Anticoagulant and Antiplatelet Drugs

Question 1

Plavix is the brand name for _________. How does it work?

Answer 1

clopidogrel; it is an ADP receptor antagonist

Question 2

Rivaroxaban and enoxaparin inhibit _________.

Answer 2

Xa (think of the xa in the middle of each)

Question 3

Dabigatran inhibits __________.

Answer 3

thrombin (the big clotting factor)

Question 4

Which types of heparin can inhibit both thrombin and Xa?

Answer 4

Unfractionated (think, the x in fondaparinux stands for only Xa)

Question 5

Low-molecular weight heparin is ________ eliminated.

Answer 5

renally

Question 6

__________ is a potential adverse side effect of heparin treatment in those with thrombocytopenia.

Answer 6

Platelet activation with thromboemboli

Question 7

There are also vitamin-K dependent enzymes involved in bone production, so one side effect of warfarin is ____________.

Answer 7

osteoporosis

Question 8

Cholestyramine decreases the effect of warfarin by ____________.

Answer 8

binding it in the gut (it steers [styrs] warfarin to the colon [cholon])

Question 9

Dabigatran is administered as a ___________.

Answer 9

prodrug

Question 10

What is the antidote for warfarin?

Answer 10

Vitamin K and decreasing the dose of warfarin

Question 11

What is PCI?

Answer 11

Percutaneous intervention

Question 12

What are the three plasminogen activators?

Answer 12

Renecteplase, alteplase, and tenecteplase

Question 13

Primary prevention of an MI is done with ________.

Answer 13

aspirin

Question 14

Secondary prevention of an MI is done with ___________.

Answer 14

aspirin for a recent stroke (clopidogrel added if they had an ischemic stroke)

Question 15

Those with UA, NSTEMI, STEMI, and PCI all receive ___________.

Answer 15

aspirin, clopidogrel, heparin, and sometimes a GPIIb/IIIa inhibitor

Question 16

How does Russell viper venom work?

Answer 16

It directly activates factor X,

Question 17

Dabigatran can be inhibited with __________.

Answer 17

a monoclonal antibody called idarucizumab

Question 18

Of the three factor Xa inhibitors, __________ is the one that is most cleared renally.

Answer 18

edoxaban

Question 19

Direct anticoagulants are generally over warfarin for ____________.

Answer 19

nonvalvular atrial fibrillation

Question 20

Why does aspirin preferentially affect COX-1 in circulating platelets over COX-2 in endothelial cells?

Answer 20

Aspirin gets concentrated in the portal vein; thus, it washes over circulating platelets but does not touch many of the endothelial cells.

Question 21

Name some GPIIb/IIIa inhibitors.

Answer 21

Abciximab, tirofiban, and eptifibatide

Question 22

Explain CHADS2.

Answer 22

It is a chart indicating need to treat with anticoagulation in patients with atrial fibrillation: CHF, HTN, Age >75, Diabetes, and Stroke. All count for one, except stroke which counts for two. Any score greater than or equal to two indicates anticoagulation treatment.