pharm- 9-24- Antiplatelet Rx

Question 1

A: Antiplatelet drugs decreases platelet _____, _____ and _____ thereby inhibit thrombus formation.

B: Where do these drugs function compared to [Heparin and Oral anticoagula]?

Answer 1

A: Antiplatelet drugs decreases platelet adhesion, activation and aggregation thereby inhibit thrombus formation.

B: These drugs are effective in the arterial circulation, where anticoagulants such as heparin and [oral anticoagulants] have relatively little effect

Question 2

Aspirin

A: MOA

B: Route of Administration

Answer 2

A: COX inhibitor

B: Oral

Question 3

Aspirin

A: Indications (3)

B: Adverse Effects (2)

Answer 3

A:

1) ACS
2) Stroke
3) Arterial Thrombosis

B:

(x) Bleeding
(x) Gastric Irritation

Question 4

Clopidogrel

A: MOA

B: Route of Adminsitration

Answer 4

A: [ADP receptor Blocker]–> Prevents Platelet Aggregation

B: ORAL

Question 5

Clopidogrel

A: Indications (3)

B: Side Effects (2)

C: Prodrug?

Answer 5

A:

1) ACS
2) Stroke
3) [in stent thrombosis]

B:

(x) Bleeding
(x) TTP

C: YES, PRODRUG

Question 6

Prasugrel

A: MOA

B: Route of Adminsitration

Answer 6

A: [ADP receptor Blocker]–> Prevents Platelet Aggregation​

B: ORAL

Question 7

Prasugrel

A: Indications (3)

B: Side Effects

C: Prodrug?

Answer 7

A:

1) ACS
2) Stroke
3) [in stent thrombosis]

B:

(x) Bleeding

C: YES, PRODRUG

Question 8

Ticagrelor

A: Indications (3)

B: Side Effects

C: Prodrug?

Answer 8

A:

1) ACS
2) Stroke
3) [in stent thrombosis]

B:

(x) Bleeding

C: No

Question 9

Ticagrelor

A: MOA

B: Route of Adminsitration

Answer 9

A: [ADP receptor Blocker]–> Prevents Platelet Aggregation

B: ORAL

Question 10

NSAIDs

A: MOA

B: Route of Adminsitration

Answer 10

A: COX inhibitor

B: ORAL

Question 11

Dipyridamole

A: MOA

B: Route of Adminsitration

Answer 11

A: Phosphodiesterase Inhibitor

B: ORAL

Question 12

Cilostazol

A: MOA

B: Route of Adminsitration

Answer 12

A: Phosphodiesterase inhibitor

B: ORAL

Question 13

Abciximab

A: MOA

B: Route of Adminsitration

Answer 13

A: [GP-2b-3A] inhibitor

B: IV

Question 14

EpTifiBatide

A: MOA

B: Route of Adminsitration

Answer 14

A: [GP-2b-3A] inhibitor

B: IV

Question 15

Tirofiban

A: MOA

B: Route of Adminsitration

Answer 15

A: [GP-2b-3A] inhibitor

B: IV

Question 16

NSAIDs

A: Indications

B: Adverse Effects

Answer 16

A: Various Dz

B:

(x) Bleeding

Question 17

Dipyridamole

A: Indications (2)

B: Adverse Effects (2)

Answer 17

A:

1) Stroke
2) Arterial Thrombosis (Open Heart Surgery)

B:

(x) Bleeding
(x) Potentiates Adenosine

Question 18

Cilostazol

A: Indications

B: Adverse Effects

Answer 18

A:

Intermittent Claudication

B:

(x) hypOtension

Question 19

Abciximab

A: Indications (2)

B: Adverse Effects

Answer 19

” PA ATE his 2B/3A inhibitors”

(PCI and ACS can be treated with [Abciximab/Tirofiban/EpTifiBatide] since they’re 2B/3A inhibitors )

A:

1) ACS
2) PCI

B:

(x) Bleeding

Question 20

EpiTifiBatide

A: Indications (2)

