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cardiology #2 > PHARM-- antithrombotics > Flashcards

PHARM-- antithrombotics Flashcards

1
Q

irreversibly inhibits Cyclooxygenase (COX-1, COX-2) via acetylation→ decreases thromboxane A2 (TxA2) production→ inhibits platelet aggregation

A

aspirin MOA

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2
Q

Inhibits cyclic nucleotide phosphodiesterase & block adenosine uptake→ increased cAMP (platelet inhibitor)

A

aspirin/dipyridamole (aggrenox) MOA

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3
Q

selectively & irreversibly blocks the P2Y12 part of ADP receptors→ no activation of GP2b/3a receptor complex→ reduced platelet aggregation

A

clopidogrel MOA

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4
Q

Irreversibly blocks P2Y12 of ADP receptor→ inhibits platelet aggregation

A

prasugrel MOA

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5
Q

which 2 P2Y12 inhibitors are Thienopyridines

A

clopidogrel & prasugrel

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6
Q

Reversibly & noncompetitively binds P2y12 to inhibit platelet aggregation

A

ticagrelor MOA

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7
Q

which P2y12 inhibitor is a Cyclopentyl Triazolopyrimidine

A

ticagrelor

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8
Q

which P2Y12 is a Non-thienopyridine

A

Cangrelor

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9
Q

**Selectively & Reversibly **blocks P2Y12 to inhibit platelet aggregation

A

Cangrelor MOA

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10
Q

Binds to GP2b/3a receptor which inhibits platelet aggregation

A

Eptifibatide, Tirofiban, Abciximab

the GP2b/3a inhibitors

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11
Q

Binds to GP2b/3a receptor which inhibits platelet aggregation

A

Eptifibatide, Tirofiban, Abciximab

the GP2b/3a inhibitors

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12
Q

these are indications for which antiplatelet drug

  • A fib
  • CAD prevention
  • stroke/TIA
  • Peripheral artery dz
A

aspirin

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13
Q

4 C/I of aspirin

A
  • Under 16 yo w/ viral illness (risk of reyes syn.)
  • Asthma
  • rhinitis
  • nasal polyps
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14
Q

3 ADR of aspirin

A
  • bleeding
  • dose related gastric erosion
  • ICH
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15
Q

how far in advance should you stop ASA before procedures

A

5-7 days

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16
Q

indicated for thromboembolic stoke prevention- 1 cap PO BID

A

Aspirin/Dipyridamole (Aggrenox)

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17
Q

4 indications for clopidogrel

A
  • MI (stemi, nstemi)
  • CVA
  • PAD
  • PCI
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18
Q

PGY12 used in ACS– PCI thrombosis prophylaxis

A

Prasugrel

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19
Q

which P2Y12 inhibitor has these indications

  • ACS
  • PCI
  • primary prev. in pt w/ CAD & high CV event risk
  • minor ischemic stroke & high risk TIA
A

ticagrelor

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20
Q

P2Y12 inhibitor used in PCI pts not previously loaded w/ an oral P2Y12 blocker

A

Cangrelor

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21
Q

which GP 2b/3a is used in

  • PCI
  • UA/NSTEMI not responsive to medical tx & planned PCI w/in 24 hrs
A

Abciximab

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22
Q

which GP 2b/3a is used in

  • ACS
  • PCI +/- stenting
A

Tirofiban

23
Q

which GP 2b/3a is used in

  • UA/NSTEMI
A

Eptifibatide

24
Q

which antithrombotic is used in

Afib, VTE, mechanical heart valves

A

warfarin

25
Q

which antithrombotic is used in

  • acute VTE, DIC, PCI
  • acute MI, UA
  • cardiopulmonary bypass & vascular surgery
A

UFH

26
Q

which form of heparin is ok in dialysis

A

UFH

27
Q

which antithrombotics is used in

  • VTE, PE
  • UA or non-Q wave MI
  • STEMI
A

LMWH– enoxaparin, dalteparin

28
Q

2 common indications for DOACs

A
  • DVT/PE tx & secondary prophy.
  • stroke & systemic embolism prev in pt w/ nonvalvular afib
29
Q

which DOAC can be used in stable CAD or PAD, VTE prophylaxis in acutely ill patient

A

rivaroxaban

30
Q

the only DOAC that is NOT used in VTE prophylaxis s/p surgery

A

edoxaban

31
Q

inhibits Vit K dependent clotting factor (2,7,9,10) also blocks protein C & S

A

warfarin MOA

32
Q

interacts w/ ATIII to inactivate factor X1 & blocks thrombin formation; also IXa, XIa, XIIa

A

UFH

33
Q

which DOAC is a direct thrombin inhibitor

A

dabigatran

34
Q

which class of antiplatelet should not be used in patients who have urgent CABG

A

P2Y12 inhibitors

35
Q

which P2Y12 inhibitor is C/I in ppl w/ hx of stroke/TIA & is not recommended in 75+

A

prasugrel

36
Q

which P2Y12 inhibitors should be avoided in severe hepatic impairment, ICH, active bleeding

A

Ticagrelor

37
Q

which antiplatelet has these C/I

  • rash
  • bleeding
  • rare TTP
A

clopidogrel

38
Q

which antiplatelet has these C/I

  • Bleeding
  • rash
  • rare TTP
  • HTN
  • hyperlipidemia
  • HA, backache
A

prasugrel

39
Q

which antiplatelet has these C/I

  • Bleeding
  • HA
  • increase SCR
  • dyspnea
  • bradyarrhythmias
A

Ticagrelor

40
Q

which antitplatelet has these C/I

  • bleeding
  • dyspnea
  • renal insufficiency
  • hypersensitivity
A

cangrelor

41
Q

which class of antiplatelet has these C/I

  • thrombocytopenia
  • bleeding
  • hypotension
A

GP 2b/3a inhibitors

42
Q

which two antiplatelet has dyspnea as an ADR

A

Ticagrelor & Cangrelor

43
Q

which P2Y12 inhibitor is an IV

A

cangrelor

44
Q

which two P2Y12 inhibitors are used with aspirin

A

prasugrel & ticagrelor

45
Q

which DOAC is used in dialysis vs which is not used if CrCL > 95 (good function)

A
  • used in dialysis: apixaban
  • NOT used w/ good kidney function: Edoxaban
46
Q

which class of antithrombotic is not used in epidural/spinal hematoma & spinal procedures

A

DOACs

47
Q

3 ADR of DOACs

A
  • Bleeding
  • GI (dabigatran)
  • Rash (edoxaban)
48
Q

ADR of

  • Bleeding, bruising
  • Skin necrosis
  • Purple toes syndrome
A

warfarin

49
Q

ADR of

  • bleeding, HIT
  • osteoporosis
  • Increased LFTs
A

UFH

50
Q

which type of heparin is dosing based on body weight

A

LMWH

51
Q

4 phases of hemostasis

A
  • Platelet aggregation to form plug
  • Propagation by Coagulation cascade
  • Termination by Antithrombotic mechanisms
  • Clot removal by Fibrinolysis
52
Q

which 2 DOACs are ok in obesity

A
  • rivaroxaban
  • apixaban
53
Q

which is better for ICH or hemorrhagic strokes: DOAC or warfarin?

A

DOAC

54
Q

4 risk factors for GI bleeding

A
  • previous GI bleed or PUD
  • advanced age
  • use of anticoag, steroids or NSAIDs
  • H. pylori infection

cardiology #2 (12 decks)

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