CVS

Question 1

MOA aspirin

Answer 1

Blocks prostaglandin synthesis
Non-selective for COX1 and COX2
COX1 - irreversible inhibition of platelet aggregation for 7-10/7
Prevents arachidonic acid —> thromboxane A2 (inducer of platelet aggregation)

Question 2

Class aspirin

Answer 2

NSAID/ anti-platelet

Salicylate

Question 3

MOA clopidogrel

Answer 3

metabolised to active form by carboxylesterase-1
Irreversibly binds p2y12 receptor on platelets
Prevents ADP mediated activation of glycoprotein IIb/IIIa
Inhibits platelet aggregation

Question 4

P2y12 inhibitors

Answer 4

Clopidogrel, prasugrel, ticodipine, ticagrelor, cangrelor

Question 5

which p2y12 inhibitors are pro-drugs

Answer 5

Clopidogrel
Prasugrel
Ticlopidine

Question 6

Which p2y12 inhibitors are not pro drugs, and already exist in their active forms

Answer 6

Cangrelor

Ticagrelor

Question 7

Clopidogrel class

Answer 7

P2y12 inhibitor

Antiplatelet

Question 8

How many days before surgery should clopidogrel be discontinued

Answer 8

7/7

BNF

Question 9

How many days before surgery should ticagrelor be stopped?

Answer 9

5/7

Question 10

How many days before surgery should prasugrel be stopped?

Answer 10

7/7

Question 11

MOA dipyridamole

Answer 11

Inhibits both ADENOSINE DEAMINASE and PHOSPHODIESTERASE
⬇️ release of arachidonic acid
Which ⬇️thromboxane A2 activity (inducer of platelet aggeregation)

Also directly stimulates release of prostacyclin

Question 12

Normal dose of dipyridamole

Answer 12

200mg bd

M/r

Question 13

How long after opening the original container should dipyridamole m/r capsules be discarded

Answer 13

6/52

Question 14

Clopidogrel dosing/ and duration of tx

Answer 14

PCI - 300mg (or 600mg) plus aspirin
TIA or acute stroke in pts with aspirin hypersens - 75mg od
NSTEMI - 300mg, then 75mg up to 12/12 plus aspirin
STEMI - 75mg for at least 4/52 plus aspirin (give loading dose 300mg if ≤75)
Pts with AFib who can’t take warfarin - 75mg od

Question 15

MOA warfarin

Answer 15

Inhibits vitamin K epoxide reductase
Diminishes vit K
Coagulation factors cannot be carboxylated - II, VII, IX, X - vitamin K dependent

Question 16

Antiarrhythmic Class Amiodarone

Answer 16

III - K+ channel blocker

Question 17

Antiarrhythmic Class - Dronedarone

Answer 17

III - K+ channel blocker

Question 18

Antiarrhythmic Class - Propranolol

Answer 18

Class II - beta blocker

Question 19

Antiarrhythmic Class - Sotalol

Answer 19

Class II - beta blocker
AND
Class III - K+ channel blocker

Question 20

Antiarrhythmic Class - Flecainide

Answer 20

Class I - Na+ blocker/ membrane stabilising