PHAR 451 Lecture Notes - Lecture 13: Intracranial Hemorrhage, Coronary Artery Disease, Cardiac Muscle Cell
10 Dec 2016
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Stemi is more serious, so we treat it differently. Morphine analgesic of choice for ischemic pain mvo2 (decreases myocardial oxygen demand) 0. 4 sl q5min to a total of 3 doses; iv nitro for refractory ischemia. Use cautiously if sbp <90 or use of pde inhibitor in last 24-48 hrs. Does not effect mortality or outcomes, it just treats ischemic symptoms. Isis-2 trial (asa 160 mg vs. placebo) 2. 4% arr mortality at 35 days. Insert a coronary artery stent at site of plaque to open up the coronary artery. Bare metal stent (bms) = stainless steel stents. Drug eluting stents (des) = stent coated with antiproliferative drugs (zotarolimus, everolimus, or sirolimus) to prevent re-stenosis of lesion. Fibrinolytic tx drugs used to break up the clot. Attach a new vessel to bypass the block one end is attached to the aorta, the other end is attached to the coronary artery below the blockage.
