Published Mar 7, 2014
So I transport a lot of patients that are going for catheterization for NSTEMI. My question is, why are some patients sent on integrilin and heparin and some with nothing? Does it just depend on their history? It just seems that nearly identical patients get sent out with different meds.
Anna Flaxis, BSN, RN
It can depend on a lot of different things. It can depend on where they're coming from, who the provider is, etc. Sometimes the gtts will just be started in the cath lab.
Doctor preference basically. There's really no set protocol. As a general rule....if they've ruled in for a Nstemi and are having active chest pain they will be put on integrilin and nitro usually. Sometimes just nitro. Sometimes they wait and start the integrilin in the cath lab and run it for 18 hrs post PCI. I see it more with Stemi's post cath though. Integrilin costs $900 for a 100cc bottle....it's ridiculously expensive.
Doctors preference and it also depends on the hospital too. For active chest pain we will use a Nitro gtt if not controlled by other means. Also, Heparin gtt is common too especially with suspected MI's.
I've only seen integrilin gtt once, and yeah it's quite costly. It's made from snake venom, which I thought was pretty neat
We used a lot of Angiomax when I worked cardiac, which is made from leech spit!
I also learned that Rapamune, a drug used to prevent graft vs. host disease, was synthesized from soil bacteria from Easter Island.
Pretty cool! Maybe this could be the topic for a new thread.
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