Lesson 1High-intensity statin initiation: timing, expected benefits, monitoring for adverse effectsExplains when and how to start high-intensity statins in suspected ACS, expected plaque-stabilising benefits, baseline labs, monitoring for myopathy or liver injury, and counselling to support long-term adherence.
Timing of statin start in ACS pathwayChoosing appropriate statin and doseBaseline liver and muscle assessmentsMonitoring for myopathy and hepatotoxicityPatient counselling and adherence supportLesson 2Oxygen therapy: evidence-based thresholds for use, titration to target SpO2, risks of hyperoxiaExamines oxygen therapy in suspected ACS, emphasising evidence-based thresholds for initiation, titration to target oxygen saturation, avoidance of hyperoxia, and documentation of indications and patient response.
When to start oxygen in suspected ACSTarget SpO2 ranges and titration stepsRisks and mechanisms of hyperoxia harmDevice selection and flow adjustmentsMonitoring and documenting oxygen responseLesson 3Nitroglycerin: sublingual administration steps, hemodynamic checks, contraindications (PDE-5 inhibitors), management of hypotensionOutlines safe nitroglycerin use, including sublingual administration steps, pre- and post-dose haemodynamic checks, contraindications such as PDE-5 inhibitors, and management strategies for nitro-induced hypotension.
Sublingual nitroglycerin administration stepsPre-dose blood pressure and pain checksScreening for PDE-5 inhibitor useRecognising nitroglycerin side effectsManaging and documenting hypotensionLesson 4Aspirin: dosing, mechanism in ACS, contraindications, assessment before and after administrationProvides a focused review of aspirin use in ACS, including loading and maintenance doses, antiplatelet mechanism, contraindications, and structured assessments before and after administration for safety and efficacy.
Aspirin loading and maintenance dosingMechanism of platelet inhibition in ACSContraindications and relative cautionsPre-dose assessment and risk screeningPost-dose monitoring and reassessmentLesson 5Medication interaction and allergy checks: cross-checking home meds, diabetes and beta-blocker interactions, renal dosing considerationsFocuses on systematically identifying allergies, prior adverse reactions, and high-risk drug interactions, including diabetes therapies, beta-blockers, and renally cleared drugs, to prevent avoidable harm in ACS patients.
Structured allergy and reaction historyCross-checking home and inpatient medsDiabetes drugs and beta-blocker maskingRenal dosing and nephrotoxic combinationsUsing EHR alerts and pharmacist supportLesson 6Overview of ACS pharmacotherapy: antiplatelets, anticoagulants, nitrates, beta-blockers, statins, oxygen rationaleReviews core ACS medications, their mechanisms, indications, and contraindications, with emphasis on initial selection, sequencing, and bedside safety checks to balance ischaemia relief with bleeding and haemodynamic risks.
Roles of antiplatelet agents in ACSAnticoagulant options and selectionUse of nitrates for ischaemic chest painEarly beta-blocker therapy considerationsHigh-intensity statins in ACS careOxygen use and current ACS evidenceLesson 7Anticoagulation with enoxaparin: dosing based on weight/renal function, timing relative to procedures, bleeding risk assessment and monitoringCovers enoxaparin use for ACS anticoagulation, including weight and renal-based dosing, timing around invasive procedures, bleeding risk assessment, monitoring strategies, and coordination with the cardiology team.
Weight-based dosing calculationsRenal impairment dose adjustmentsTiming with PCI and other proceduresBaseline and ongoing bleeding assessmentMonitoring anti-Xa and lab parametersReversal and management of major bleedingLesson 8Beta-blockers (metoprolol): indications, IV vs PO use, blood pressure and heart rate criteria, dose titration and monitoring for bradycardiaReviews metoprolol use in ACS, including indications, choosing IV versus oral routes, blood pressure and heart rate criteria, titration strategies, and monitoring for bradycardia, hypotension, and bronchospasm.
Indications and contraindications in ACSIV versus oral metoprolol selectionBlood pressure and heart rate thresholdsDose titration and reassessmentMonitoring for bradycardia and hypotensionLesson 9Documentation and communication with the provider about medication responses and lab-guided adjustmentsDetails best practices for documenting medication indications, responses, and adverse events, and for communicating with providers to guide lab-based dose adjustments and therapy escalation or de-escalation.
Recording indications and time of dosingCharting responses and side effectsCommunicating critical changes promptlyUsing labs to guide dose adjustmentsHandoff reports and interdisciplinary notesLesson 10Monitoring for adverse effects: hypotension, bradycardia, bleeding, allergic reactions, and stepwise response algorithmsCovers early recognition and management of hypotension, bradycardia, bleeding, and allergic reactions after ACS medications, using stepwise algorithms, escalation triggers, and documentation of response to interventions.
Vital sign and perfusion surveillanceBleeding risk signs and bedside checksRecognition of drug-induced bradycardiaIdentifying and treating allergic reactionsStepwise response and escalation pathwaysPost-event reassessment and documentation
