NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

What is recommended for chest pain management in unstable angina (NSTE-ACS)?

1. MONA-GAP-BA +/- PCI

2. PCI only

3. Fibrinolytic therapy

4. Conservative management

The correct answer is: MONA-GAP-BA +/- PCI

In the management of chest pain in unstable angina (NSTE-ACS), the recommended approach is to use the MONA-GAP-BA protocol, which stands for Morphine, Oxygen, Nitroglycerin, Aspirin, GP IIb/IIIa inhibitors, Anticoagulants, and P2Y12 inhibitors. This combination is crucial for addressing the symptoms promptly and preventing further complications. Morphine helps alleviate pain and reduce anxiety, oxygen ensures adequate oxygenation, nitroglycerin dilates blood vessels to improve blood flow to the heart, aspirin inhibits platelet aggregation, GP IIb/IIIa inhibitors prevent platelet aggregation, anticoagulants reduce the risk of clot formation, and P2Y12 inhibitors further inhibit platelet activation. The MONA-GAP-BA protocol, along with the possibility of adding Percutaneous Coronary Intervention (PCI) if indicated, is the standard of care for managing unstable angina to stabilize the patient and mitigate the progression to a myocardial infarction. Other options like PCI only, fibrinolytic therapy, and conservative management are not the recommended initial strategies for managing chest pain in unstable angina.