This micro lecture discusses the use of Aspirin when treating an acute coronary syndrome.
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Welcome to the micro lecture on aspirin. Now in this session, we’re going to talk about the use of aspirin when treating an acute coronary syndrome.
So let’s just remind ourselves. An acute coronary syndrome is made up of three conditions of the heart. Number one, ST segment elevation, myocardial infarction. Number two, a non ST segment elevation, myocardial infarction. Number three, unstable angina. Now in all of those conditions there’s an element of ischaemia, in other words lack of oxygen to the heart muscle, caused by what’s called atheromatous plaques.
Now living your life, you gain a level of lipid proteins that build up in coronary arteries, your coronary arteries are the arteries that serve into the heart. Now fats build up in the coronary arteries and eventually if there’s enough of this fatty plaque, in other words atheroma, it will rupture and cause an occlusion of the coronary artery which cause a myocardial infarction.
Now aspirin is what we know as an antiplatelet drug. When you get this build up you tend to end up with platelets and fiber, and a whole range of other substances that clog the coronary arteries. Aspirin is used as a drug to provide antiplatelet, not only to stop any further platelets from aggravating and getting into that area where there’s a kind of block, but also to try, and reduce the amount of platelets that are currently in the area.
The idea is that if aspirin’s able to do that, and pulls platelet away from the site of the blockage, then you’re more likely to have flower blood go back into that circulation. Therefore, reduce the effects of a myocardial infarction.
Now when the tutor asks you what is the purpose of aspirin, your answer is dead simple. It’s an antiplatelet and it reduces the accumulation of platelets at the site of the blockage in your coronary arteries. Now aspirin is given in a tablet form at 300mg, and ideally,
You do not want the patient to swallow it because it takes much longer to take effect. You want to the patient to crunch the aspirin and rub it around the mucus mucosa inside the mouth, because you end up with more bio availability. In other words, more of it is able to do the job. You end up with a faster absorption rate.
Now let’s just talk a little bit about some of the effects of aspirin. Something you keep hearing time and time again is if the patient is on anticoagulation therapy. Now some of the Acts and service guidelines have moved this from a contra indication and put into the cautions. A contra indication is when you’re absolutely would give a drug, whereas a caution mean you got to be careful. You’ve got to rule out some things.
Now when patients have anticoagulation therapy they all have this thing called a, it’s basically a personal test that’s done just for them. International normalized ratio, the INR, and if you give aspirin it messes up the INR.
So aspirin is used in the treatment of ACS, you ideally want the patient to crunch it up and rub it around their mucus mucosa, rather than swallowing it. It’s an antiplatelet drug, and of course with any drug you have to go with the systems of the safety system check, by 5 R’s if that’s what you’re using at the time. Of course check your guidelines for the indications and contraindications.
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