In the MONA protocol for acute coronary syndrome, which option is included?

• A. MONA therapy (morphine, oxygen, nitroglycerin and aspirin)
• B. Beta-blocker therapy
• C. Aspirin only
• D. Thrombolytic therapy

Answer: (A)

MONA therapy is the classic initial approach to suspected acute coronary syndrome, representing Morphine for pain relief, Oxygen to improve oxygen delivery when needed, Nitrates to dilate vessels and decrease myocardial oxygen demand, and Aspirin to inhibit platelet aggregation. The option that includes this MONA combination matches what is traditionally taught as the initial steps, making it the best choice. In current practice, oxygen is used primarily if there's hypoxemia, morphine is used selectively for pain, nitrates are avoided in hypotension or with certain drugs, and aspirin is given unless contraindicated. Beta-blockers and thrombolytics are important in ACS management but are not part of the MONA acronym.