Quick treatment of a myocardial infarction is key to improving survival and overall patient outcomes while also preserving future quality of life. While the exact method of treatment will depend on the type of myocardial infarction and the area of the heart that it affects, you will want to look out for some specific pharmacologic treatment orders from the doctor and will want to give your patient the recommended treatment as soon as possible.
In some cases, this may require you to work closely with your hospital’s pharmacy to determine when medications or IV drips will be ready and to ensure that the proper medications are given prior to other treatments, such as angioplasty. In addition, you may need to check with your hospital’s pharmacist to determine if there are possible interactions between certain drugs. Here are a few of the primary pharmacological treatments that you will see used for emerging myocardial infarctions.
Aspirin
Aspirin has become such a widely recognized first treatment step for emerging MIs that many of your patients may have already chewed an aspirin at home before arriving at your facility. If your patient has not done so already, he should chew 325 mg of aspirin as soon as possible.
Fibrinolytics
Fibrinolytic therapy forms the foundation of therapy for restoring blood flow to the heart muscle. In the best cases, this therapy will dissolve the clot in the artery. However, patients must receive this therapy within 12 hours from the start of the chest pain, and they must not be at increased risk for internal bleeding. While there are many types of fibrinolytics, perhaps the most widely recognized option is tPA, or tissue plasminogen activator.
Anticoagulants
Anticoagulants will prevent the further formation of clots and can be given along with or instead of fibrinolytics. Heparin, which is injected subcutaneously, is the most common option given. Your patient will need to undergo regular clotting studies to determine the exact follow-up dosages of heparin.
Beta Blockers
Although beta blockers are not usually given during NSTEMI events, they are frequently given during STEMI events when full blockages are present. These are usually given intravenously for patients suffering from hypertension and tachycardia.
Morphine
Morphine is the primary treatment for chest pain, but it has the added benefit of also improving blood flow throughout the body as it dilates the arteries.
Nitrates
Nitroglycerin was once an initial pharmacological treatment of choice, but it is not used with such frequency today due to the lack of clinical data proving its benefits on mortality. However, it can decrease chest pain in some when given sublingually.
Understanding the effects and uses of these drugs can be difficult as many recommendations change over the years. However, if you want to stay up-to-date with treatment measures for myocardial infarctions, you can look into continuing education modules that focus on this, or you can take ACLS refresher classes, which go over some of these medications. A recertification course will also focus on how to treat a variety of life-threatening heart rhythms, which you may see occurring after myocardial infarctions in some patients. Contact Project Heartbeat today to learn more about our many health care education classes or to sign up for an upcoming ACLS initial certification or recertification class at our Oakland or Sacramento locations.
