Question
(
(a) Diazepam ( 4 mark(s)
(b) Describe the management of Acute Myocardial Infarction. 4 mark(s)
Q7 8 marks Short Essays ★ ✓
Answer
a) Diazepam
A benzodiazepine. MOA : binds the benzodiazepine site on the GABA-A receptor, enhancing GABA-mediated chloride channel opening frequency, producing neuronal hyperpolarization. Uses : status epilepticus (first-line IV), anxiety disorders, skeletal muscle spasm, pre-anesthetic medication, alcohol withdrawal. Adverse effects : sedation, drowsiness, tolerance and dependence with prolonged use, respiratory depression at high doses/IV administration.
b) Management of acute myocardial infarction
Morphine — analgesia, reduces sympathetic drive/preload.
Oxygen (if hypoxic).
Sublingual/IV Nitrates — venodilation, reduces preload, relieves pain.
Aspirin (chewed) — immediate antiplatelet effect.
P2Y12 inhibitor (Clopidogrel/Ticagrelor) — dual antiplatelet therapy.
Heparin/LMWH — prevents thrombus propagation.
Beta-blocker — reduces O2 demand and arrhythmia risk.
High-intensity statin — plaque stabilization.
ACE inhibitor — limits remodeling.
Reperfusion : primary PCI (preferred) or thrombolysis if PCI unavailable within 90-120 min.
1 Antianginal Drugs
Other Years Asked
1 Mr. X, a 65-year-old retired teacher had severe retrosternal chest pain radiating to
shoulder and left arm. He was profusely sweating and his ECG revealed ST elevation
and a diagnosis of Acute Myocardial infarction was made.
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