Medications

Question 1

Name 3 antiplatelet medications

Answer 1

Plavix
ASA
Aggrenox (dipyridamole 200mg/ASA 25mg

Question 2

What antiplatelet medication is indicated for primary stroke prevention?

Answer 2

ASA

Question 3

Which medications are indicated for secondary stroke prevention?

Answer 3

Aggrenox

Plavix

Question 4

Are antiplatelet meds reversible?

Answer 4

No

Question 5

How do antiplatelets work?

Answer 5

Decrease platelet aggregation

Question 6

Name some anticoagulants

Answer 6

Coumadin
Pradaxa a Dabigatran
Factor Xa inhibitors
- eliquis
- xarelto

Question 7

What is the reversal agents for Coumadin

Answer 7

Vite K - 24 hrs
FFP - 1-4 hrs
PCC - 10-15 min

Question 8

Contraindications for anticoagulants

Answer 8

• Pregnancy
• Major bleeding disorders/tendencies
• Aneurysm
• pericarditis
• Endocarditis
• Active bleeding

Question 9

Interactions of anticoagulants

Answer 9

Increases effects 
-herbals
-amiodarone/dronedarine
-ABX
-antifungals
-HIV meds
-phenytoin
-acute ETOH use
Decreases effects
-phenobarbital 
-carbamazepine
-rifampin
-foods/drugs w/ vite k
-chronic ETOH use

Question 10

What is the therapeutic INR range for Coumadin

Answer 10

2-3

Question 11

How does Coumadin wrk and onset of action

Answer 11

Vite K antagonist

Onset 36-48 hrs

Question 12

Antiplatelet interactions

Answer 12

• Increased bleeding risk when taken with anticoagulants
• NSAIDS
• Garlic, ginger

Question 13

What is the indication for the anticoagulant dabigatran

Answer 13

Non-vascular afib and VTE treatment

Question 14

What is the dosage of Pradaxa dabigatran

Answer 14

75-150mg BID

Question 15

What is the mechanism of action for dabigatran

Answer 15

Direct thrombin inhibitor

Onset 1-3 hrs

Question 16

Contraindications for dabigatran

Answer 16

Active bleeding
Known hypersensitivity
Mechanical prosthetic heart valve

Question 17

Interactions of dabigatran

Answer 17

Increases effects: dronedarone, ketoconazole

Decreases effects: rifampin

Question 18

What are reversal agents for dabigatran PRADAXA

Answer 18

• Praxbind - reverses ICH bleeding in 21 min
• PCC
• Dialyzable (50% of drug is removed in 4 hrs)

Question 19

Indications for Xa inhibitor anticoagulants

Answer 19

Non-valvular afib

VTE treatment

Question 20

Dosing for rivaroxaban Xarelto

Answer 20

15-20mg daily with evening meal

Question 21

Dosing for Xa inhibitor apixaban Eliquis

Answer 21

5mg BID

2. 5mg BID if 2 of the following:
   - > 79 y/o
   - wt >61 kg
   - creat >1.4

Question 22

Onset of action for

rivaroxaban Xarelto and apixaban Eliquis

Answer 22

Xarelto 2-4 hrs

Eliquis 3-4 hrs

Question 23

Contraindications of factor Xa inhibitors

Answer 23

• Bleeding
• Known hypersensitivity
• Spinal procedure/puncture
• Mechanical heart valve
• Caution pregnancy
• Child-Pugh C (hepatic dz)

Question 24

Interactions of factor Xa inhibitors

Answer 24

Increases effects:
-clarithromycin, EES, ketoconazole, fluconazole, ratinovir
Decreases effects:
- phenytoin, phenobarbital, carbamazepine, rifampin

Question 25

Name some thrombolytics

Answer 25

Alteplase
Reteplase
Tenscteplase

Question 26

Contraindications for thrombolytics

Answer 26

• INR >1.7
• Plt < 100,000
• LMWH in the last 24 hrs
• NOAC in last 48 hrs