Acute Coronary Syndromes: Basic questions with correct answers

Which of the following are standard medications that may be used to treat a patient with an acute coronary syndrome characterized as NSTEMI? (select all that apply) - Answer Morphine and Aspirin Look for drugs in the acronym MONA, which represent standard care for a MI: Morphine, Oxygen, Nitrates (nitroglycerin in various formulations), and Aspirin (MONA). Additional medications will be added to MONA depending on the clinical situation. Which of the following statements are true regarding the use of ACE inhibitors in patients with UA/NSTEMI? (select all that apply) - Answer They should be administered within the first 24 hours unless there is a contraindication They reduce preload and afterload as well as prevent cardiac remodeling An ARB can be substituted if the patient is intolerant to an ACE inhibitor. Which of the following is an absolute contraindication to fibrinolysis? - Answer A prior intracranial hemorrhage Absolute CIs to using a fibrinolytic for STEMI include any prior intracranial hemorrhage, active bleeding, recent stroke (usually defined as within 3 months), intracranial/intraspinal surgery or trauma in last 2-3 months and others. Severe uncontrolled hypertension (usually defined as > 175/110) is considered an absolute CI unless it can be controlled emergently before administering the fibrinolytic. Because of the risk of serious bleeding with fibrinolytics, careful risk/benefit assessment must be conducted. Fibrinolytics are also used for acute ischemic stroke. CIs differ for that indication.