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Vascular Surgery by Emi > Medication > Flashcards

Medication Flashcards

1
Q

Characteristics of Aspirin

A

irreversible COX inhibitor

limits thromboxane 2 production

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2
Q

Characteristics of Clopidogrel

A 
prasurgel (thienpyridine)
ticagrelor
Plavix
ADP receptor inhibitor
prevents activation of GPIIa/IIIb
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3
Q

what is Abciximab

A

GPIIa/IIIb RC inhibitor

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4
Q

What are the GPIIa/IIIb RC inhibitors?

A

Abciximab (ReoPro), Eptifibatide (Integrillin), Tirofiban (Aggrastat)

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5
Q

GPIIa/IIIb RC inhibitors characteristics

A

inhibit binding of fibrinogen to vW factor

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6
Q

Characteristics of Pletal

A

cilostazol
phosphodiesterase inhibitor
increases cAMP
decreases platelet aggregation

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7
Q

characteristics of Pentoxifiline

A

increases RBC deformability

decreases viscosity

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8
Q

What does Jupiter trial say?

A

20mg rosuvastatin
decreased the risk of stroke, MI and need for CABG by 44%
total mortality decreased by 20%

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9
Q

What does CAPRIE trial say?

A

75 Plavix vs 325 Aspirin
Plavix more effective in total
Individually Plavix more effective in everything aside from MI

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10
Q

What does HOPE study say?

A

22% risk reduction in cardiovascular events in patients taking ramipril

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11
Q

what does warfarin augments

A 
hypoglycemia
aminoglycoside
cipro
metronidazole
omeprazole
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12
Q

what does warfarin inhibits

A

haldol
spironolactone
cyclosporin
barbiturates

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13
Q

Characteristics of Apixaban

A

Eliquis
direct factor Xa inhibitor
stroke prevention and atrial fibrillation and DVT treatment
Peak effect 1-3h
half-life 8-14h
oxidative, intestinal and renal (25%) elimination
Cannot give in ESRD

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14
Q

Characteristics of Rivaroxaban

A 
Xarelto
factor Xa inhibitor
stroke prevention with AF and VTE prophylaxis after ortho surgery
DVT treatment 
half-life 7-11h
Peak effect 2-4h
2/3 kidney and 1/3 liver exctretion
Not recommended for ESRD patients (risk of accumulation)
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15
Q

Characteristics of Dabigatran

A

Pradaxa
thrombin (factor II) inhibitor
stroke prevention in AF and treatment of DVT
halflife 14-17h
80% kidney excretion
Peak effect 1-3h
Removed by dialysis (65%) but concentration rebounds as drug reequilibrates

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16
Q

Characteristics of Heparin

A

polysacharide
increases affinity of antithrombin to thrombin
halflife 60 min
cleared by endothelium and macrophages

17
Q

Characteristics of low molecular weight heparin

A

UFH enzymatically depolarized
halflife 6h
renal clearance

18
Q

Characteristics of Argatroban

A 
direct thrombin inhibitor
hepatic metabolism mainly (22% in kidneys though)
halflife 45 min
Indications: HIT, PCI
Peak effect 1-3h
19
Q

Characteristics of Bivalirudin

A 
direct thrombin inhibitor
halflife 25 min
limited renal clearance
Indication: unstable angina, NSTEMI, PCI with or without HIT
Can give IV or SC
Peak effect 1-3h
20
Q

Characteristics of Lepirudine

A

direct thrombin inhibitor
halflife 60 min
renal clearance

21
Q

tPA half life

22
Q

what does ADVANCE trial say?

A

Apixiban vs 30 BID and 40qd Lovenox in DVT prevention in knee and hip replacement
NON inferior

23
Q

RECORD trial

A

Rivaroxiban vs Lovenox in hip and knee replacement. Rivaroxibam superior in 30 day prophilaxis in hip. Noninferior in knee

24
Q

EINSTEIN trial

A

Rivaroxiban vs standrd anticoagulation in treatment of acute DVT
outcome measured was recurrent DVT
result: noninferior

25
Q

RE-MODEL, RE-NOVATE, RE-MOBILIZE, RE-COVER

A

Dabigatran vs different doses of prophilactic Lovenox in knee and hip replacement. All showed noninferiority

26
Q

characteristics of Edoxaban

A

Savaysa
stroke prevention in a.fib patients without valvular disease and DVT treatment after 5-10 days of parenteral @coagulation
blackbox warning - if patients have normal creatinine clearance, the drug does not work properly
Peak effect 1-3h
Half life 9-11h
50% renal clearance

27
Q

Fondaparineux characteristics

A 
Indication: DVT prophylaxis after Ortho and abd surgery, treatment of DVT/PE
subcutaneous administration
Peak effect 2-3h
Half life 17-21h
Rental clearance as primary rout
28
Q

What does PCC work for

A

Rivaroxaban or Alicia not

29
Q

What works for dabigatan

A

Antibody

Activated pcc

30
Q

Ab for pradaxa

A

Idarucizumab

31
Q

SPRINT trial

A

Lowering BP goal to 120mmHg decreased CV death by 43%. Also significant reduction in all cause mortality and incidence of stroke and MI

32
Q

What’s Vorapax

A

Protease activator receptor-1 inhibitor (platelet thrombin receptor)

33
Q

ACC/AHA guidelines for PAD

A

Smoking cessation
Platelet inhibition
Statins
ACE inhibitor

Vascular Surgery by Emi (15 decks)

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