antiplatelet medications

Question 1

What are the 4 antiplatelet meds to know?

Answer 1

• ASA
• clopidogrel (plavix)
• prasugrel (Effient)
• ticagrelor (Brillinta)

Question 2

How does ASA work?

Answer 2

inhibits platelet adhesion & aggregation by blocking COX-1

Question 3

How do clopidogrel, ticagrelor. & prasugrel work?

Answer 3

• P2Y12 inhibitors - block ADP-stimulated platelet activation hindering clot formation
• block receptor sites on the platelet which keep them from sticking

Question 4

What are the indications for ASA?

Answer 4

• CAD/CVA/PAD prevention
• post MI
• post ischemic stroke, TIA
• post stent placement
• other vascular disease
• maintains AV grafts for dialysis

Question 5

ASA is _______ bound to plasma proteins

Answer 5

highly

Question 6

How long can one 325mg dose of ASA inhibit platelet aggregation for?

Answer 6

a single dose of ASA can inhibit aggregation for the life of the platelet (about 7 days)
- can take effect in 15 minutes

Question 7

When should a pt generally stop taking ASA before surgery?

Answer 7

should be stopped at least 1 week before surgery (will require clearance from prescriber)

Question 8

When ASA is used as an anti-platlet what is the typical dose?

Answer 8

81mg (baby asprin)

Question 9

What are side effects of ASA?

Answer 9

• GI side effects including bleeding, ulcers, & gastritis
• tinnitus
• toxicity that can lead to metabolic acidosis & death

Question 10

What are nursing considerations for ASA

Answer 10

• assess for bleeding
• use cautiously with renal patients
• do not use in those under 18

Question 11

What are drug interactions with ASA?

Answer 11

• steroids may decrease effect & cause ulcers
• NSAIDS
• other anticoagulants

Question 12

What should you teach patients taking ASA?

Answer 12

• soft toothbrush
• electric razor
• always take with food
• watch ETOH intake
• do not chew enteric coated tablet
• keep out of reach from children

Question 13

What are clopidogrel and dipyridamole known as and what do they do?

Answer 13

known as ADP (adenosine diphosephate antagonists) which inhbit platelet aggregation

Question 14

What is clopidogrel often combined with?

Answer 14

ASA

Question 15

When are other antiplatelets indicated?

Answer 15

• post stent
• post MI
• in some non-cardiac stenting procedures

Question 16

how long does it take for clopidogrel to begin working?

Answer 16

will take effect in 24-48 hours but not be therapeutic for 4-5 days

Question 17

How long does clopidogrel need to be stopped for platelets to begin to function again?

Answer 17

needs to be stopped for 5-7 days until platelets begin to function again