Antiplatelets, Anticoagulants, And Fibrinolytics
Through several mechanisms of action, these agents are used to achieve the fine balance between clotting and systemic bleeding. These drugs are very common, so you should become an expert on every detail regarding them. Test your wit with various forms of questions and see if you have what it takes to be a pharmacist!
- 1.What is the average lifespan of a platelet?
- A.
1 day
- B.
2-5 days
- C.
5-10 days
- D.
90 days
- 2.Is Ticagrelor (Brilinta) reversible?
- A.
Yes
- B.
No
- 3.Which of the following is NOT an indication of aspirin?
- A.
Primary prophylaxis
- B.
Secondary prophylaxis
- C.
Treatment of acute coronary syndromes
- D.
Treatment of acute ischemic stroke
- E.
Treatment of peripheral arterial disease
- F.
All of the above are indications of aspirin
- 4.Clopidogrel (Plavix) has interactions primarily with which of the following CYP isozymes?
- A.
CYP 3A4 inhibitors
- B.
CYP 2D6 inhibitors
- C.
CYP 2E1 inhibitors
- D.
CYP 2C19 inhibitors
- 5.Ticagrelor (Brilinta) has interactions primarily with which CYP isozyme?
- A.
CYP 3A4 inhibitors
- B.
CYP 3A4 inducers
- C.
CYP 2C19 inhibitors
- D.
CYP 2D6 inhibitors
- E.
A and B
- 6.Which of the following are indications of cilostazol (Pletal)? Check all that apply.
- A.
Secondary prophylaxis
- B.
Intermittent claudication (peripheral arterial disease)
- C.
Invasive management of PCI
- D.
Stroke prevention
- 7.Which of the following are indications of aspirin/dipyridamole (Aggrenox)? Check all that apply
- A.
Secondary MI prophylaxis
- B.
Fibrinolysis
- C.
Recurrent stroke prophylaxis
- D.
Primary MI prophylaxis
- 8.What are glycoprotein IIb/IIIa inhibitors used for?
- A.
Invasive management during a PCI
- B.
Treatment of heart failure
- C.
Chronic prevention of blood clots
- D.
Coating of invasive lines
- 9.Which of the following glycoprotein IIb/III inhibitors are reversible? Check all that may apply.
- A.
Abciximab (Reopro)
- B.
Eptifibatide (Integrilin)
- C.
Tirofiban (Aggrastat)
- 10.Which enzyme does warfarin act upon to exert its pharmacological effect?
- 11.Warfarin is bound to which plasma protein?
- A.
Albumin
- B.
Alpha-1 acid glycoprotein
- C.
Hemoglobin
- 12.Which of the following can affect the INR for a patient on warfarin? Check all that apply.
- A.
Demographics
- B.
Vitamin K intake
- C.
Hepatic function
- D.
Drug interactions
- 13.For which indications should the goal INR be 2.0-3.0?
- A.
Prophylaxis of VTE
- B.
Treatment of VTE (DVT/PE)
- C.
Prophylaxis of stroke/systemic embolism
- D.
Mechanical aortic valve
- E.
Mechanical mitral valve
- F.
Bioprosthetic aortic valve
- G.
Bioprosthetic mitral valve
- 14.The heparin or LMWH bridge with warfarin should be continued until the INR is greater than 2.0 for how many consecutive days?
- 15.True or False: Unfractionated heparin can dissolve clots
- A.
True
- B.
False
- 16.Check all of the advantages of direct thrombin inhibitors.
- A.
Do not require cofactor (antithrombin)
- B.
Bind clot-bound thrombin
- C.
Predictable effects of anticoagulation
- D.
Decreased bleeding compared to heparin
- 17.True or false: fondaparinux (Arixtra) requires antithrombin to inhibit Factor Xa
- A.
True
- B.
False
- 18.Which of the following plays a role in the dosing of fondaparinux? Check all that apply.
- A.
Weight
- B.
Indication
- C.
Renal function
- D.
Prior use of fondaparinux
- 19.Which of the following affect the dosing of apixaban (Eliquis)?
- A.
Age
- B.
Body weight
- C.
Serum creatinine
- D.
CYP 3A4 or P-gp inhibitors
- 20.True or false: fibrinolytics only work on fibrin to bust a clot.
- A.
True
- B.
False
- 21.True or false: streptokinase is a direct tissue plasminogen activator?
- A.
True
- B.
False
- 22.To change the INR due to therapy with warfarin by 1.0, change the WEEKLY dose by how much?
- A.
5-10%
- B.
10-15%
- C.
15-20%
- D.
20-25%
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