急性心肌梗塞病人開立阿斯匹靈(Aspirin),理由為何?(選所有適合的)
A client with an acute MI is prescribed aspirin. What is the reason for this? (Select all that apply.)
- AAnalgesic effect止痛效果
- BAntiplatelet effect✓ 正解抗血小板效果
- CAntipyretic effect退燒效果
- DPrevention of further clot formation✓ 正解預防進一步的血栓形成
- EVasodilation血管擴張
急性心肌梗塞(MI)發生時,冠狀動脈內的粥狀斑塊破裂導致血小板聚集與血栓形成,進而阻塞血管。阿斯匹靈(Aspirin)在此情境下屬於抗血小板藥物,透過不可逆地抑制環氧化酶(COX-1),減少血栓素A2(Thromboxane A2)的合成,從而抑制血小板凝集。在急性期,預防血栓擴大與維持冠狀動脈通暢是治療的核心優先目標(ABC原則)。雖然阿斯匹靈具有止痛與退燒效能,但在MI的急性治療方案中,這些僅為次要作用,抗血栓才是挽救心肌細胞的關鍵。
Aspirin is prescribed during an acute myocardial infarction primarily for its antiplatelet properties, which inhibit platelet aggregation and prevent further thrombus formation. By irreversibly blocking cyclooxygenase-1, aspirin reduces thromboxane A2 synthesis, helping to maintain coronary artery patency and limit myocardial damage.
在美國,急性MI病人抵達急診或救護車上即會給予嚼碎的阿斯匹靈(通常為324mg,即4顆81mg),以求快速吸收。台灣臨床亦遵循此原則,但在給藥劑量與劑型選擇上,美國更強調「嚼碎」以增加生物利用度。