Antiplatelet/ Thrombolytic

Question 1

3 types of drugs effecting coagulation

Answer 1

Anticoagulants
Antiplatelet
Thrombolytic Therapy

Question 2

prevents the formation of clots- VENOUS (DVT)

Answer 2

Anticoagulantsz

Question 3

inhibits platelet aggregation (arterial - MI/Stroke)

Answer 3

Antiplatelet Agents

Question 4

dissolves life threatening clots

Answer 4

Thrombolytic

Question 5

4 types of antiplatelet agents?

Answer 5

1. Aspirin
2. Adenosine Diphosphate Receptor (ADP) Antagonists
3. PAR-1 Antagonists
4. Glycoprotein Ilb/llla Receptor Antagonists

Question 6

how does apirin fxn?

Answer 6

• antiplatelet
• interfere with platelet aggregation or “stickiness”
• Used to prevent clot formation in arteries

Question 7

how long is single dose of aspirin good for antiplatelet effects?

Answer 7

up to 1 week!

Question 8

how does 1 week dose of aspirin fxn? what is the dose?

Answer 8

• –>Irreversible inhibition of cyclooxygenase (COX)

- –>Used to prevent heart attack, TIA & stroke with 81mg

Question 9

side effects of aspirin? what we gonna do about it?

Answer 9

GI Bleed

-GI Bleed not reduced with enteric coated but is helped with proton pump inhibitor

Question 10

If we put someone on bigger dose of aspirin will it make their shit less sticky and their heart more good?

Answer 10

No!

-if increase dose - increase side effects and no CV benefits

Question 11

Prototype for Adenosine Diphosphate Receptor (ADP) Antagonists

Answer 11

clopidogrel (Plavix)

Question 12

How does clopidogrel (Plavix) fxn?

Answer 12

• Irreversible blockade of ADP receptors on platelet surfaces
• Used to prevent clots –> high risk MI, CVA patients

Question 13

What is clopidogrel (Plavix) used for? which patient populations?

Answer 13

prevent clots –> high risk MI, CVA patients

Question 14

Side effects of clopidogrel (Plavix)? what we gonna do about it?

Answer 14

Adenosine Diphosphate Receptor (ADP) Antagonists

GI bleed
-Might just let them bleed if risk of thrombotic event (MI/Stroke) is high

Question 15

Always check with provider before stopping

Answer 15

Adenosine Diphosphate Receptor (ADP) Antagonists

clopidogrel (Plavix)

Question 16

What is dual platelet therapy? when ya gonna do it?

Answer 16

give Aspirin + ADP Antagonist

-give this ACS (acute coronary Syndrome)

Question 17

Stop clopidogrel (Plavix) ___ _____ before surgery

Answer 17

5 days

Question 18

CYP2C19 genetic variant testing with which drug? what we gonna do about it?

Answer 18

Adenosine Diphosphate Receptor (ADP) Antagonists
Prototype: clopidogrel (Plavix)

–poor metabolizers should use another ADP

Question 19

drug interaction with clopidogrel (Plavix)? what we gonna do about it?

Answer 19

PPI - but still give it

Question 20

Prototype for PAR-1 Antagonists

Answer 20

vorapaxar (Zontivity)

Question 21

how does vorapaxar (Zontivity) fxn?

Answer 21

REVERSIBLY blocks the PAR-1 expressed on platelets

Question 22

Route for vorapaxar (Zontivity)?

Answer 22

PAR-1 Antagonists

-oral

Question 23

_____ lasts 7-10 days after last dose

Answer 23

PAR-1 Antagonists

Prototype: vorapaxar (Zontivity)

Question 24

What do we give vorapaxar (Zontivity) with to prevent CV events? which patient populations?

Answer 24

clopidogrel and/or ASA

high risk patients history of MI, PAD disease

Question 25

Prototype for Glycoprotein Ilb/llla Receptor Antagonists

Answer 25

abciximab (ReoPro)

Question 26

abciximab (ReoPro) fxn?

Answer 26

Reversible inhibition of all factors in platelet aggregation Glycoprotein Ilb/llla Receptor Antagonists

Question 27

This antiplatelet is IV only

Answer 27

Glycoprotein Ilb/llla Receptor Antagonists | Prototype: abciximab (ReoPro)

Question 28

When do we give abciximab (ReoPro)

Answer 28

Glycoprotein Ilb/llla Receptor Antagonists - Short term use for ongoing instability - -->during cardiac catheterization/ balloon angioplasty/stents - -->ACS

Question 29

Why does abciximab (ReoPro) suck?

Answer 29

costs 1200$! | -major risk of bleeding

Question 30

What other drugs do we give abciximab (ReoPro) with?

Answer 30

ASA or Heparin

Question 31

prototype for thrombolytic?

Answer 31

alteplase (tPa)

Question 32

fxn of alteplase (tPa)?

Answer 32

Break down clots (lysis) Thrombolytic

Question 33

When do we want to administer alteplase (tPa) for MI?

Answer 33

within 6 hours of onset | -3o min ideal!

Question 34

When do we want to administer alteplase (tPa) for CVA?

Answer 34

within 3 hours

Question 35

Half life of alteplase (tPa) ?

Answer 35

5 Minutes

Question 36

does alteplase (tPa) have narrow or wife margin of safety?

Answer 36

narrow

Question 37

What do we do if their are signs of bleeding with alteplase (tPa)?

Answer 37

STOP!

Question 38

Contraindication considerations for alteplase (tPa)?

Answer 38

``` Has someone had recent preg? Already on anticoag? Internal bleeding? Severe HTN? Peptic ulcer disease? ```