Full Answer
When are ACE inhibitors indicated in the treatment of acute MI?
Patients within the first 24 hours of a suspected acute MI with ST-segment elevation in two or more anterior precordial leads or with clinical heart failure in the absence of significant hypotension or known contraindications to use of ACE inhibitors. 2.
Should postmenopausal patients with an mi consider emergency hormone replacement therapy (ERT)?
All postmenopausal patients who have an MI should be carefully counseled about the potential beneficial effects of ERT and offered the option of ERT if they desire it.
When should exercise testing be performed in the treatment of mi?
Before hospital discharge or shortly thereafter, the patient with recent acute MI should undergo standard exercise testing (submaximal at 4 to 7 days or symptom limited at 10 to 14 days).
Can maintenance therapy be given for long periods of time?
Maintenance therapy can be given for long periods of time in either of these situations. A maintenance therapy treatment plan may include chemotherapy, hormonal therapy, immunotherapy, or targeted therapy. How is maintenance therapy used to prevent cancer recurrence?
What is the preferred treatment for MI?
Analgesia and anti-emetics. The pain of myocardial infarction is usually severe and requires potent opiate analgesia. Intravenous diamorphine 2.5–5 mg (repeated as necessary) is the drug of choice and is not only a powerful analgesic but also has a useful anxiolytic effect.
What two treatments do we have for myocardial infarction?
The treatment of MI includes, aspirin tablets, and to dissolve arterial blockage injection of thrombolytic or clot dissolving drugs such as tissue plasminogen activator, streptokinase or urokinase in blood within 3 h of the onset of a heart attack.
Which of the following medical therapy is recommended to prevent MI and death?
Statin therapy is recommended after an MI and should be continued indefinitely in patients without contraindications. Early initiation of statin therapy is recommended during hospitalization after an MI.
Which combination of medications are prescribed to the patient post MI to decrease the risk of a second MI?
Patients who have had an MI without ST segment elevation should take clopidogrel (75 mg/d) and aspirin (81 mg/d) for 12 months. The combination has been shown to result in a 2.1% ARR (NNT=48) in deaths, recurrent MI, and stroke compared with aspirin alone.
Why is Asa given for MI?
Aspirin is now widely accepted as an essential component in the early treatment of acute MI. The giving of aspirin by a health professional on first contact with a patient who has chest pain and who is suspected to have a MI or acute coronary syndrome is therefore recommended,6,7 and has become accepted practice.
How can you treat a patient with previous myocardial infarction?
How Can I Treat A Patient With Previous Myocardial Infarction (MI)?NSAIDs and ASA with Digoxin, Captopril, Propranolol: limit prescribing to 4 days or less.Antibiotics (e.g., erythromycin, tetracycline) with Digoxin, Propranolol.Barbiturates, benzodiazepines with Digoxin, Verapamil, Lovastatin.
What medication is given after myocardial infarction?
Clopidogrel and ticagrelor are recommended for conservative medical management of MI in combination with aspirin (162 to 325 mg per day) for up to 12 months. Early administration of beta blockers is recommended during hospitalization after an MI.
Which of the following are medications commonly used to treat myocardial infarction MI or acute coronary syndrome ACS )?
Anticoagulant Drugs. Either a low molecular weight heparin (LMWH), unfractionated heparin, or bivalirudin is given routinely to patients with acute coronary syndrome unless contraindicated (eg, by active bleeding or planned use of streptokinase or anistreplase).
Which of the following are medications commonly used to treat myocardial infarction or acute coronary syndrome?
Thrombolytics (clot busters) help dissolve a blood clot that's blocking an artery. Nitroglycerin improves blood flow by temporarily widening blood vessels. Antiplatelet drugs help prevent blood clots from forming and include aspirin, clopidogrel (Plavix), prasugrel (Effient) and others.
What secondary prevention medications should post STEMI patients take?
Up to 12 months of DAPT with aspirin and ticagrelor is recommended in NSTEMI and STEMI patients following treatment with either PCI or CABG.
Which type of medication would prevent a second MI?
Current clinical guidelines for MI recommend secondary prevention with certain drugs, if not contraindicated, including aspirin, P2Y12-receptor inhibitors, statins, beta-blockers, and ACE inhibitors or angiotensin receptor blockers (ARBs), all of which have demonstrated long-term survival benefits for post-MI patients ...
What drugs reduce mortality after MI?
ACE inhibitors reduce mortality rates after myocardial infarction. Administer ACE inhibitors as soon as possible as long as the patient has no contraindications and remains in stable condition. ACE inhibitors have the greatest benefit in patients with ventricular dysfunction.
How long does it take to take a syringe for MI?
1. For the first 24 to 48 hours in all patients with acute MI who do not have hypotension, bradycardia, or tachycardia. 2. Continued use (beyond 48 hours)* in patients with a large or complicated infarction.
What is MI in medical terms?
1. When MI is suspected to have occurred by a mechanism other than thrombotic occlusion at an atherosclerotic plaque. This would include coronary embolism, certain metabolic or hematological diseases, or coronary artery spasm.
How long should an ED evaluation take?
