Medication

Question 1

Characteristics of Aspirin

Answer 1

irreversible COX inhibitor

limits thromboxane 2 production

Question 2

Characteristics of Clopidogrel

Answer 2

prasurgel (thienpyridine)
ticagrelor
Plavix
ADP receptor inhibitor
prevents activation of GPIIa/IIIb

Question 3

what is Abciximab

Answer 3

GPIIa/IIIb RC inhibitor

Question 4

What are the GPIIa/IIIb RC inhibitors?

Answer 4

Abciximab (ReoPro), Eptifibatide (Integrillin), Tirofiban (Aggrastat)

Question 5

GPIIa/IIIb RC inhibitors characteristics

Answer 5

inhibit binding of fibrinogen to vW factor

Question 6

Characteristics of Pletal

Answer 6

cilostazol
phosphodiesterase inhibitor
increases cAMP
decreases platelet aggregation

Question 7

characteristics of Pentoxifiline

Answer 7

increases RBC deformability

decreases viscosity

Question 8

What does Jupiter trial say?

Answer 8

20mg rosuvastatin
decreased the risk of stroke, MI and need for CABG by 44%
total mortality decreased by 20%

Question 9

What does CAPRIE trial say?

Answer 9

75 Plavix vs 325 Aspirin
Plavix more effective in total
Individually Plavix more effective in everything aside from MI

Question 10

What does HOPE study say?

Answer 10

22% risk reduction in cardiovascular events in patients taking ramipril

Question 11

what does warfarin augments

Answer 11

hypoglycemia
aminoglycoside
cipro
metronidazole
omeprazole

Question 12

what does warfarin inhibits

Answer 12

haldol
spironolactone
cyclosporin
barbiturates

Question 13

Characteristics of Apixaban

Answer 13

Eliquis
direct factor Xa inhibitor
stroke prevention and atrial fibrillation and DVT treatment
Peak effect 1-3h
half-life 8-14h
oxidative, intestinal and renal (25%) elimination
Cannot give in ESRD

Question 14

Characteristics of Rivaroxaban

Answer 14

Xarelto
factor Xa inhibitor
stroke prevention with AF and VTE prophylaxis after ortho surgery
DVT treatment 
half-life 7-11h
Peak effect 2-4h
2/3 kidney and 1/3 liver exctretion
Not recommended for ESRD patients (risk of accumulation)

Question 15

Characteristics of Dabigatran

Answer 15

Pradaxa
thrombin (factor II) inhibitor
stroke prevention in AF and treatment of DVT
halflife 14-17h
80% kidney excretion
Peak effect 1-3h
Removed by dialysis (65%) but concentration rebounds as drug reequilibrates

Question 16

Characteristics of Heparin

Answer 16

polysacharide
increases affinity of antithrombin to thrombin
halflife 60 min
cleared by endothelium and macrophages

Question 17

Characteristics of low molecular weight heparin

Answer 17

UFH enzymatically depolarized
halflife 6h
renal clearance

Question 18

Characteristics of Argatroban

Answer 18

direct thrombin inhibitor
hepatic metabolism mainly (22% in kidneys though)
halflife 45 min
Indications: HIT, PCI
Peak effect 1-3h

Question 19

Characteristics of Bivalirudin

Answer 19

direct thrombin inhibitor
halflife 25 min
limited renal clearance
Indication: unstable angina, NSTEMI, PCI with or without HIT
Can give IV or SC
Peak effect 1-3h

Question 20

Characteristics of Lepirudine

Answer 20

direct thrombin inhibitor
halflife 60 min
renal clearance

Question 21

tPA half life

Answer 21

4-5 min

Question 22

what does ADVANCE trial say?

Answer 22

Apixiban vs 30 BID and 40qd Lovenox in DVT prevention in knee and hip replacement
NON inferior

Question 23

RECORD trial

Answer 23

Rivaroxiban vs Lovenox in hip and knee replacement. Rivaroxibam superior in 30 day prophilaxis in hip. Noninferior in knee

Question 24

EINSTEIN trial

Answer 24

Rivaroxiban vs standrd anticoagulation in treatment of acute DVT
outcome measured was recurrent DVT
result: noninferior

Question 25

RE-MODEL, RE-NOVATE, RE-MOBILIZE, RE-COVER

Answer 25

Dabigatran vs different doses of prophilactic Lovenox in knee and hip replacement. All showed noninferiority

Question 26

characteristics of Edoxaban

Answer 26

Savaysa stroke prevention in a.fib patients without valvular disease and DVT treatment after 5-10 days of parenteral @coagulation blackbox warning - if patients have normal creatinine clearance, the drug does not work properly Peak effect 1-3h Half life 9-11h 50% renal clearance

Question 27

Fondaparineux characteristics

Answer 27

``` Indication: DVT prophylaxis after Ortho and abd surgery, treatment of DVT/PE subcutaneous administration Peak effect 2-3h Half life 17-21h Rental clearance as primary rout ```

Question 28

What does PCC work for

Answer 28

Rivaroxaban or Alicia not

Question 29

What works for dabigatan

Answer 29

Antibody | Activated pcc

Question 30

Ab for pradaxa

Answer 30

Idarucizumab

Question 31

SPRINT trial

Answer 31

Lowering BP goal to 120mmHg decreased CV death by 43%. Also significant reduction in all cause mortality and incidence of stroke and MI

Question 32

What’s Vorapax

Answer 32

Protease activator receptor-1 inhibitor (platelet thrombin receptor)

Question 33

ACC/AHA guidelines for PAD

Answer 33

Smoking cessation Platelet inhibition Statins ACE inhibitor