In the ambulance, a paramedic initiates oxygen

In the ambulance, a paramedic initiates oxygen therapy and administers morphine to ST, as well as a low dose of aspirin. After ST arrives at the hospital, investigations confirm that he is suffering from an acute myocardial infarction. ST receives an intravenous infusion of the fibrinolytic agent alteplase, as well as the antidysrhythmic amiodarone for ventricular tachycardia. : Overview the pathological process of acute myocardial infarction and how each of the above therapies fit into that. Cardiac enzyme level tests indicate that the damage to the myocardium is extensive. During his hospital stay, ST receives treatment with subcutaneous heparin and the Beta-blocker atenolol. Acute heart failure develops, which requires treatment with the ACE inhibitor enalapril and the loop diuretic frusemide. The diuretic is for the treatment of ST’s pulmonary oedema. After a prolonged hospital stay, ST is discharged. He goes on to develop chronic heart failure, which is managed with an ACE inhibitor, a diuretic, and a peripheral vasodilator. Questions What is the rationale for the use of fibrinolytic agents in acute myocardial infarction (AMI)? Full marks can be achieved in about 50 words) Compare and contrast the mechanisms of action of the fibrinolytic agents and aspirin. (Full marks can be achieved in about 50 words) What adverse reactions should be monitored for during and after fibrinolytic drug therapy? To which Vaughan Williams antidysrhythmic drug class does amiodarone belong? What are cardiac enzymes and why are they raised in an AMI? Compare and contrast the actions of heparin and alteplase. Pulmonary oedema is caused by alterations in fluid distribution between pulmonary blood vessels and the lung tissue. Using fluid dynamics and changes in fluid pressure, explain the link between acute heart failure and pulmonary oedema. Outline the pathophysiology of ST’s chronic heart failure and explain where ACE inhibitors, diuretics and peripheral vasodilators fit into this clinical picture. Be sure the reader can picture the pathophysiology of the disorder and how each of the medications work to help decrease the effects of chronic heart failure. Compare and contrast the actions of the loop and thiazide diuretics SCIENCE

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