PHAR 451 Lecture Notes - Lecture 19: Chest Pain, Proteinuria, Hypotension
10 Dec 2016
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Presents with 3 hr history of 8/10 chest pain at whistler health clinic. Current meds: amlodipine 2. 5 mg daily; hctz 25 mg daily. Troponin = pending always do troponin testing on any presentation of chest pain. Asa 160 mg stat critical/urgent because there is a profound mortality reduction by giving asa. Morphine 1-5 mg iv second/third line (give asa/nitro first) give iv b/c you want immediate pain relief. Whistler health clinic is not close to pce capable hospital. Benefit of lytic therapy compared to placebo = 2. 6% reduction of death at 30 days. Asa + lytic = 5% reduction of death at 30 days. 55 y/o, no bleeding history, don"t know hb yet. No absolute cis (ich, active bleeding, aortic dissection, etc. ) Options: don"t have to know dose, just recognize the drugs you use. Streptokinase (off the market now), alteplase, reteplase (not on market), tnk (has better evidence, bolus, expensive)
