16: Drugs for PAD and DVT

Question 1

PAD: Peripheral artery disease

Answer 1

narrowed arteries -> reduced blood flow to limbs -> claudication (leg pain with walking)

Question 2

sx of PAD

Answer 2

1. painful cramps in hips, thighs or calves after certain activities
2. numbness, weakness, weak pulses, coldness
3. skin changes: shiny, hair loss, slow toenail growth
4. sores on feet/legs that dont heal
5. ED in men

Question 3

most common cause of PAD

Answer 3

atherosclerosis

Question 4

RFs of PAD

Answer 4

smoking**, DM, obesity, HTN, HLD, age 50+, FHx PAD/CAD/CVA, high homocysteine

Question 5

critical limb ischemia

Answer 5

sores that dont heal -> tissue gangrene -> may require amputation of affected limb

Question 6

prevention of PAD

Answer 6

1. stop smoking
2. exercise regularly
3. control comorbidities
4. avoid vasoconstricting drugs

Question 7

ankle-brachial index

Answer 7

ratio of BP in ankle:arm

Question 8

normal range for ankle-brachial index

Answer 8

1 - 1.4

Question 9

the one drug used for PAD

Answer 9

cilostazol

Question 10

three groups of drugs that interact with warfarin

Answer 10

1. drugs that increase warfarin effects: inhibit degradation / decrease clotting factor synthesis
2. drugs that promote bleeding
3. drugs that decrease warfarin effects: oral contraceptives, vit K, etc.

Question 11

two blood tests to monitor heparin levels

Answer 11

aPTT, anti-Xa

Question 12

blood test to monitor warfarin level

Answer 12

INR

Question 13

blood test to monitor DOAC factor Xa inhibitors

Answer 13

anti-Xa

Question 14

blood test to measure DOAC direct thrombin inhbitor levels

Answer 14

TT (thrombin time)