Antiplatelets

Question 1

Antiplatelet drugs inhibit thrombus formation in veins or arteries?

Answer 1

Arteries ( in fast flowing circulation the thrombi are composed of platelets)

Question 2

Is aspirin recommended in primary prevention of CV?

Answer 2

No evidence of this with or without diabetes.

There is only evidence in established CV diseases.

Question 3

Before aspirin is given what should be controlled?

What else could you consider prescribing with it?

Answer 3

Control high BP

consider PPI if at risk of GI bleed

Question 4

For NSTEMI how long should we dual antiplatelet for?

Answer 4

12 months (most benefit in first three months )

Question 5

What dual antiplatelet is given post PCI

For how long

Answer 5

Aspirin indefinitely
Clopidogrel for 1 month if elective
For 12 months if as a result of ACS
12 months for drug eluding stent

Question 6

Indications for dipyrimidole 3

Answer 6

Diagnostic procedures
Prophylaxis of thromboembolism following prosthetic heart valves
Secondary prevention of stroke/TIA

Question 7

Use of epoprostenol (2)

More of action

Answer 7

Inhibit platelets aggregation during renal dialysis when heparin are contraindicated
& for pulmonary hypertension

• potent vasodilator & glycoprotein inhibitor

(duration of action 3 mins therefore continuous IV infusion)

Question 8

Abciximab, epitifbatide and tirofiban are…. Mode of action

Answer 8

Glycoprotein IIb/IIIa inhibitors - prevent platelet aggregation by blocking binding fibrinogen receptors to platelets

(Specialist use)

Question 9

Why should abiciximab only b used once

Answer 9

Risk of thrombocytopenia