Antiplatelets Carey Lecture

Question 1

How does aspirin work?

Answer 1

• Inhibits COX enzyme

- COX is responsible for prostaglandin and TXA2 synthesis

Question 2

What are the ADP P2Y12 receptor inhibitors?

Answer 2

• Clopiogrel
• Prasugrel
• Ticagrelor

Question 3

When should prasugrel dose be reduced?

Answer 3

If weight is less than 60 kg

Question 4

When is prasugrel contraindicated?

Answer 4

• 75+ yo (unless they have DM or previous MI)

- Previous stroke/TIA

Question 5

How does dipyridamole work?

Answer 5

Inhibits adenosine and PDE (preventing platelet activation)

Question 6

Aside from bleeding, what is another ADE of dipyridamole?

Answer 6

Headache

Question 7

How does cilostazol work?

Answer 7

Inhibits PDE3 (preventing platelet activation)

Question 8

How do GP IIb/IIIa inhibitors work?

Answer 8

Prevent platelets from crosslinking with fibrinogen

Question 9

When should eptifibatide be reduced? When is it contraindicated?

Answer 9

• Reduce if CrCl less than 50

- Avoid in ESRD

Question 10

How does vorapaxar work?

Answer 10

Inhibits PAR-1 to prevent platelet aggregation

Question 11

How is Vorapaxar given?

Answer 11

ONLY used with aspirin or clopidogrel

Question 12

When is vorapaxar contraindicated?

Answer 12

Previous stroke/TIA or active bleeding

Question 13

How do fibrinolytics work?

Answer 13

Convert plasminogen to plasmin to break up fibrin

Question 14

When is alteplase (tPA) given in MI?

Answer 14

• Only for STEMI

- If no PCI performed within 30 minutes

Question 15

What is the treatment of acute ischemic stroke?

Answer 15

• IV t-PA

- Aspirin 325 mg daily

Question 16

If IV t-PA is given to a patient, how long should you wait before starting daily aspirin?

Answer 16

24 hours