Question

Which class of medications commonly given to patients with acute coronary syndrome may be adversely affected by morphine administration?

a. B-blockers
b. Calcium channel blockers
c. Phosphodiasterase inhibitors
d. Oral anti platelet meds

Answer 1

D.oral anti platelet meds

Step-by-step explanation:

Morphine is a commonly used medication in acute coronary syndromes (ACS) to help relieve pain which in turn can help reduce sympathetic tone. Over the past few years however, there has been some concern raised about the drug-drug interactions with antiplatelet agents causing impaired platelet inhibition as well as an association with worsened clinical outcomes. P2Y12 receptor antagonists (i.e. Clopidogrel, Pasugrel, Ticagrelor) are typically administered with aspirin (dual anti-platelet therapy) as one of the cornerstones of treatment for ACS. This drug-to-drug interaction can cause delayed inhibition of platelet activation and potentially worsen clinical outcomes.

The last AHA/ACC guidelines for the management of patients with Non-ST-Elevation Acute Coronary Syndromes was published in 2014 [10]. There have been several trials published since its publication questioning several of the early treatment modalities commonly used in the pre-hospital and emergency department settings.