ACS medication quiz

Q. Pick out the 5 true statements to make naveed a happy patient

Every correct answer puts in a jigsaw piece of a smiling Naveed

1. ACS patients should be given 300mg of aspirin at presentation (true)
2. All ACS patients should be given b-blockers (false)
   FEEBDACK: b-blockers are contra-indicated in patients who have asthma. In ACS patients who are hypotensive or bradycardic, b-blockers may worsen these features
3. Tirofiban is an anti-coagulant (false)
   FEEBDACK: tirofiban is an anti-platelet agent
4. Patients with normal cholesterol levels do not need statin treatment (false)
   FEEBDACK: statins are recommended for all ACS patients regardless of lipid levels
5. Heparin should be given intra-venously for patients having primary angioplasty (true)
6. Opiate analgesia reduces myocardial oxygen demand (true)
7. All ACS patients should be given high flow oxygen (false)
   FEEBDACK: patients with COPD may lose respiratory drive when given high flow oxygen
8. Patients who have drug eluting stents require dual anti-platelet therapy for 12 months (true)
9. Following a STEMI, patients should be prescribed long term ACE-inhibitors (true)
10. Nicotine replacement therapy is contra-indicated after an ACS (false)
    FEEBDACK: it is better for ACS patients to have NNT than to continue to smoke and the stress of nicotine withdrawal may increase cardiac work