lenka SRN

Hi guys, My patient is scheduled for PCI this morning. His meds include: ASA 360mg PO; Metoprolol 50mg PO, Metformin and Bumex 2mg IV. Which if any of these meds should I hold and more specifically why? I am pretty sure that I should give the ASA but not sure what to give as rationale for it. I am also sure that metformin should be held possibly because of its interaction with contrast dye? Please help me understand this Thank you for your expertise

This was a generic question for school from a case study, mcg/min were not given. My assumption is that they wanted us to come up with any concerns related to a patient with chest pain on a dopamine drip and give rationale for our answer. Your answer was very helpful thank you very much!

What is the treatment for peripherally infiltrated dopamine?

Besides dopamine having an inotropic effect on the myocardium. Are there any other specific concerns regarding a patient with chest pain on a dopamine drip?

Isordil comes in extended release tabs as well. I was able to speak with a PA and he said that you develop a tolerance to Nitro which is why they would choose to wean the patient off and start them on Isordil 30-60 minutes prior to turning down the drip so that the effects of Isordil have enough time to kick in. Just me, I am glad to know that some of my schooling is starting to pay off :cheers: Thank you both for replying!

My questions are as follows: When the plan is to wean off Nitroglycerin the MD may order Isordil PO. Why might Isordil be ordered? I have a guess, but many hours of research gone bad and no definitive answer. My guess is that nitro can't be stoped cold turkey in a patient with hypertension and angina and Isordil helps this transition, but I am not able to give any rationale and I have been unsuccessful at finding a source with the answer. Then I also need to know how many hours should Isordil be given prior to turning off NTG drip? Thank you for your knowledge and support!