Please enable JavaScript.

Coggle requires JavaScript to display documents.

ACS Classification (12-lead ECG (ST Segment Elevation (Yes (STEMI) (Take…

- - - - Take blood work but do not wait for blood results
        
        Give MONA and Stop NSAIDs (other than ASA) and COX-2 Inhibitors: Morphine; Oxygen (keep 90% saturated); Nitroglycerin 400mcg Q5 min up to 3 doses sublinigual or IV infusion (d/c 24 hrs after relief); Aspirin 81mg chewed
        
        PCI
        
        Parenteral anticoagulants
        
        UFH + GP IIb/IIIa:
        Tirofiban IV
        Eptifibatide IV
        Abciximab IV or intracoronary
        *not w/ prior hemorrhagic stoke or recent ischemic stroke
        
        Maintenance
        
        4 more items...
        
        Heparin: or UFH IV bolus + IV infusion (adjust to ACT)
        Bivalirudin: IV bolus + IV infusion (adjust if CrCl <30 ml/min)
        Enoxaparin: SubQ (adjuts if CrCl <30ml/min)
        
        Dual Antiplatelet Therapy (DAPT)
        
        Aspirin 162-325mg PO+ one of the following
        Clopidogrel loading dose: 600mg PO
        Prasugrel oading dose: 60 mg PO
        Ticagrelor loading dose: 180 mg PO
        Cangrelor 30mcg/kg IV bolus initated prior to PCI and followed by 4mcg/kg/min IV infusion for duration of PCI or 2 hrs
        
        High Intensity Statin
        
        Atorvastion 40-80mg QD or Rovastatin 20-40mg QD
        
        Fibrinolytics
        
        Parenteral anticoagulants
        
        UFH: IV 60 units/kg bolus + 12 units/kg/hr infusion adjusted to target aPTT x48hrs; Enoxaparin (perfered) SubQ for up to 8 days (renal adjust); Fondaparinux SubQ: contraindicated if CrCl <30ml/min; Bivalirudin: for pts who develop HIT
        
        Dual Antiplatelet Therapy (DAPT)
        
        Aspirin + P2Y12 inhibitor
        
        Aspirin loading dose: 162-325mg PO
        
        1 more item...
        
        Clopidogrel: Loading dose 300mg PO if <75yrs and 75 mg PO if >75yrs
        
        1 more item...
        
        Alteplase (tPA): Single IV weight-based bolus; Reteplase (rPA): 10 units+10 units IV boluses given 30 mins apart; Tenecteplase (TNK-tPA): Single IV weight-based bolus
    - - Increase in Biomarker
        
        Yes (NSTEMI)
        
        Give MONA and Stop NSAIDs (other than ASA) and COX-2 Inhibitors: Morphine; Oxygen (keep 90% saturated); Nitroglycerin 400mcg Q5 min up to 3 doses sublinigual or IV infusion (d/c 24 hrs after relief); Aspirin 81mg chewed
        
        Parenteral anticoagulants
        
        Early Invasive and Ischemia guided Strategy
        
        UFH (weight based) IV: 60 units/kg bolus +12 units/kg/hr infusion (adjusted to target aPTT); Enoxaparin: 1mg/kg SubQ Q12H (adjust if CrCL <30ml/min, contraindicated in dialysis pts; Fondaparinux: 2.5 mg SubQ QD
        
        1 more item...
        
        Early Invasive Strategy Only
        
        Bivalirudin IV (weight-based): 0.10 mg/kg loading dose followed by 0.25 mg/kg/hr
        
        1 more item...
        
        UFH or enoxaparin + eptifibatide or tirofiban
        
        1 more item...
        
        DAPT
        
        Aspirin loading dose: 162-325 mg PO
        
        Clopidogrel loading dose: 300-600mg PO; Ticagrelor loading dose: 180 mg PO
        
        No (UA)