Prescribing Safety Assessment (PSA) Practice Exam

What is included in the initial management of an acute STEMI?

1. Insulin Therapy

2. MONABASH Protocol

3. Antibiotic Administration

4. Fluid Resuscitation

The correct answer is: MONABASH Protocol

The initial management of an acute ST-Elevation Myocardial Infarction (STEMI) typically follows the MONABASH protocol. This acronym encapsulates a comprehensive strategy to address STEMI effectively. It includes administering Morphine to relieve severe chest pain, providing Oxygen to patients with low saturation levels, giving Nitrates to alleviate ischemic pain, and Aspirin to inhibit platelet aggregation and prevent further clot formation. Additionally, β-blockers help decrease the heart's workload, and Statins are introduced to manage cholesterol levels and stabilize plaque. In the context of STEMI management, this approach is critically important because rapid intervention with these measures has been shown to significantly improve patient outcomes, contributing to decreased morbidity and mortality associated with myocardial infarction. While the other options may have relevance in different medical scenarios, they do not constitute the foundational elements of initial STEMI management as outlined in clinical protocols. For instance, insulin therapy is typically not a first-line treatment for STEMI; fluid resuscitation generally pertains to conditions like hypovolemia or shock rather than acute myocardial infarctions; and antibiotic administration is not a standard part of the immediate treatment for STEMI unless there is a concurrent infection. Therefore, the MONABASH protocol remains the