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Com Acute Coronary Syndrome

4
Acute Coronary Syndrome
Q&A
1-A 72-year-old women who was previously had hypertension and hypothyroidism, she
was admitted to the hospital with severe pain in her chest and was diagnosed as STEMI.
The initial treatment was chewable ASA 80 mg, Heparin i.v. 5000 u and t-PA 15mg IVP,
Atenolol i.v. 5 mg then atenolol 50g tid. Captopril 25 mg was added tid, the reafter
(after 1 day). From the medication orders written for Ms. Sandra, it appears that
captopril was prescribed shortly after the acute period of the heart attack. Based on the
patient’s profile, what is the most logical reason for including captopril in this setting?
I. Adjunctive therapy to prevent left ventricular dysfunction after acute M.I.
II. Additive therapy to help bring the patient B.P. down
III. Treatment of suspected renal dysfunction
A-I only B-III only C-I and II only D-II and III only E-I, II, III
Ans: A (I only)
Tips: Since heart failure is a sequale 80% post MI, treatment of Blood pressure during
acute attack of MI is not recommended.

2-Myocardial Infarction oxygen demand is increased by all of the following EXCEPT:

A-Smoking B-Isoproterenol C-Cold temperature D-Exercise E-Metoprolol
Ans-E
Tips: b-blockage cause: decrease heart rate, inotropic effect, and BP. Oxygen demand.
Isoproterenol causes reverse of b-blockage. (B-agonist)

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