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DAY 4, WEEK 1 (PCI) - Coggle Diagram
DAY 4, WEEK 1 (PCI)
Patient not under follow up
Uncontrolled hyperuricemia worsened STEMI patient
High serum uric acid level associated with lower LVEF, higher Killip class, elevated cTnI and cholesterol level
Suggest to check the serum uric acid level
If high uric acid level, suggest to initiate xanthine oxidase inhibitor to reduce uric acid level
Monitor the serum uric acid level every 2 to 5 weeks
Inappropiate drug use
S/C Fondaparinux 2.5 mg OD
Not be used as the sole anticoagulant with PCI
Associated with catheter thrombosis
Change to unfractionated heparin
Drug-drug interaction
Fondaparinux and
Clopidogrel
Increase the risk of bleeding
Monitor any sign or risk of bleeding
Fondaparinux (anticoagulant) with Clopidogrel (antiplatelet) may increase the risk of bleeding
Spironolactone and
Bisoprolol/Perindopril(Moderate)
Serum potassium and renal function should be check regularly
Increase the risk of hyperkalemia
Inhibition of ACE results in decreased aldosterone secretion causing increases in serum potassium
B-blocker can induce hyperkalemia is by reduction of potassium cellular transport
Spironolactone is potassium-sparing diuretics that increase the serum potassium level