Dosing:
LD: 60mg PO (no later than 1 hour after PCI)
MD: 10mg daily with ASA (5mg daily if patient weighs < 60kg)
Once PCI is planned, give the dose promptly and no later than 1 hour after the PCI.

Boxed Warnings:
- Do NOT initiate if CABG likely, STOP at least 7 days prior to elective surgery.
- Significant, sometimes fatal, bleeding
- Not recommended in patients > 75 years old due to high bleeding risk, unless patient is considered high risk (DM or prior MI)

Contraindications:
Active serious bleeding, history of stroke or TIA

Warnings:
-Bleeding risk (stop 5 days prior to elective surgery) Do Not Use with omeprazole or esomeprazole.
-Premature discontinuation increases risk for thrombosis
-(TTP) thrombotic thrombocytopenic purpura

Side Effects:
Generally well tolerated, unless bleeding occurs (higher risk than clopidogrel)

Pearls/Notes:
**Prodrug “gets metabolized to active metabolite by primarily CYP3A4”

**Dispense in original container!

Drug-Drug/Food interactions:

24
Q

Brilinta

class:
Indications:
MOA:
Dosage forms:
Dosing:
Boxed Warnings:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

ticagrelor

class: antiplatelet, P2Y12 inhibitors (antagonist)

Indications: For ACS

MOA: reversibly binds to & block the P2Y12 component of the ADP receptors on platelets. This prevents activation of GPIIb/IIIa receptor complex, thereby reducing platelet activation and aggregation.

Dosage forms: Oral tablet 60mg & 90mg

Dosing:
LD: 180mg
MD: 90mg PO BID for 1 year, then 60mg BID.
“tablets can be crushed and mixed with water to be swallowed or given via NG tube”

Boxed Warnings:

  • Significant, sometimes fatal, bleeding
  • After the initial dose of 162-325mg of aspirin, DO NOT EXCEED a maintenance dose of aspirin 100mg daily because higher daily doses reduce the effectiveness of ticagrelor
    -** Avoid use when CABG likely, stop 5 days before any surgery

Contraindications:
active serious bleeding, history of intracranial hemorrhage

Warnings:

Side Effects:
Bleeding, dyspnea (>10%), increased SCr, increased uric acid.

Monitor:
monitor digoxin levels with initiation of or any change in ticagrelor dose

Pearls/Notes:
Not a Prodrug
Not a thienopyridine
Keep Maintenance Aspirin Dose to less than < 100mg daily

Drug-Drug/Food interactions:
Avoid with other strong CYP3A4 inhibitors or inducers, avoid with simvastatin and lovastatin doses greater than 40mg/day

25
Q

Kengreal

class:
Indications:
MOA:
Dosage forms:
Dosing:
Boxed Warnings:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

cangrelor

class: antiplatelet, P2Y12 inhibitors (antagonist)

Indications: Indicated as an adjunct to PCI in patients who are P2Y12 inhibitor naive and are not receiving a GPIIb/IIIa inhibitor

MOA:

Dosage forms: solution for reconstitution of 50mg/5mL vial sterile water. For injection

Dosing: Is in mcg
30mcg/kg IV bolus prior to PCI,
- then 4mcg/kg/min IV infusion for 2 hours or for duration of the procedure (whichever is longer)

Contraindications:
Significant active bleeding

Warnings:

Side Effects:
bleeding

Pearls/Notes:
- effects are gone 1 hour after drug discontinuation
-** Transition to one of the oral P2Y12 inhibitors after PCI**

Drug-Drug/Food interactions:

26
Q

So, if you have an ACS patient and, on their profile, they have a past Hx of a stroke then which P2Y12 inhibitor CAN’T be used?

A

Effient prasugrel

27
Q

Which P2Y12 inhibitor needs to be dispensed in its original container?

A

Effient prasugrel

28
Q

When we use P2Y12 inhibitors, once we initiate in the setting of ACS. How do we initiate?

A

We give a big Loading Dose with these agents in order to inhibit platelet aggregation.

29
Q

Which P2Y12 inhibitor is available as an injection?

A

cangrelor (Kengreal)

30
Q

ReoPro

class:
Indications:
MOA:
Dosage forms:
Dosing:
Boxed Warnings:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

abciximab

class: (GPIIb/IIIa) Glycoprotein IIb/IIIa receptor antagonists

Indications: Is only indicated for PCI +/- stent

MOA: these drugs block the GPIIb/IIIa receptor on platelets, which is where fibrinogen is supposed to bind. This results in inhibition of platelet aggregation and clot formation.