B: Adverse Effects

Answer 20

” PA ATE his 2B/3A inhibitors”

(PCI and ACS can be treated with [Abciximab/Tirofiban/EpTifiBatide] since they’re 2B/3A inhibitors )

A:

1) ACS
2) PCI

B:

(x) Bleeding

Question 21

Tirofiban

A: Indications (2)

B: Adverse Effects

Answer 21

” PA ATE his 2B/3A inhibitors”

(PCI and ACS can be treated with [Abciximab/Tirofiban/EpTifiBatide] since they’re 2B/3A inhibitors )

A:

1) ACS
2) PCI

B:

(x) Bleeding

Question 22

Which Dual Antiplatelet therapy is the Hallmark of Cardiovasulcar Disease Tx?

Answer 22

Aspirin + [ADP receptor inhibitor]

Question 23

2 Small Vessel Diseases that are treated with antiplatelet drugs

Answer 23

1. [Membrane Proliferative Glomerulonephritis]
2. [Thrombotic Thrombocytopenic purpura]

Question 24

4 Drugs that have Interactions with Antiplatelet Drugs

Answer 24

Drug interactions with antiplatelet agents:

1. Thrombolytic agents (urokinase, streptokinase and tissue plasminogen activator).
2. Heparin and LMW heparin
3. [oral anticoagulants]
4. Antithrombin agents (hirudin, bivalirudin and argatroban)

Question 25

* Arachidonic acid is metabolized by two major pathways:* * Cyclooxygenase pathway* * Lipoxygenase pathway* **Describe the Cyclooxygenase Pathway**

Answer 25

Consist of COX1 and COX2 which converts [Arachidonic Acid from phospholipid membrane] into either: \* [Thromboxane TXA2] \* [Prostacyclin PGi2] \*[Prostaglandin PGE2]

Question 26

* Arachidonic acid is metabolized by two major pathways:* * Cyclooxygenase pathway* * Lipoxygenase pathway* **Describe the Lipooxygenase Pathway**

Answer 26

Consist of [Non-Heme but iron containing DiOxygenases] which convert [Arachidonic Acid from phospholipid membrane] into: \*_Leukotrienes_ --\> _Inflammation_ \*HETE \*H**PETE**

Question 27

**Montelukast** A: MOA B: Route of Administration

Answer 27

A: Leukotriene Receptor Inhibitor B: Oral

Question 28

**ZafirLeukast** A: MOA B: Route of Administration

Answer 28

A: Leukotriene Receptor Inhibitor B: Oral

Question 29

**Zileuton** A: MOA B: Route of Administration

Answer 29

A: Lipoxygenase inhibitor B: Oral

Question 30

**Monteleukast** A: Indications (3) B: Adverse Effects (2)

Answer 30

A: 1) Allergic rxn 2) Asthma 3) Seasonal Allergies B: (x) hypOtension (x) Behavioral Changes

Question 31

**ZafirLeukast** A: Indications B: Adverse Effects

Answer 31

A: 1) Asthma B: (x) hypOtension

Question 32

**Zieuton** A: Indications B: Adverse Effects

Answer 32

A: 1) Asthma B: (x) hypOtension

Question 33

3 Steps for *Plate Aggregation Assay* B: Between primary and secondary aggregation, which should have a greater OD?

Answer 33

1. Prepare PRP 2. Activate Platelets by adding [PRP + **RATE** (**R**istocetin/ **A**DP/ **T**RAP/ **E**Pi)] 3. Measure Light Transmittance (*OD*) **(HIGH LIGHT SHINING THRU = Platelet Aggregation)** B: **PRIMARY AGGREGATION WILL HAVE HIGHER OD**

Question 34

A: List the 3 ACtive ingredients in [Omega-3-fatty acid Fish Oil] B: MOA for antiplatelet action (2)

Answer 34

Active ingredients (Omega-3 fatty acid): = **DEA** **α**-linolenic acid **E**icosapentaenoic acid **D**ocosahexaenoic acid B: Has membrane effects and forms [**inactive** Thromboxane A3] --\> DEC Platelets