Question about meds and PCI

[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

[Putu2Sleep]

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

i would say you hold the ASA and the metformin. Usually ASA is held like 5 days prior to PCI and the metformin should be held because the patient was probably NPO after midnight anyway and won't really need it.

[MONITORHOSPITAL]

:redbeatheAspirin is usually given to achieve enough thinning of blood in cath lab whereas Plavix is held because that may hinder the possibility of bypass surgery if needed immediately. Metformin can be held if they have been NPO from previous night, I dont know about interaction with Dye

Hope this helps..........

[Sunflowerinsc, ADN, RN]

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

What is "PCI"? If it is surgical ,I would hold the ASA and the Bumex and Metformin and give the b/p med. Our hospital policy is to give po b/p meds, antseizure and acid reducer with sips of water unless Dr orders not to.

[Virgo_RN, BSN, RN]

Percutaneous Coronary Intervention. I would hold everything but the ASA.

[nursej22, MSN, RN]

I would hold the metformin (yes, it interacts with dye to impair kidney function), also would hold bumex, pt will be npo until after procedure, need to prevent dehydration. Also if pt doesn't get a foley they will be extremely uncomfortable. the contrast dye has some diuretic effect, and PCIs can take a long time.

Yes give the metoprolol, you want that heart nice and relaxed while they are mucking around in there, and the BP needs to be well controlled for pulling arterial sheaths and obtaining hemostasis. ASA inhibits platelet aggregation which in turn inhibits clots, so by all means they need it.

[seanpdent, ADN, BSN, MSN, APRN, NP]

I have come across both scenarios. Hold the ASA, and give the ASA. I think it all depends on what the anticipated procedure is, as well as the patients given history AND given cardiac history.

If in doubt double check with the physician.

[jaccimv]

We give ASA but do hold the metformin. All the other bp meds should be given. :redpinkhe

[jmgrn65, RN]

ASA is given, I have known Physicians that have given ASA during a procedure if they havent' rec'd. It is given the same reason as for an AMI. BetaBlockers should always be given, as well as other cardiac and bp meds.

[Nightcrawler, BSN, RN]

Give the ASA, give the Metoprolol, but hold the Metformin. Not only won't they need the Metformin, but there is a contraindication with Metformin and the dye. The risk for bleeding with the ASA is very minor, and if they do an intervention they will likely heparinize and or use Integrillin or another med. Metoprolol will not only help the patients blood pressure, but will also reduce the workload of the heart.

[BBFRN, BSN, PhD]

Duplicate threads merged.

[Sunflowerinsc, ADN, RN]

What is "PCI"? If it is surgical ,I would hold the ASA and the Bumex and Metformin and give the b/p med. Our hospital policy is to give po b/p meds, antseizure and acid reducer with sips of water unless Dr orders not to.

Opps, I didn't read this right, had PICC on my mind. Well, I would still hold the Bumex and Metformin,give b/p med. Some of our Dr's want the ASA given and another doesn't. They have their own set of orders,