Dosage forms: IV injection

Dosing:

Contraindications:
- thrombocytopenia (platelets < 100,000 cells/mm3)
- Hx of bleeding diathesis (bleeding disposition)
- active internal bleeding
- severe uncontrolled hypertension
- recent major surgery or trauma (within the past 6 weeks)
- Hx of stoke within 2 years

-*- recent (within 6 weeks) clinically significant GI or GU bleeding
-increases prothrombin time
- hypersensitivity to murine proteins
- intracranial neoplasm, arteriovenous malformation or aneurysm

Side Effects: bleeding, thrombocytopenia

Monitoring: Hgb, Hct, platelets, s/sx of bleeding, renal function

Pearls/Notes:
- has irreversible blockade
- if used in PCI, the GPIIb/IIIa antagonist is given with Heparin
- must be filtered
- do NOT shake vials
- platelet function returns in ~24-48 hours after stopping drug
Drug-Drug/Food interactions:

31
Q

Integrilin

class:
Indications:
MOA:
Dosage forms:
Dosing:
Boxed Warnings:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

eptifibatide

class: (GPIIb/IIIa) Glycoprotein IIb/IIIa receptor antagonists

Indications:

MOA: these drugs block the GPIIb/IIIa receptor on platelets, which is where fibrinogen is supposed to bind. This results in inhibition of platelet aggregation and clot formation.

Dosage forms: IV injection

Dosing:

Contraindications:
- thrombocytopenia (platelets < 100,000 cells/mm3)
- Hx of bleeding diathesis (bleeding disposition)
- active internal bleeding
- severe uncontrolled hypertension
- recent major surgery or trauma (within the past 6 weeks)
- Hx of stroke within 30 days or any history of hemorrhagic stroke

-*- dependency on renal dialysis

Side Effects: bleeding, thrombocytopenia

Monitoring: Hgb, Hct, platelets, s/sx of bleeding, renal function

Pearls/Notes:
- has reversible blockade
- if used in PCI, the GPIIb/IIIa antagonist is given with Heparin
- platelet function returns in ~4-8 hours after stopping drug
-do NOT shake vials

Drug-Drug/Food interactions:

32
Q

Contraindications with these agents all relate to _____

A

bleeding risk

33
Q

Aggrastat

class:
Indications:
MOA:
Dosage forms:
Dosing:
Boxed Warnings:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

tirofiban

class: (GPIIb/IIIa) Glycoprotein IIb/IIIa receptor antagonists

Indications:

MOA: these drugs block the GPIIb/IIIa receptor on platelets, which is where fibrinogen is supposed to bind. This results in inhibition of platelet aggregation and clot formation.

Dosage forms: IV injection

Dosing:

Contraindications:
- thrombocytopenia (platelets < 100,000 cells/mm3)
- Hx of bleeding diathesis (bleeding disposition)
- active internal bleeding
- severe uncontrolled hypertension
- recent major surgery or trauma (within the past 4 weeks)

Side Effects: bleeding, thrombocytopenia

Monitoring: Hgb, Hct, platelets, s/sx of bleeding, renal function

Pearls/Notes:
- has reversible blockade of receptor
– if used in PCI, the GPIIb/IIIa antagonist is given with Heparin
- platelet function returns in ~4-8 hours after stopping drug
- do NOT shake vials

Drug-Drug/Food interactions:

34
Q

Activase

class:
Indications:
MOA:
Dosage forms:
Dosing:
Boxed Warnings:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

alteplase
“recombinant tissue plasminogen activator”

class: fibrinolytic

Indications: Used ONLY FOR STEMI, also used for acute stroke (different dosing)

MOA: medication causes fibrinolysis (clot breakdown) by binding to fibrin and converting plasminogen to plasmin.

Timing:
- PCI preferred (optimal door to balloon time: 90 minutes)
- If NOT able to receive PCI within 120 minutes of first medical contact, use fibrinolytic therapy! Must be started within 30 minutes of hospital arrival (door-to-needle time).

Dosage forms: IV

Dosing: Given as accelerated infusion

Contraindications:
- active internal bleeding or bleeding diathesis (bleeding predisposition)
- Hx of recent stroke
- any prior intracranial hemorrhage (ICH)
- severe uncontrolled hypertension (unresponsive to emergency therapy)
- recent intracranial or intraspinal surgery or trauma (in the last 2-3 months)

Side Effects: Bleeding (including ICH)

Monitoring: Hgb, Hct, s/sx of bleeding

Pearls/Notes:
- When fibrinolytic therapy is used, it should be given within 30 minutes of hospital arrival (door-to-needle time).
- In the absence of contraindications, and when PCI is not available, fibrinolytic therapy is reasonable in STEMI patients who are still symptomatic within 12-24 hours of symptom onset.

  • Alteplase contraindications & Dosing differ when used for ischemic stroke

Drug-Drug/Food interactions:

35
Q

Cathflo Activase

A

(single use 2mg vial) used to restore function of potentially clotted central lines and devices.

36
Q

The abbreviation tPA is prone to errors; though it is commonly used, it is NOT recommended by _____________

A

ISMP

37
Q

TNKase

class:
Indications:
MOA:
Dosage forms:
Dosing:
Boxed Warnings:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

tenecteplase

class: fibrinolytic

Indications: Used ONLY FOR STEMI = (complete blockage)

MOA: medication causes fibrinolysis (clot breakdown) by binding to fibrin and converting plasminogen to plasmin.

