ASA - Actions - answer 1.ASA affects platelet function by inhibiting the enzyme
prostaglandin cyclooxygenase in platelets, thereby preventing the formation of the
aggregating agent thromboxane A
2. ASA may also inhibit formation of the platelet aggregation inhibitor prostacyclin
(prostaglandin I2)
2.Salicylate competitively inhibits prostaglandin synthesis activity in various tissues,
thereby producing peripherally mediated analgesia, anti-inflammatory, and anti pyretic
effects
3.Produces analgesia and reduces inflammation and fever by inhibiting the production
of prostaglandins; decreases platelet aggregation
ASA - Indications - answer 1.Anti-platelet therapy in Acute Coronary Syndrome
(ACS)
2.Early in the treatment of MI to reduce infarct size and mortality
3.Relief of mild pain,fever and inflammation due to a variety of conditions
ASA - ContraIndications - answer 1.Hypersensitivity to salicylates/NSAIDS
2.Asthma (relative contraindication)
3.Patients with active ulcer disease (active GI hemorrhage)
4.Bleeding disorders
5.Pregnancy (especially third trimester)
ASA - Dose - answer Adult: 160mg PO Chewed (AHS ACS) Pediatric: Not
recommended
ASA - Onset/Duration - answer 1-2hrs, 4-5hrs
ASA - Considerations - answer Patient taking warfarin - potentiation,
Diabetics may be hypoglycemic,
Can cause Reye's Syndrome in peds
Nitro - Actions - answer Nitroglycerin mimics natural endogenous substances which
cause relaxation of vascular smooth muscle. Although venous relaxation effects
predominate, nitroglycerin causes a dose dependent dilation of both arterial and venous
blood vessels, decreasing both preload and afterload.
Myocardial perfusion is increased through coronary and collateral blood vessel dilation
Nitro - ContraIndications - answer 1.Systolic BP less than 100 mmHg
2.Right ventricular infarction
3.Patients taking phosphodiesterase inhibitor
Nitro - Dose - answer 1.0.4 mg SL q 5 mins prn or until systolic BP less than 100
mmHg
2.0.8 mg/Hr (Patch) Apply to upper left chest (Remove if hypotension develops)
Nitro - Considerations - answer Contraindicated in right ventricular MI,
STEMI indicated on 12 lead,
Male enhancement pills within 24-48hrs,
Atrovent - Actions - answer 1.Derivative of atropine
2.Exerts anticholinergic action in the bronchioles thereby inhibiting
bronchoconstriction3.Blocks increased mucus secretions resulting from increased vagal
activity. Produces bronchodilation by competitive inhibition of cholinergic receptors on
bronchial smooth muscle. This effect antagonizes the action of acetylcholine at its
membrane.
Atrovent - ContraIndications - answer Hypersensitivity to atropine/atrovent product
Atrovent - Dose (Adult) - answer 500mcg via neb, max 1500mcg (with salbutamol)
(AHS)
Or MDI with spacer 10 puffs only if patient not received a total of 3 doses of neb
atrovent q 20 min prn, max 30 puffs (AHS)
Or MDI with spacer 1 puff (20mcg/puff) q 30-60 secs prn, max 15 puffs (AHS)
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