Which option best describes the initial management approach for unstable angina (MONA)?

Which option best describes the initial management approach for unstable angina (MONA)?

• A. Oxygen, Nitroglycerin, Aspirin only
• B. Morphine, Oxygen, Nitroglycerin, Aspirin
• C. MONA (Morphine, Oxygen, Nitroglycerin, Aspirin)
• D. IV antibiotics

Answer: (C)

Unstable angina requires rapid relief of ischemia and prevention of thrombus progression, achieved by analgesia, oxygen if needed, vasodilation, and antiplatelet therapy. The best description is MONA: Morphine, Oxygen, Nitroglycerin, and Aspirin. Morphine provides analgesia and lowers sympathetic drive, which reduces heart rate and myocardial oxygen demand. Oxygen is given if the patient is hypoxemic or in respiratory distress, not routinely to everyone. Nitroglycerin dilates veins, reducing preload and improving coronary blood flow, helping relieve chest pain and decrease oxygen demand; monitor blood pressure and avoid if hypotensive or after recent PDE-5 inhibitor use. Aspirin irreversibly inhibits platelet aggregation, and a chewable dose around 162–325 mg should be given promptly unless contraindicated, to reduce mortality and infarct size. This combination targets pain control, oxygen delivery, ischemia reduction, and thrombus prevention. The option that includes antibiotics is not appropriate for unstable angina, since infection isn’t the issue here.

Unstable angina requires rapid relief of ischemia and prevention of thrombus progression, achieved by analgesia, oxygen if needed, vasodilation, and antiplatelet therapy. The best description is MONA: Morphine, Oxygen, Nitroglycerin, and Aspirin. Morphine provides analgesia and lowers sympathetic drive, which reduces heart rate and myocardial oxygen demand. Oxygen is given if the patient is hypoxemic or in respiratory distress, not routinely to everyone. Nitroglycerin dilates veins, reducing preload and improving coronary blood flow, helping relieve chest pain and decrease oxygen demand; monitor blood pressure and avoid if hypotensive or after recent PDE-5 inhibitor use. Aspirin irreversibly inhibits platelet aggregation, and a chewable dose around 162–325 mg should be given promptly unless contraindicated, to reduce mortality and infarct size. This combination targets pain control, oxygen delivery, ischemia reduction, and thrombus prevention. The option that includes antibiotics is not appropriate for unstable angina, since infection isn’t the issue here.