PAD Flashcards
What is the most common form of peripheral vascular disease
Peripheral artery disease
What is PAD
progressive narrowing of arteries due to atherosclerosis (decreased blood flow to legs)
What is PAD associated with
elevated risk of CVD, morbidity and mortality
How do PAD patients typically present
40+ y/o, with HTN, hypercholesterolemia, DM, impaired renal function, Hx smoking, and Hx CAD/CVD
What are symptoms of PAD
Intermittent claudication
Pain at REST if LE
What will PAD physical exam show
nonspecific signs of decreased blood flow (cool extremities, thick toe nails, lack of hair on halves and feet)
What diagnostic test can you use to diagnose PAD
Ankle Brachial Index
What is treatment for PAD
smoking cessation
exercise
Percutaneous transluminal angioplasty (stent)
When should you administer drug control
cholesterol
blood pressure
blood sugar
prevent blood clots
How much aspirin should you give to a patient with PAD
81-325 mg daily
How does aspirin affect PAD
Irreversibly inhibits PG in platelets, preventing thromboxane A2 formation
What are side effects of aspirin
GI upset
bleeding
What are contraindications of aspirin
active bleeding
hemophilia
thrombocytopenia
What is thromboxane A2
a powerful vasoconstrictor and platelet agonist made from the Arachidonic Acid cascade
What is dipyridamole
inhibits platelet aggregation
give at 400 mg (+ 50 mg aspirin)
What are side effects of Dipyridamole
angina dyspnea hypotension headache dizziness
Who should NOT use Dipyridamole
those with CAD or active bleeding
What is Cilostazole
a Phosphodiesterase inhibitor that supresses platelet aggregation and causes direct artery vasodilation
Give 100mg 2xday
What are side effects of Cilostazole
fever
infection
tachycardia
Who should never use Cilostazle
CHF patients
What is clopidogrel (plavix)
inhibits binding of ADP to platelet receptor causing irreversible inhibition of platelets
What are side effects of plavix
CP
purpura
generalized pain
rash
Who should not use clopidogrel
Those with active bleeding (ulcer, IC hemorrhage)
What is Pentoxifylline
Alters RBC flexibility, decreases platelet adhesion, reduces blood viscosity, and decreases fibrinogen concentration
Give 1.2 g
What are side effects of Pentoxifylline
Dyspnea
N/V
HA
dizziness
Who should not use Pentoxifylline
those with active bleeding
if w/ recent retinal or cerebral hemorrhage
What is Ticlopidine
inhibits ADP binding to platelet receptor causing irreversible inhibition of platelets
Give 500mg
What are side effects of ticlopidine
leukopenia rash thrombocytopenia neutropenia aplastic anemia
Who should not use Ticlopidine
those with active bleeding
hemophilia
thrombocytopenia
Is there clinical significance behind giving antiplatelet therapy to one with PAD?
No, there is no statistical significance showing prevention or delay in progression of PAD with anti-platelet therapy
