PAD

Question 1

What is the most common form of peripheral vascular disease

Answer 1

Peripheral artery disease

Question 2

What is PAD

Answer 2

progressive narrowing of arteries due to atherosclerosis (decreased blood flow to legs)

Question 3

What is PAD associated with

Answer 3

elevated risk of CVD, morbidity and mortality

Question 4

How do PAD patients typically present

Answer 4

40+ y/o, with HTN, hypercholesterolemia, DM, impaired renal function, Hx smoking, and Hx CAD/CVD

Question 5

What are symptoms of PAD

Answer 5

Intermittent claudication

Pain at REST if LE

Question 6

What will PAD physical exam show

Answer 6

nonspecific signs of decreased blood flow (cool extremities, thick toe nails, lack of hair on halves and feet)

Question 7

What diagnostic test can you use to diagnose PAD

Answer 7

Ankle Brachial Index

Question 8

What is treatment for PAD

Answer 8

smoking cessation
exercise
Percutaneous transluminal angioplasty (stent)

Question 9

When should you administer drug control

Answer 9

cholesterol
blood pressure
blood sugar
prevent blood clots

Question 10

How much aspirin should you give to a patient with PAD

Answer 10

81-325 mg daily

Question 11

How does aspirin affect PAD

Answer 11

Irreversibly inhibits PG in platelets, preventing thromboxane A2 formation

Question 12

What are side effects of aspirin

Answer 12

GI upset

bleeding

Question 13

What are contraindications of aspirin

Answer 13

active bleeding
hemophilia
thrombocytopenia

Question 14

What is thromboxane A2

Answer 14

a powerful vasoconstrictor and platelet agonist made from the Arachidonic Acid cascade

Question 15

What is dipyridamole

Answer 15

inhibits platelet aggregation

give at 400 mg (+ 50 mg aspirin)

Question 16

What are side effects of Dipyridamole

Answer 16

angina
dyspnea
hypotension
headache
dizziness

Question 17

Who should NOT use Dipyridamole

Answer 17

those with CAD or active bleeding

Question 18

What is Cilostazole

Answer 18

a Phosphodiesterase inhibitor that supresses platelet aggregation and causes direct artery vasodilation
Give 100mg 2xday

Question 19

What are side effects of Cilostazole

Answer 19

fever
infection
tachycardia

Question 20

Who should never use Cilostazle

Answer 20

CHF patients

Question 21

What is clopidogrel (plavix)

Answer 21

inhibits binding of ADP to platelet receptor causing irreversible inhibition of platelets

Question 22

What are side effects of plavix

Answer 22

CP
purpura
generalized pain
rash

Question 23

Who should not use clopidogrel

Answer 23

Those with active bleeding (ulcer, IC hemorrhage)

Question 24

What is Pentoxifylline

Answer 24

Alters RBC flexibility, decreases platelet adhesion, reduces blood viscosity, and decreases fibrinogen concentration
Give 1.2 g

Question 25

What are side effects of Pentoxifylline

Answer 25

Dyspnea N/V HA dizziness

Question 26

Who should not use Pentoxifylline

Answer 26

those with active bleeding | if w/ recent retinal or cerebral hemorrhage

Question 27

What is Ticlopidine

Answer 27

inhibits ADP binding to platelet receptor causing irreversible inhibition of platelets Give 500mg

Question 28

What are side effects of ticlopidine

Answer 28

``` leukopenia rash thrombocytopenia neutropenia aplastic anemia ```

Question 29

Who should not use Ticlopidine

Answer 29

those with active bleeding hemophilia thrombocytopenia

Question 30

Is there clinical significance behind giving antiplatelet therapy to one with PAD?

Answer 30

No, there is no statistical significance showing prevention or delay in progression of PAD with anti-platelet therapy