anticoagulation

Question 1

if patient has both CV disease (requiring antiplatelet) as well as AF/valvular disease (requiring anticoag) - what should be done?

Answer 1

anticoagulant monotherapy is given without the addition of antiplatelets !!

• theres exception to this! ACS/VTE

(obvs together would be massive bleed risk)

Question 2

medical management post-ACS in patients who require both antiplatelets + anticoag

Answer 2

4wks-6months after = triple therapy (2 antiplatelets + 1 anticoag)

6-12months = dual (1 antiplatelet + 1 anticoag)

Question 3

med mx post-VTE for patient taking antiplatelet therapy

Answer 3

will be given anticoag for 3/6months

calculate ORBIT
- low bleed risk - continue antiplatlets
- high risk - stop antiplatelets

Question 4

MoA of clopidogrel

Answer 4

anatagonist of the P2Y12 adenosine diphosphate (ADP) receptor
- inhibiting activation of platelets

Question 5

aspirin MoA

Answer 5

blocking the action of both cyclooxygenase-1 and 2
- BLOCKING OF THROMBOXANE a2 FORMATION REDUCES ABILITY OF PLATELETS TO AGREGATE

Question 6

what drugs does aspirin potentiate (increase effect of)

Answer 6

oral hypoglycaemics
warfarin
steroids

Question 7

adenosine diphosphate (ADP) receptor inhibitors

Answer 7

clopidogrel
prasugrel
ticagrelor
ticlopidine

Question 8

clopidogrel interaction

Answer 8

PPIs - esp omeprazole

• reduces antiplatelet effects