The initial evaluation of the patient ideally should be accomplished within 10 minutes of his or her arrival in the ED; certainly no more than 20 minutes should elapse before an assessment is made. On arrival in the ED the patient with suspected acute MI should immediately receive (1) oxygen by nasal prongs; (2) sublingual nitroglycerin (unless systolic arterial pressure is less than 90 mm Hg or heart rate is less than 50 or greater than 100 beats per minute [bpm]); (3) adequate analgesia (with morphine sulfate or meperidine); and (4) aspirin, 160 to 325 mg orally. A 12-lead electrocardiogram (ECG) should also be performed. ST-segment elevation (equal to or greater than 1 mV) in contiguous leads provides strong evidence of thrombotic coronary arterial occlusion and makes the patient a candidate for immediate reperfusion therapy, either by fibrinolysis or primary percutaneous transluminal coronary angioplasty (PTCA). Symptoms consistent with acute MI and left bundle branch block (LBBB) should be managed like ST-segment elevation. In contrast, the patient without ST-segment elevation should not receive thrombolytic therapy. The benefit of primary PTCA in these patients remains uncertain.
What is the best treatment for monomorphic ventricular tachycardia?
If monomorphic ventricular tachycardia is not accompanied by chest pain, pulmonary congestion, or hypotension, it should be treated with intravenous lidocaine, procainamide, or amiodarone. The patient with acute MI and symptomatic sinus bradycardia or atrioventricular block should receive atropine.
What is a baroreflex test?
Ambulatory (Holter) monitoring, signal-averaged ECG, heart rate variability, baroreflex sensitivity monitoring, alone or in combination with these or other tests, including functional tests (ejection fraction, treadmill testing) for risk assessment after MI, especially in patients at higher perceived risk, when findings might influence management issues, or for clinical research purposes.
How long should a patient be monitored for electrical shock?
The patient should be monitored closely for adverse electrical or mechanical events because reinfarction and death occur most frequently within the first 24 hours. The patient's physical activities should be limited for at least 12 hours, and pain and/or anxiety should be minimized with appropriate analgesics.
How long does diltiazem last?
It may be added to standard therapy after the first 24 hours and continued for 1 year.
What type of therapy does Alice choose?
Alice is trying to decide on a type of therapy. Two that were recommended to her were Heinz Kohut's contemporary psychodynamic therapy and humanistic psychotherapy.
What is integrative therapy?
a therapy that combines cognitive therapy and behavior therapy with the goal of developing self-efficacy. integrative therapy. use of a combination of techniques from different therapies based on the therapist's judgment of which particular methods will provide the greatest benefit for the client. antianxiety drugs.
What is client centered therapy?
client centered therapy. a form of humanistic therapy in which the therapist provides a warm, supportive atmosphere to improve the client's self-concept and to encourage the client to gain insight into problems. reflective speech. a technique in which the therapist mirrors the client's own feelings back to the client.
What is Freud's therapy?
Psychodynamic therapies. treatments that stress the importance of the unconscious mind, extensive interpretation by the therapist, and the role of early childhood experiences in the development of an individual's problems. psychoanalysis. Freud's therapeutic technique for analyzing an individual's unconscious thoughts.
What is behavioral therapy?
behavior therapies. treatments that use principles of learning to reduce or eliminate maladaptive behavior. systematic desensitization. a method of behavior therapy that treats anxiety by teaching the client to associate deep relaxation with increasingly intense anxiety-producing situations.
What is the best treatment for agitation?
powerful drugs that diminish agitated behavior, reduce tension, decrease hallucinations, improve social behavior, and produce better sleep patterns in individuals with a severe psychological disorder. electroconvulsive therapy. a treatment that sets off a seizure in the brain. psychosurgery.
What is Freud's therapeutic technique for analyzing an individual's unconscious thoughts?
psychoanalysis. Freud's therapeutic technique for analyzing an individual's unconscious thoughts. dream analysis. a psychoanalytic technique fro interpreting a person's dream. transference. a client's relating to the psychoanalyst in ways that reproduce or relive important relationships in the individual's life.
What is the best treatment for myocardial perfusion?
International guidelines recommend improving myocardial perfusion or decreasing the cardiac workload using a combination of therapies known as MONA: morphine, oxygen, nitrates, and aspirin. 1,2.
What is the AMI of CHD?
Acute myocardial infarction (AMI), which leads to myocardial injury and necrosis, is a common initial presentation of CHD and may recur over the course of the disease. 1. Cardiac ischemia may occur via many mechanisms, such as coronary thrombosis due to atherosclerotic plaque rupture, endothelial dysfunction, hypotension, and coronary embolism.
Can oxygen be given to patients with AMI?
Oxygen for AMI: Current Practice. Oxygen, via face mask or nasal cannula, is often administered to patients with suspected AMI in an attempt to increase myocardial oxygenation and decrease infarct size. 1.
Does oxygen help with AMI?
While treating AMI with oxygen makes sense from a physiologic standpoint, no studies have convincingly demonstrated that oxygen therapy improves outcomes in AMI. 1 In addition, recent data suggest that this practice may even be harmful.
Is oxygen therapy needed for myocardial infarction?
Evidence is lacking to support oxygen therapy for acute myocardial infarction. Coronary heart disease (CHD) remains a significant cause of death, accounting for 1 in 10 deaths worldwide and 1 in 7 deaths in the United States, even though medical advances have reduced mortality rates from CHD in developed nations.