Acetylsalicylic Acid
Mechanism of action
• antiplatelet agent that inhibits the formation of thromboxane A2. This inhibition reduces reocclusion recurrent coronary events after fibrinolytic therapy, reducing mortality
IAM general.
Indications.
• Administer as soon as possible to all patients with suspected AMI or ACS, especially candidates
reperfusion.
Dose.
• 160 to 325 mg.
Precautions.
• Relatively contraindicated in patients with active peptic ulcer disease and a history of asthma


• Contraindicated in patients with known hypersensitivity to the drug
• High doses (more than 1000 mg.) Can interfere with the production of prostacyclin and alter their possible benefits.

Adenosine
Mechanism of action.
• endogenous purine nucleoside that depresses the activity of AV node and sinus node without affecting conduction through accessory pathways, so only interrupts the reentry circuits involving the AV node.



The half-life of adenosine is <5 sec. because it is rapidly metabolized by enzymatic degradation in blood and peripheral tissues. It also has a vasodilatory effect of short duration.
Indications.
• For most of the SVT, supraventricular tachycardia that generally involve a reentry pathway including the AV node or sinus node
• Do not reverse those arrhythmias that do not obey reentry involving the AV node or sinus, and atrial flutter, AF, atrial or ventricular tachycardia.
Dose.
• Adult: Can be applied up to 3 doses IV (every 1 to 2 min.): 6 – 12 to 12 mg. Each dose should be administered in 1 to 3 seconds, followed by 20 ml of SF.
• Pediatrics: 0.1 mg / kg fast IV bolus (max 6 mg.) Followed by 5 ml of SF. You can double (0.2 mg / kg) for the second dose (12 mg max.).
Precautions.
• Worsening hypotension in hypotensive patients
• Side effects: redness, pain or chest tightness, brief periods of asystole (up to 15 sec.) Or bradycardia, ventricular ectopy, dyspnea.
• In patients with denervated hearts, must be used cautiously.
• Interact with theophylline, caffeine and theobromine, which inhibit its action.
• The dipirimadol blocks the reuptake of adenosine and its impact strength.
• May be harmful in narrow complex tachycardias if an accessory pathway and / or preexitacion syndrome as Swpw, as there is a risk of paradoxical acceleration of heart rate and dangerous.
• In wide complex tachycardia of unknown type and TV could cause hypotension
• Contraindicated in tachycardia induced by intoxication with drugs and / or drugs.

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