CCS - AAA , plz help, my exam is tomorrow - zindagani
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CCS - AAA , plz help, my exam is tomorrow - zindagani
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09-17-2010, 02:43 AM
In case of abdominal aortic aneurysm - in UW ,they consider stopping metoprolol and aspirin y ?
I know in usual practice in aneurysm , patient is started on propranolol iv drip plz lemme know what is correct to do and y to discontinue metoprolol Thanks
09-17-2010, 05:19 AM
Dear,
Beta blocker is generally indicated in treatment of AAA rupture ..and of course it is given to pt with AAA rupture. Make sure the systolic BP is high and no associated contraindication.. Pt with AAA rupture have varying mode of presentation..means varying vital signs..when high BP ---give IV metoprolol..when Low BP- stop metoprolol..In the setting of hypotension, reduction of blood pressure may be contraindicated. PT with AAAs, if normotensive, do not require pharmacotherapy. so, when ever you so, unstable pt with AAA--stop beta blocker.. other C/I of Beta blocker IN AAA.. @ h/0 previous MI-UW pt has history.. @ 2nd or 3 rd degree Heart block.. Aspirin ---Rupture AAA is acute emergancy as you know, so, to prevent bleeding complication stop it before proceeding further.. anyone find anything wrong then, pl draw my attention to correct what i know.. thanks MKJS..
09-17-2010, 07:05 AM
zindagani,
The case in UW is ruptured AAA,so that is the reason metoprolol and aspirin cancelled
09-17-2010, 07:23 AM
beta blockers are given in AAA to prevent the rupture by decreasing the heart rate....so no point in giving beta blockers when it is already rutured
09-17-2010, 07:24 AM
beta blockers are given in AAA to prevent the rupture by decreasing the heart rate....so no point in giving beta blockers when it is already ruptured
09-17-2010, 07:25 AM
is history of previous MI contraindication for use of beta blockers
09-17-2010, 07:36 AM
Though hypotension, backpain and pulsatile mass is classic triad of AAA rupture, not all pt present with this triad,,and 50% of have normal BP and quite high..
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