End of Misc Cardiac Flashcards
what is the father of anti platelets
aspirin
name the two first generation anti platelet drugs
Ticlopidine
Clopridogrel
adverse effects of ticlopidine
neutropenia
thrombocytopenia
what a/e with clopidogrel?
potential Proton pump inhibitor interaction, results in reduced efficacy
what are the 2nd generation anti platelet agents?
prasurgel
ticagrelor
what is the benefit of prasugrel?
no ppi interactions
QD
benefit of ticagrelor
BID
faster shorter so quicker reversibility if you have to take the patient to surgery.
SHORT ON SHORT OFF
NO PPI interaction
Unfractioned Heparin
derived from what?
activated what?
administered how?
porcine derived
activates antithrombin 3
inhibits 9a 10a 12a
IV or SQ ONLY (no po)
indications for unfractioned heparin?
venous thrombosis
pulmonary embolism
bridge to warfarin
other cardiovascular disease states
how do you monitor unfractioned heparin?
aPTT
does unfractioned heparin used in pregnant patients?
yes does not cross placenta
standard dose of unfractioned heparin
80 u /kg load
18 u/kg/he
what are the two indications for anti platelet agents
post stent
stroke
What is unfractioned heparin antidote?
IV protamine (1 mg for every 80-100 units of heparin)
Beware! salmon semen (allergy risk)
What is the risk with unfractioned heparin?
Heparin induced thrombocytopenia (HIT)
decreased platelets when heparin binds to platelet, body immune system destroys it
Under 100K worry, Under 50K bad
How is LMWH administered? Eliminated?
SQ
Renal elimination
Whats the benefit of LMWH?
more predictable
Use caution in what patients for LMWH?
> 150 kg, standard dose not standard
Pregnant patients- more likely to cross placenta
What is LMWH antidote?
IV Protamine
*only blocks 60% of anti Xa activity
What is Nesiritide used for? Administered how? Caution with what? What is it?
IV
Acute decompensated CHF with dyspnea at rest
Peptide so do not shake preparation
B-type natriuretic peptide analogue, so increases concentration of peptides
How does dopamine effect the body? 3 things
Renal artery vasodilation (increases urine) B1 agonist (treat bradycardia, CHF) A1 agonist (vasoconstricts, treat hypotension)
positive inotrope
What are doses for R B A?
2-5 mcg/kg/min
5-10 mcg/kg/min
>10 mcg/kg/min
What is dobutamine? used for what?
B1 agonist
decompensated CHF
Glycoprotein IIB & IIIA antagonists are administered how?
UV
