Term
| Avoidance of MACE (Major Cardiovascular event) following an MI. What pharmacologic strategy caused lowered relative risk? |
|
Definition
| Use of BB, ASA, lipid lowering agents, and ACEIs |
|
|
Term
| When is dual antiplatelet therapy indicated? |
|
Definition
| Dual antiplatelet therapy is indicated for accute occlusion of stents after PCI |
|
|
Term
| How long is clopidogrel therapy indicated after any MI? |
|
Definition
|
|
Term
Prasugrel
Onset of action vs clopidogrel ?
Potency vs clopidogrel ?
Bleeding risk vs clopidogrel ?
Which patients should not use prasugrel?
Should prasugrel and clopidogrel be used in combination ?
Duration of prasugrel treatment |
|
Definition
Prasugrel
Onset of action vs clopidogrel ? FASTER than clopidogrel
Potency vs clopidogrel ? HIGHER potency than clopidogrel
Bleeding risk vs clopidogrel ? HIGHER bleeding risk
Which patients should not use prasugrel? Elderly >75, a history of stroke/TIA, and low body weight <60kg.
Should prasugrel and clopidogrel be used in combination ? NO
Duration of prasugrel treatment is as long as clopidogrel --> 1 year after MI |
|
|
Term
BB
Who should use them post MI?
When should BB treatment begin following an MI?
When should BBs be avoided?
Reduced LV function vs normal LV function post MI. How should BB treatment differ? |
|
Definition
BB
Anyone not contraindicated should use them post MI
Treatment should begin a few days after the event. Acutely, IV BB should be used cautiously as it can cause hemodynamic instability.
Avoid in bradycardia, active HF
BB should be continued long term in patients with reduced LV function. If side effects are an issue, they can be d/c in NORMAL LV function. |
|
|
Term
ACEIs
Who should use them post MI?
Evidence of benefit with ARBS? |
|
Definition
ACEIs
EVERYONE should use them unless contraindicated (hyperkalemia, significant renal dysfunction)
NO benefit with ARBs. |
|
|
Term
Eplerenone & Spironolactone
Beneficial in post MI?
What are they good in combination with?
What monitoring parameter is important? |
|
Definition
Eplerenone & Spironolactone
Beneficial in post MI
Good in combination with ACEI + diuretic
Monitor for hyperkalemia |
|
|
Term
Lipid lowering agents
What has better outcomes, high or lower doses of statins post MI?
Following an MI, what risk level are patients considered for subsequent events?
Recommended combination if statins are not enough to achieve target lipid levels? |
|
Definition
Lipid lowering agents
What has better outcomes, high or lower doses of statins post MI? HIGHER
Following an MI, what risk level are patients considered for subsequent events? HIGH
Recommended combination if statins are not enough to achieve target lipid levels? Niacin XR + Statins |
|
|
Term
When is warfarin (oral anticoagulants in general) recommended in post MI patients?
Monitoring parameter ?
Risk when using with clopidogrel ?
General duration of clopidogrel if indefinite warfarin therapy |
|
Definition
When is warfarin (oral anticoagulants in general) recommended in post MI patients?
- Afib
- LV thrombus
- Large infarcts with extensive or aneurysmal segments.
Monitor INR
Bleeding risks
Reduce clopidogrel therapy duration in the presence of warfarin. |
|
|
