Acute MI

Acute Myocardial infarction


MONA
--------
morphine 2 mg every 5 minutes IVI  (upto 15 mg)
oxygen 100%
nitrate (glyceryl trinitrate) (e.g. Angised) 0.5 mg every 5 minutes (upto X 3)
aspirin 300 mg oral


B S
---------
betablocker - metoprolol 25 mg PO
Statin - atorvastatin 80 mg PO



REPERFUSION STRATEGY
------------------------
PCI / Fibrinolysis

PCI can be done upto 36 hrs after the onset of symptoms. - ideally should be done within 90 min after presentation.

Fibrinolysis can be done if PCI can't be done within 90 min after presentation, symptoms < 12 hrs, no contraindication (e.g. Hx of intracranial hemorrhage, stroke within last 3 months, head injury within last 3 months)

Antiplatelet therapy (in addition to aspirin)
-------------------------------------
Clopidogrel 300 mg

Anticoagulant therapy
--------------------
Enoxaparin 30mg IV loading then 1 mg/kg bd SC


mem tip:
MONO
B S
-> 모(노)비스 <농구팀 이름>
reperfusion strategy
antiplatelet, anticoagulation