Patient's on antiplatelet therapy

Question 1

True or false: warfarin use requires regular INR monitoring

Answer 1

true

Question 2

How many days before elective surgery should warfarin be stopped?

Answer 2

5 days

Question 3

What is the mechanism of unfractionated heparin?

Answer 3

it forms a complex which inhibits thrombin (II), factors Xa, IXa, XIa and XIIa

Question 4

What is the mechanism of LMWH?

Answer 4

it increases the action of antithrombin III on factor Xa

Question 5

What can be used to treat overdoses of heparin?

Answer 5

protamine sulphate

Question 6

What is heparin-induced thrombocytopenia? (HIT)

Answer 6

where antibodies form against platelets, causing thrombocytopenia but a thrombotic state

Question 7

What are the main 4 groups of antiplatelet drugs?

Answer 7

1) aspirin
2) clopidogrel, prasugrel and ticagrelor
3) dipyridamole
4) glycoprotein IIb/IIIa inhibitors

Question 8

What is the mechanism of clopidogrel, prasugrel and ticagrelor?

Answer 8

P2Y12 receptor blockers (platelet receptor)

Question 9

Give 3 examples of glycoprotein IIb/IIIa inhibitors:

Answer 9

1) abciximab
2) eptifibatide
3) tirofiban

Question 10

What is the mechanism of dipuridamol?

Answer 10

inhibitors phosphodiesterase enzymes

Question 11

What is the main indication for antiplatelet drugs?

Answer 11

secondary prevention in those with ACS, angina, peripheral vascular disease, MIs, stroke or TIA

Question 12

Describe dual antiplatelet therapy used for acute conditons:

Answer 12

aspirin and ticagrelor OR prasugrel is given with the second antiplatelet usually continued for up to 12 months