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Rotation Prep Mod 3 > Antiplatelet Agents > Flashcards

Antiplatelet Agents Flashcards

1
Q

What is the drug interaction that occurs when ibuprofen is taken before aspirin?

A

Ibuprofen significantly reduces the magnitude and duration of platelet inhibition expected from aspirin

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2
Q

If someone takes ibuprofen first how long should they wait to take aspirin?

A

8 hrs

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3
Q

If someone takes aspirin first, how long should they wait to take ibuprofen?

A

30 minutes to 2 hours

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4
Q

What is the estimated percentage of the general population estimated to be ASA non-responders?

A

20%

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5
Q

Which medications increase the risk of a patient being an aspirin non-responder

A

NSAIDs and dipyridamole

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6
Q

Which medication is associated with decreased risk of aspirin non-responsiveness

A

clopidogrel

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7
Q

Plavix Class

A

P2Y12 antagonist / antiplatelet agent

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8
Q

Plavix dosing for Ischemic stroke/ TIA

A

DAPT: 600mg once -> 75mg daily for 90 days -> dc clopidogrel and continue ASA

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9
Q

Plavix dosing for STEMI/NSTEMI

A

600mg once -> 75mg daily for >/= 12 months

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10
Q

Plavix altered kidney function dosing

A

no adjustment necessary

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11
Q

Plavix (clopidogrel) altered liver function dosing

A

no adjustment necessary

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12
Q

Plavix (clopidogrel) pediatric dosing

A
  • infants and children < 24 months: 0.2 mg/kg/dose once daily
  • children > 2yo and adolescents: 1 mg/kg/dose once daily
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13
Q

Plavix (clopidogrel) administration instructions

A

Take by mouth with or without food, but avoid / minimize grapefruit juice

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14
Q

Plavix (clopidogrel) contraindications

A
  • hypersensitivity
  • planned surgery (DC 24hrs to 5 days prior)
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15
Q

Plavix (clopidogrel) in pregnancy and lactation

A

limited human data, probably compatible

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16
Q

Plavix (clopidogrel) Serious ADE

A
  • bleeding
  • hypersensitivity
  • Thrombotic Thrombocytopenic Purpura (TTP)
    – skin reactions
    – neuro changes (dizziness, confusion, HA, seizure)
    – fever
17
Q

Plavix (clopidogrel) common ADE

A

bleeding

18
Q

Plavix (clopidogrel) DDI

A

CYP2C19 inhibitors
- omeprazole
- azole antifungals
- SSRIs
- Carbamazepine

19
Q

Plavix (clopidogrel) MOA

A

converted to active form by CYP2C19 -> active metabolite irreversibly blocks the P2Y12 component of ADP receptors on platelet surface

20
Q

Plavix (clopidogrel) onset of action

A

Loading dose: 2 hrs
No loading dose: 2 days

21
Q

Plavix (clopidogrel) time to peak effect

A

Loading dose: 6 hrs
No loading dose: 5-7 days

22
Q

Plavix (clopidogrel) duration of action

A

5 days

23
Q

Aspirin MOA

A

irreversible inhibition of platelet cyclooxygenase -> prevents production of Thromboxane A2

24
Q

Dipyridamole MOA

A

inhibits phosphodiesterase -> increased intracellular concentration of cAMP and cGMP -> reversibly inhibit platelet aggregation

25
Q

Aggrenox (ASA/dipyridamole) indications / dosing

A

Ischemic stroke / TIA secondary prevention
- 1 capsule (25mg / ER200 mg ASA/Dip) BID

26
Q

Aggrenox (ASA/dipyridamole) altered kidney function dosing

A

Avoid use in GFR < 10 mL/min

27
Q

Aggrenox (ASA/dipyridamole) hepatic impairment dosing

A

Avoid use in severe hepatic impairment

28
Q

Aggrenox (ASA/dipyridamole) administration

A

Take with or without food
do not crush or chew

29
Q

Aggrenox (ASA/dipyridamole) ADE

A
  • headache
  • abdominal pain
  • heart burn
  • nausea
  • diarrhea
30
Q

Aspirin Class

A

Antiplatelet agent, NSAID analgesic

31
Q

Aspirin dosing for analgesic/ antipyretic/ anti-inflammatory

A

325mg-1g Q4-6H IR

32
Q

Aspirin dosing for Stroke/TIA secondary prevention

A

75-325mg QD IR

33
Q

Aspirin dosing for STEMI/NSTEMI secondary prevention

A

81mg QD IR

34
Q

Aspirin altered kidney function dosing

A

Antiplatelet uses: no adjustment needed
Analgesia/ anti-inflammatory:
- CrCl < 10 avoid use

35
Q

Aspirin hepatic impairment dosing

A

avoid use in severe liver disease

36
Q

Aspirin administration

A

take with food/full glass of water to minimize GI sx

37
Q

Aspirin ADE

A
  • inc risk of GI bleed or ulcer
  • hypersensitivity
  • abdominal pain
  • nausea/vomiting
  • rectal irritation (w/suppositories)

Rotation Prep Mod 3 (4 decks)

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