Fibrinolytics

Question 1

Clopidogrel MOA

Answer 1

Anti-platelet that antagonizes adenosine diphosphate (ADP) binding to platelets, impairing function

Question 2

Clopidogrel Preparation

Answer 2

75mg tablets

Question 3

Clopidogrel Indication

Answer 3

STEMI in conjunction with fibrinolytic therapy

Question 4

Clopidogrel Contraindications

Answer 4

Nil

Question 5

Clopidogrel Precautions

Answer 5

Clinically significant bleeding
At risk of bleeding
Pregnancy

Question 6

Clopidogrel Doses

Answer 6

<75yo 300mg (x4 tablets)

>75yo 75mg (x1 tablet)

Question 7

Clopidogrel Onset

Answer 7

30-60min

Question 8

Clopidogrel Duration

Answer 8

The life of the platelet, 3-5 days

Question 9

Clopidogrel Adverse Effects

Answer 9

Increased bleeding

Question 10

Enoxaparin MOA

Answer 10

Low molecular weight Heparin (LMWH) anticoagulant that potentiates the activity of anti-thrombin III, inhibiting multiple coagulation factors- particularly Xa

Question 11

Enoxaparin Preparation

Answer 11

100mg 1ml

Question 12

Enoxaparin Indication

Answer 12

STEMI in conjunction with fibrinolytic therapy

Question 13

Enoxaparin Contraindication

Answer 13

Nil

Question 14

Enoxaparin Precautions

Answer 14

Clinically significant bleeding
At risk of bleeding
Pregnancy

Question 15

Enoxaparin Doses

Answer 15

Based off age & weight- see chart

Question 16

Enoxaparin Onset

Answer 16

10-30min

Question 17

Enoxaparin Duration

Answer 17

12-24hrs

Question 18

Enoxaparin Adverse Effect

Answer 18

Increased bleeding

Question 19

Heparin MOA

Answer 19

Anticoagulant that potentiates activity of anti-thrombin III, inhibiting multiple coagulation factors

Question 20

Heparin Preparation

Answer 20

5000 units 0.2ml

Question 21

Heparin Indication

Answer 21

STEMI in conjunction with fibrinolytic therapy

Question 22

Heparin Contraindication

Answer 22

> 75yo

Question 23

Heparin Precaution

Answer 23

Clinically significant bleeding
At risk of bleeding
Pregnancy

Question 24

Heparin Dose

Answer 24

5000 units diluted to a total of 5-10mls IV bolus

Question 25

Heparin Onset

Answer 25

5-15min

Question 26

Heparin Duration

Answer 26

2-4hrs

Question 27

Heparin Adverse Effect

Answer 27

Increased bleeding

Question 28

Metoprolol MOA

Answer 28

Beta blocker that antagonizes beta1 receptors, decreasing HR, CO, and BP

Question 29

Metoprolol Preparation

Answer 29

5mg 5ml

Question 30

Metoprolol Indication

Answer 30

HTN prior to STEMI fibrinolytics

Question 31

Metoprolol Contraindications

Answer 31

Bradycardia | Hypotension

Question 32

Metoprolol Precautions

Answer 32

1st degree heart block Sick sinus syndrome without pacemaker 2nd or 3rd degree heart block without pacemaker Asthma/COPD/HF

Question 33

Metoprolol Dose

Answer 33

2.5mg IV

Question 34

Metoprolol Onset

Answer 34

2-3min

Question 35

Metoprolol Duration

Answer 35

1-2hrs

Question 36

Metoprolol Adverse Effects

Answer 36

Bradycardia Bronchospasm Hypotension

Question 37

Tenecteplase MOA

Answer 37

Fibrinolytic that accelerates the breakdown of blood clots and converts plasminogen into plasmin (active enzyme) that breaks down fibrin in clots

Question 38

Tenecteplase Dose

Answer 38

Based off age + weight, see chart

Question 39

Tenecteplase Onset

Answer 39

5-10min

Question 40

Tenecteplase Duration

Answer 40

2-6hrs

Question 41

Tenecteplase Preparation

Answer 41

50mg powder

Question 42

Tenecteplase Indication

Answer 42

STEMI in conjunction with fibrinolytic therapy

Question 43

Tenecteplase Contraindications

Answer 43

``` Suspected aortic dissection Major surgery/trauma/TBI 6/52 Intracranial surgery within 6/12 Ischaemic CVA within 6/12 Previous Intracerebral Bleed Known cerebral aneurysm/malformation/tumor ```

Question 44

Tenecteplase Precautions

Answer 44

``` Clinically significant bleeding >10min CPR Vascular puncture within 24hrs Internal bleed within 6/52 Lumbar puncture within 6/52 TIA within 3/12 Known bleeding disorder Anticoagulant SBP >180 or DBP >110 Pregnant or <2/52 post partum Onset of sxs >12hrs Dependant activities daily living Comorbidity shortening life Frail ```

Question 45

Tenecteplase Adverse Effects

Answer 45

Increased bleeding | Dysrhythmia