Antithrombotic Drugs

Question 1

venous thrombi define

Answer 1

fibrin and trapped RBC with FEW PLATELETS

Question 2

arterial thrombi

Answer 2

platelet aggregates with small fibrin

Question 3

anticoag, antiplatelet or both

afib

Answer 3

yes both PO

Question 4

anticoag, antiplatelet or both

primary/secondary prevention ACS

Answer 4

only platelet PO

Question 5

anticoag, antiplatelet or both

unstable angina/NSTEMI

Answer 5

+/- IV anticoag

Yes antiplatelet PO

Question 6

anticoag, antiplatelet or both

acute MI (STEMI)

Answer 6

yes both

anticoag IV
antiplatelet PO

Question 7

anticoag, antiplatelet or both

PCI

Answer 7

yes both IV

Question 8

anticoag, antiplatelet or both

VTE treatment or prevent

Answer 8

only anticoag

Question 9

Platelet and coag cascade

Answer 9

1) wall defect
2) adhesion based on Gp1A/1B
3) release of ADP/TXA2 to activate expression of Gp2b/3a for aggregation

Question 10

Half life of heparin is ____

Answer 10

dose dependent (zero order)

Question 11

___ infusion preferred for heparin

Answer 11

continuous infusion

Question 12

LMW heparins have ___ durations (___ dosing)

Answer 12

longer duration

once-twice daily dosing

Question 13

LMW heparins have ___ renal elimination kinetics

Answer 13

first order

Question 14

LMW heparins can be dosed on

Answer 14

mg/kg if normal renal function

Question 15

non-vitamin K oral anticoags

Answer 15

1) dabigatran
2) rivaroxaban
3) apixaban
4) edoxaban

Question 16

lab test for intrinsic pathways

Answer 16

aptt

Question 17

lab test for extrinsic pathway

Answer 17

PT–> INR

Question 18

incr vitamin K, ____ effect of warfarin

Answer 18

decr

Question 19

NOAC preferred over warfarin for ____

Answer 19

nonvalvular Afib

Question 20

concerns with warfarin relative to NOAC (4)

Answer 20

1) variability in dosage requirements
2) dietary restrictions related to vit K
3) need for close monitoring to maintain INR
4) DDI

Question 21

warfarin should be used with

Answer 21

Afib assoc with
1) mech/bioprosth valve

2) mitral repair or mitral stenosis

Question 22

warfarin is reasonable choice for (4)

Answer 22

1) unlikely to comply with BID dosing (dabigatrain) and once daily NOAC not availabl
2) chronic kidney disease
3) cost is concern