Chemoprevention

Question 1

Which pathway does Aspirin have the greatest affect on?

Answer 1

COX-1

Question 2

Aspirin inhibits Prostaglandin H2 production which in turns

Answer 2

decreases Thromboxane and Prostacyclin

Question 3

What is the role of thromboxane A2?

Answer 3

platelet aggregation (vasoconstriction)

Question 4

What is the role of prostacyclin?

Answer 4

decrease platelet aggregation (vasodilation)

Question 5

What effect does aspirin have on platelets and vascular endothelium

Answer 5

permanent effect

and transient effect

Question 6

Why is there not a long term problem w/ aspirin?

Answer 6

because vascular endothelium adapts and starts to reproduce prostacycins 1-2dys

Question 7

Aspirin significantly reduced the risk of what in men?

Answer 7

1st MI

Question 8

When is there a increased risk of clotting due to taking aspirin?

Answer 8

When first taken

Question 9

What is theory concerning ASA?

Answer 9

if taken on a regular basis, might shift to pro-antiaggregatory system favoring inhibition of platelet aggregation

Question 10

What kind of study was the Physicians Health Study of 1989?

Answer 10

randomized double blind, placebo controlled trial

Question 11

Men took what dosage of aspirin in the PHS study?

Answer 11

325mg every other day for 5 yrs

Question 12

Decrease in MI occurred the greatest in what group?

Answer 12

men > 50 yr

Question 13

Decrease in MI occurred the smallest in what group?

Answer 13

men < 50yr

Question 14

ASA did not ?? in men

Answer 14

decrease risk of 2nd MI

Question 15

In the PHS what did ASA increase the risk of …

Answer 15

Hemorrhagic stroke (but no effect on overall mortality)

Question 16

What is the most common bleeding disorder seen in ASA?

Answer 16

Hemorrhagic

Question 17

What is the recommend guideline of ASA for men?

Answer 17

low dose for men w/ hyperlipidemia, HTN

Question 18

High doses of ASA can cause?

Answer 18

GI ulcers

Question 19

What dosage of ASA is used in the Women’s Health Study

Answer 19

100mg every other day or placebo for 10 yrs

Question 20

In the WHS study ASA was shown to..

Answer 20

NOT decrease risk of MI, CVA & cv Death

Question 21

A decrease risk in CV events in women ??? yr

Answer 21

> over 65yr

Question 22

ASA did what to the risk of ischemic stroke in WHS

Answer 22

decreased risk of stroke

Question 23

What was the overall positive effect of ASA in WHS?

Answer 23

decreased stroke no effect on MI

Question 24

What was the overall positive effect of ASA in PHS?

Answer 24

decreased MI no effect on CVA

Question 25

What is the recommend guidelines on ASA for women?

Answer 25

women over >65

Question 26

ASA did not do what in WHS?

Answer 26

reduce the risk of MI, CVA, and CV death

Question 27

What is the recommended dose for ASA?

Answer 27

81 mg

Question 28

What dose of aspirin is very effective but has the highest side effect

Answer 28

> 75mg

Question 29

Taking more aspirin pills will just

Answer 29

increase side effects

Question 30

Primary prevention trials show that ASA is actually

Answer 30

has LITTLE TO NO additional benefit for prevention of CV events

Question 31

T/F taking statins works better than aspirin?

Answer 31

TRUE

Question 32

T/F aspirin should not be used for primary prevention of CV?

Answer 32

TRUE