Acute cardiac medications.
Which of the following statements is CORRECT about Glyceryl trinitrate?
The GTN patch comes in a 5mg over 24hours.
GTN used in medicine is so diluted it removes its explosive "qualities".
It is a vasodilator.
Some patients are unable to be started on a B Blocker like Metoprolol after a STEMI or non STEMI. Which of the following is NOT a contraindication?
If you have a LVEF of <40% then a B Blocker is considered contraindicated.
What is the dose of Tenecteplase in a 70kg patient who has suffered a STEMI?
Obviously you need to check for contraindications and in many institutions the patient will go directly to the cath lab rather then getting thrombolysed.
Needs to be drawn up in Normal Saline as it precipitates in Dextrose.
What is the mechanism of action of Clopidogrel (Plavix)?
Giving 600mg rather than 300mg of Clopidogrel is sometimes preferred in a patient with a STEMI if the time to going to the catheter lab is short. The theory is that the 600mg dose has a faster onset.
The compound "Aspirin" was named and registered on Feb 1 1899. How did they derive the name?
The use of salicylic acid which is the active ingredient in Aspirin has been around since 2500BC . It is found in Meadowsweet which has been a herbal treatment as an analgesic for centuries.
Ticagrelor (Brilinta) is an antiplatelet medication. Which of the following about it is INCORRECT?
Side effects like dyspnoea and ventricular pauses are significantly higher in patients given Ticagrelor and aspirin vs Clopidogrel and aspirin.
Which of the following is not a recognised use for Adenosine?
Yes---adenosine applied topically to the scalp causes local vasodilation and is meant to improve hair growth.
Who am I? Used in heart failure. Positive inotrope. Cardiac glycoside. High bioavailability.
Digoxin comes from the foxglove plant and has been used for centuries to treat "fluid retention conditions".
It still has a role in ED when trying to get rate control of patients in atrial fibrillation iwhen they have compromised left ventricular function.
A patient suffering a STEMI is placed on a heparin infusion before going to the cath lab. He starts having significant haematuria. What can you do to reverse the heparin?
Protamine sulphate specifically reverses heparin and was derived from fish sperm.
The first ACE inhibitor---Captopril---was released in 1981. What was it's active ingredient derived from?
It was based on an ingredient from the Brazilian viper.
Lovastatin was discovered from oyster mushrooms.
Quinine is from the bark of the cinchona tree.