antiplatelets

Question 1

MOA

Answer 1

decrease platelet aggregation and inhibit thrombus formation in the arterial circulation, because in faster-flowing vessels, thrombi are composed mainly of platelets with little fibrin.

Question 2

Should you use aspirin for primary prevention of CVD

Answer 2

Use of aspirin in primary prevention of cardiovascular disease, in patients with or without diabetes, or hypertension, is not recommended.

Question 3

When is long term use of low dose aspirin recommended

Answer 3

Long-term use of low-dose aspirin is recommended in patients with established cardiovascular disease (secondary prevention);

unduly high blood pressure must be controlled before aspirin is given.

If the patient is at a high risk of gastro-intestinal bleeding, a proton pump inhibitor can be added.

Question 4

MOA glycoprotein inhibitors

Answer 4

Glycoprotein IIb/IIIa inhibitors prevent platelet aggregation by blocking the binding of fibrinogen to receptors on platelets.

Question 5

If anti platelet effect not desirable, discontinue clopidogrel … days before surgery

Answer 5

7 days

Question 6

Clopidogrel in P/BF

Answer 6

avoid

Question 7

Name the drugs that you need to avoid with clopidogrel because they reduce its efficacy

Answer 7

Esomeprazole, fluconazole, voriconazole fluoxetine, fluvoxamine, grapefruit, moclobemide

Question 8

Avoid these AD drugs because they reduce efficacy of clopidogrel

Answer 8

fluoxetine
fluvoxamine

Question 9

Interaction with vortioxetine and clopidogrel

Answer 9

Increased bleeding risk

Question 10

Do not use in children under 16 (aspirin)

Answer 10

Reyes syndrome UNLESS Specifically indicated e.g. Kawasaki disease

Question 11

When can aspirin be given to <16

Answer 11

Kawasaki disease

Question 12

G6PD deficiency - possible risk of haemolysis in some pt with this drug

Answer 12

Aspirin

Question 13

Use of aspirin and pregnancy and breastt feeding

Answer 13

Avoid if possible in pregnancy
Avoid in BF - Reyes & regular use of high doses could impair platelet function and produce hypoprothimbinaemia in infant if neonatal vit K stores low

Question 14

Rx comes in for aspirin but no strength stated. What do you do

Answer 14

BP directs that when no strength is stated the 300 mg strength should be dispensed, and that when soluble aspirin tablets are prescribed, dispersible aspirin tablets shall be dispensed.

Question 15

Aspirin - sold to the public

Answer 15

Can be sold to the public provided packs contain no more than 32 capsules or tablets; pharmacists can sell multiple packs up to a total quantity of 100 capsules or tablets in justifiable circumstances.