A client presents in the Emergency Department with a suspected MI. Which medications should be given as soon as possible?(Select all that apply.)
1. Clopidogrel (Plavix)
2. Morphine
3. Aspirin (ASA)
4. Metoprolol (Lopressor)
2, 3, 4
Rationale 1: Clopidogrel (Plavix) is an antiplatelet drug used in patients with a stroke who cannot tolerate aspirin.
Rationale 2: Morphine is essential following acute MI to ensure the patient's comfort and reduce stress.
Rationale 3: Aspirin has been found to dramatically reduce mortality, by as much as 50%, in the weeks following an acute MI. Unless contraindicated, 160–324 mg of aspirin is given as soon as possible following a suspected MI.
Rationale 4: Metoprolol (Lopressor) is a beta-adrenergic blocker that is used to reduce the cardiac workload by slowing the heart rate, decreasing contractility, and reducing blood pressure.
Global Rationale: The most immediate needs of the patient with MI are to ensure that the heart continues functioning and that permanent damage from the infarction is minimized. Aspirin has been found to dramatically reduce mortality, by as much as 50%, in the weeks following an acute MI. Unless contraindicated, 160–324 mg of aspirin is given as soon as possible following a suspected MI. Other drugs that can be administered are beta-adrenergic blockers such as metoprolol (Lopressor), angiotensin-converting enzyme inhibitors, and opioids such as morphine.
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