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Pharmacology Spring 2021: Set 2 > Hematologic: Antiplatelets > Flashcards

Hematologic: Antiplatelets Flashcards

1
Q

What are antiplatelet drugs are used to treat?

A

To prevent arterial thromboembolism-particularly in patients at risk for:

  1. MI
  2. Stroke
  3. Arteriosclerosis (hardening of the arteries)
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2
Q

Generic names of antiplatelet drugs

A
  1. aspirin
  2. clopidogrel
  3. ticlopidine
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3
Q

How fast are antiplatelet drugs absorbed?

A

very quickly

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4
Q

When do antiplatelet drugs reach peak concentration?

A

1 and 2 hours

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5
Q

How long does aspirin maintain its antiplatelet effect?

A
  1. Approximately 10 days

2. Or as long as platelets normally survive.

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6
Q

How long does clopidogrel maintain its antiplatelet effect?

A

5 days

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7
Q

Pharmacodynamics Details

A

Antiplatelet drugs interfere with platelet activity in different drug specific and dosage-related ways.

SEE SPECIFIC DRUGS BELOW

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8
Q

Pharmacodynamics Details: aspirin

A

Low dosages of aspirin appear to inhibit clot formation by blocking the synthesis of prostaglandin, which in turn prevents formation of the platelet-aggregating substance thromboxane A2

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9
Q

Pharmacodynamics Details: Clopidogrel

A

Inhibits platelet aggregation by inhibiting platelet-fibrinogen binding.

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10
Q

Pharmacodynamics Details: Ticlopidine

A

Inhibits the binding of fibrinogen to platelets during thefirst stage of the clotting cascade.

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11
Q

Pharmacotherapeutics

A

Antiplatelet drugs have many different uses.

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12
Q

What is aspirin used to treat?

A

Previous MI or unstable angina
Men to reduce the risk of transient
ischemic attacks (TIAs; temporary reduction in circulation to the
brain).

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13
Q

Why is aspirin used in patients with previous MI or unstable angina?

A

Reduce risk of death

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14
Q

Why is aspirin used in Men?

A
  1. Reduce the risk of transient ischemic attacks (TIAs)

2. TIA-temporary reduction in circulation to the brain

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15
Q

What is Clopidogrel used to treat?

A
  1. Hx of a recent MI, stroke, or PAD

2. Acute coronary syndromes (esp. in patients who undergo percutaneous transluminal coronary angioplasty or CABG)

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16
Q

Why is Clopidogrel used in patients with Hx of a recent MI, stroke, or PAD?

A

reduce the risk of an ischemic stroke or

vascular death

17
Q

What is Ticlopidine used to treat?

A
  1. Reduce the risk of thrombotic stroke in high risk patients (TIAs)
  2. Patients who have already had a thrombotic stroke.
18
Q

When is Ticlopidine indicated? Why?

A
  1. Should only be used in patients who have not responded to or cannot use aspirin.
  2. Severe adverse effects
19
Q

Drug-drug interactions with antiplatelet drugs:

A
  1. NSAIDs
  2. heparin
  3. oral anticoagulants
  4. methotrexate
  5. valproicacid
  6. sulfinpyrazone (relieve signs and symptoms of gout)
  7. Antacids
20
Q

ANTIPLATELETS INTERACTION RATIONALE:

NSAIDs, heparin, or oral anticoagulants

A

increase the risk of bleeding

21
Q

ASPARIN INTERACTION RATIONALE:

methotrexate and valproicacid

A

increases the risk of toxicity of methotrexate and valproicacid.

22
Q

ASPARIN AND TICLOPIDINE INTERACTION RATIONALE:

sulfinpyrazone (relieve signs and symptoms of gout)

A

reduce the effectiveness of sulfinpyrazone

23
Q

TICLOPIDINE INTERACTION RATIONALE:

Antacids

A

reduce the plasma levels of ticlopidine

24
Q

Don’t mix and match

A

Because guidelines haven’t been established for administering ticlopidine with heparin, oral anticoagulants, aspirin, or fibrinolytic drugs, discontinue these drugs before starting ticlopidine therapy.

25
Q

Patricianly what hypersensitivity reaction is important to be aware of when prescribing anticoagulants?

A

anaphylaxis

26
Q

Adverse reactions: aspirin

A
  1. stomach pain
  2. heartburn
  3. nausea
  4. constipation
  5. blood in the stool
  6. slight gastric blood loss.
27
Q

Adverse reactions: Clopidogrel

A
  1. headache
  2. skin ulceration
  3. joint pain
  4. flulike symptoms
  5. upper respiratory tract infection
  6. thrombotic thrombocytopenic purpura (rare but potentially fatal)
28
Q

Adverse reactions: ticlopidine

A
  1. diarrhea
  2. nausea
  3. dyspepsia
  4. rash
  5. elevated liver function test results
  6. neutropenia.
29
Q

During long-term therapy with aspirin, what should be monitored?

A
  1. Serumsalicylate level

2. Hearing assessments.

30
Q

What labs should be monitored for patient on anti platelets?

A
  1. HGB/HCT

2. Platelet count

31
Q

Pateint education for antiplatelets

A
  1. Avoid injections to avoid bleeding
  2. Give aspirin with food, milk, an antacid, or a large glass of water to reduce adverse GI reactions.
  3. Stop antiplatelet drugs 5 to 7 days before elective surgery as appropriate.

Pharmacology Spring 2021: Set 2 (14 decks)

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