Timing:
- PCI preferred (optimal door to balloon time: 90 minutes)
- If NOT able to receive PCI within 120 minutes of first medical contact, use fibrinolytic therapy! Must be started within 30 minutes of hospital arrival (door-to-needle time).

Dosage forms: given as a single IV bolus dose dosed on patients weight(kg)

Dosing:

Contraindications:
- active internal bleeding or bleeding diathesis (bleeding predisposition)
- Hx of recent stroke
- any prior intracranial hemorrhage (ICH)
- severe uncontrolled hypertension (unresponsive to emergency therapy)
- recent intracranial or intraspinal surgery or trauma (in the last 2-3 months)

Side Effects: Bleeding (including ICH- intracranial hemorrhage “bleeding in head”)

Monitoring: Hgb, Hct, s/sx of bleeding

Pearls/Notes:
- When fibrinolytic therapy is used, it should be given within 30 minutes of hospital arrival (door-to-needle time).
- In the absence of contraindications, and when PCI is not available, fibrinolytic therapy is reasonable in STEMI patients who are still symptomatic within 12-24 hours of symptom onset.

Drug-Drug/Food interactions:

38
Q

Retavase

class:
Indications:
MOA:
Dosage forms:
Dosing:
Boxed Warnings:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

reteplase

class: fibrinolytic

Indications: Used ONLY FOR STEMI

MOA: medication causes fibrinolysis (clot breakdown) by binding to fibrin and converting plasminogen to plasmin.

Timing:
- PCI preferred (optimal door to balloon time: 90 minutes)
- If NOT able to receive PCI within 120 minutes of first medical contact, use fibrinolytic therapy! Must be started within 30 minutes of hospital arrival (door-to-needle time).

Dosage forms: IV

Dosing:

Contraindications:
- active internal bleeding or bleeding diathesis (bleeding predisposition)
- Hx of recent stroke
- any prior intracranial hemorrhage (ICH)
- severe uncontrolled hypertension (unresponsive to emergency therapy)
- recent intracranial or intraspinal surgery or trauma (in the last 2-3 months)

Side Effects: Bleeding (including ICH)

Monitoring: Hgb, Hct, s/sx of bleeding

Pearls/Notes:
- When fibrinolytic therapy is used, it should be given within 30 minutes of hospital arrival (door-to-needle time).
- In the absence of contraindications, and when PCI is not available, fibrinolytic therapy is reasonable in STEMI patients who are still symptomatic within 12-24 hours of symptom onset.

Drug-Drug/Food interactions:

39
Q

Zontivity

class:
Indications:
MOA:
Dosage forms:
Dosing:
Boxed Warnings:
Contraindications:
Warnings:
Side Effects:
Monitoring:
Pearls/Notes:
Drug-Drug/Food interactions:

A

vorapaxar

class: Protease-Activated Receptor-1 Antagonist

Indications: For patients with a Hx of MI or PAD to reduce thrombotic cardiovascular events (CV death, MI, stroke, urgent coronary revascularization). Used for ACS.

MOA:

Dosage forms: oral tablet

Dosing:

Boxed Warnings:

Contraindications:

Warnings:

Side Effects:

Monitoring:

Pearls/Notes:

  • an inhibitor of P-gp & a substrate for 3A4, so Avoid with strong CYP2A4 inhibitors and inducers.
  • this drug was used with aspirin and/or clopidogrel in clinical trials

Drug-Drug/Food interactions:

40
Q

How we manage the patient after they have had an ACS:

Secondary Prevention After ACS: Patients should be on_

  • Look over patient profile, if we see something say, patient had an MI or patient had a STEMI. or patient had an ACS.

Make sure all medications are appropriate for patient.

A

1) Aspirin 81mg daily (81-325mg) indefinitely

2) P2Y12 inhibitor (**duration & choice of agent depends on how patient was managed in hospital)

—- If patient only received “medical management”, then: clopidogrel or ticagrelor + ASA for at least 12 months

—- If patient was “PCI-treated”, then: any oral P2Y12 inhibitor + ASA for at least 12 months

3) NTG (tabs or spray) indefinitely (use as needed), patient should always have available and be educated about how to use

4) Beta-blockers daily (target HR 50-60 BPM) for 3 years (indefinitely for some patients)

5) ACE inhibitor - we are looking for reduced EF, HTN, CKD, or DM

6) Aldosterone antagonist - reduced LVEF & symptomatic HF or DM

7) Statin- most will be on a high intensity statin

41
Q

Other considerations:

Pain

Triple antithrombotic therapy

Lifestyle counseling

A
42
Q

DAPT

A

Dual Antiplatelet Therapy

ex. aspirin + P2Y12 inhibitor

43
Q
A

Notes/Facts/Brand vs Generic (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions