ACS drugs

Aspirin >Antiplatelet

>Pain
management
>Aspirin is also used in lower doses to reduce the stickiness of platelets in the
blood, which helps to prevent unwanted blood clots from forming within the body.

>Aspirin works by reducing the production of chemicals called prostaglandins
which cause pain.
>internal bleeding, ulcers
Prasugrel >antiplatelet >Reduces the stickiness of platelets, and this helps prevent the platelets from
sticking to the inside of the artery and going on to form a further clot (thrombus).
Prasugrel is one of these antiplatelet medicines
>increased risk of bleeding

NSAIDS >arthritis
>osteoarthritis
>back pain
>neck pain
>NSAIDs variably inhibit COX-1 and COX-2

>used for pain relive and reduce inflammation

>internal bleeding, stomach
ulcers, anaemia, GI perforation
Nitrates >angina > Nitrates mainly work by relaxing the blood vessels in the body. This causes them
to dilate (widen). This then makes it easier for the heart to pump blood and
reduces the strain on the heart. This means the heart muscle does not need as
much blood and oxygen supply.
>throbbing headache, flushing,
and dizziness.
Diamorphine >pain
management
>used for the
treatment of
severe pain
>The precise mechanism of the analgesic action of morphine is unknown. >constipation
>drowsiness
>nausea and vomiting

Unfractionated
heparin
>used for the
treatment of
thrombosis
>only used in hospital settings, IV administration
> IT binds reversibly to antithrombin III (ATIII) and greatly accelerates the rate at
which ATIII inactivates coagulation enzymes thrombin (factor IIa) and factor Xa
heparin is more specific than LMWH for thrombin.
> UH has a higher risk of
bleeding and higher risk of
osteoporosis in long term use.
Unfractionated

>UH needs continuous infusions
Beta blockers >verapamil or
diltiazem is
most likely to
>Beta-blockers are drugs that bind to beta-adrenoceptors and thereby block the
binding of norepinephrine and epinephrine to these receptors.
> beta-blockers are able to reduce sympathetic influences that normally stimulate
> reduced heart rate make
cause dizziness
>not recommended for
be used during
ACS
chronotropy (heart rate), inotropy (contractility), dromotropy (electrical
conduction) and lusitropy (relaxation). Therefore, beta-blockers cause decreases in
heart rate, contractility, conduction velocity, and relaxation rate. These drugs have
an even greater effect when there is elevated sympathetic activity.
diabetics because it may mask
the symptoms of
hypoglycaemia
>cold extremities
Glycoproteins
IIb/IIIA
>tirofiban
>anti-platelet
medicine
> These medicines prevent the formation of blood clots. They can help
prevent blood clots in the coronary arteries after a heart attack.

> Tirofiban prevents the blood from clotting during episodes of chest pain or a
heart attack, or while the patient is undergoing a procedure to treat a blocked
coronary artery. It is a non-peptide reversible antagonist of the platelet
glycoprotein (GP) IIb/IIIa receptor, and inhibits platelet aggregation.
Internal bleeding is a common
side effect.

>Abdominal or stomach pain or
swelling
>arm, back, or jaw pain
>black, tarry stools