Konorev ACS Drugs

Question 1

What are the ADP receptor blockers? (antiplatelet drug)

Answer 1

• Clopidogrel
  Prasugrel
  Ticagrelor

Question 2

What are the platelet glycoprotein receptor blockers? ( Antiplatelet drug)

Answer 2

• Abciximab
• Eptifibatide
• Tirofiban

Question 3

What are the tissue type plasminogen activator drugs? (thrombolytic drug)

Answer 3

• Alteplase
• Reteplase
• Tenecteplase

Question 4

What are the streptokinase preparation drugs? (thrombolytic drug)

Answer 4

• Streptokinase

Question 5

What type of thrombus forms in high pressure arteries as a result of platelets binding to the damaged endothelium and aggregation with little involvement of fibrin?

Answer 5

White thrombus

Question 6

What type of thrombus forms in low pressure veins and in the heart as a result of platelet binding and aggregation followed by formation of bulky fibrin tails in which RBC’s become enmeshed?

Answer 6

Red thrombus

Question 7

What thrombus is a pathologic condition associated with local ischemia due to arterial occlusion and can lead to ACS?

Answer 7

White

Question 8

What are the three classes of drugs used in thromboembolic disorders?

Answer 8

• Antiplatelet drugs to prevent white thrombi
• Anticoagulants to prevent red thrombi
• Thrombolytics to destroy formed clots

Question 9

Which drugs will be most efficacious in preventing thrombus formation in arteries?

• Anticoagulant
• Antiplatelet
• Thrombolytic

Answer 9

• Antiplatelet agent

Question 10

What is the antiplatelet drug tha inhibts thromboxan A2 synthesis?

Answer 10

Aspirin

Question 11

MOA of aspirin?

Answer 11

• Irreversible inhibition of cyclooxygenase to bloc TxA₂ production which is a potent inducer of platelet aggregation

Question 12

Clinical use of aspirin?

Answer 12

• started asap in acute coronary events
• secondary prevention of coronary events

Question 13

AE of aspirin?

Answer 13

GI bleeding and hypersensitivity

Question 14

MOA of the ADP (P2Y12) receptor blockers?

Answer 14

• cAMP prevents platelet aggregation
• ADP activates P2Y₁₂ receptor a GPCR coupled to G_i protein this inhibits adenylyl cyclase and reduces cAMP

Question 15

Clopidogrel metabolism and resistance?

Answer 15

• CYP2C19 metabolizes this prodrug into its active metabolite
• Those who have a nonfunctional CYP2C19 have resistance to this drug

Question 16

Clinical use of P2Y₁₂ receptor blockers?

Answer 16

• Started ASAP with acute coronary events
• Used alone in patients with aspirin hsn reactions
• Secondary prevention in patients with history of acute coronary events

Question 17

How do Glycoprotein IIB/IOIIA inhibitors work?

Answer 17

• Platelet glycoprotein (GP) IIB/IIIA is an integrin that binds to extracellular ligands to trigger platelet aggregation
• These drugs prevent binding of ligands to the GP IIb/IIIa receptor
• Prevents aggregation of platelets

Question 18

Clinical use of GP IIV/IIIA inhibitors?

Answer 18

• Use declined in USA
• Used during PCI in high risk patients
  *

Question 19

65 yo man leaving hospital after an MI received an appropriate post discharge therapy that included aspirin low dose once daily. Which of the following actions most likely mediates the therapeutic effect of the drug in this patients disease?

• Competitive inhibition of cyclooxygenase
• Competitive inhibition of lipoxygenase
• Irreversible inhibition of ADP receptors
• Activation of GP IIb/IIIa receptor complex
• Irreversible acetylation of cyclooxygenase

Answer 19

• Irreversible acetylation of cyclooxygenase

Question 20

Describe how streptokinase works?

Answer 20

• SK is a protein produces by streptococci that binds and activates plasminogen to activate it

Question 21

Clinical uses of Thrombolytic drugs?

Answer 21

• Used if PCI cannot be performed in timely manner
• Used in STEMI and lessoften in NSTEMI w/n 12 hrs

Question 22

AE of thrombolytics?

Answer 22

• Bleeding especially with SK causing systemic fibrinogenolysis
• allergic reactions to SK