aspirin, 324mg; P2Y12 inhibitor
What medications do we use Pre-PCI in STEMI patients?
anticoagulant; optional Gllb/IIIa inhibitor
What medications do we use during PCI in STEMI patients?
delays absorption; decreases GI bleeding
Why do we use enteric-coated tablets in ASA therapy?
a
Which P2Y12 inhibitor has the least bleeding risk?
a) clopidogrel
b) prasugrel
c) ticagrelor
d) cangrelor
b
Which P2Y12 inhibitor is ONLY indicated post PCI?
a) clopidogrel
b) prasugrel
c) ticagrelor
d) cangrelor
b
Which requires CYP3A4 & CYP2B6 to be activated?
a) clopidogrel
b) prasugrel
c) ticagrelor
d) cangrelor
pts >75; weigh < 60 kg
Who is Prasugrel not recommended in? (2)
clopidogrel=5 days; Prasugrel= 7 days
How long do we maintain Clopidogrel & Prasugrel prior to PCI treatment?
c
Which is ONLY available under the Brand name?
a) clopidogrel
b) prasugrel
c) ticagrelor
d) cangrelor
c
Which has a dosing cap of 81 mg daily of ASA?
a) clopidogrel
b) prasugrel
c) ticagrelor
d) cangrelor
no: P2Y12 inhibitor, oral med, GP IIa/IIIB; can only do PCI with it
Cangrelor clinical notes?
d
Which works the fastest?
a) clopidogrel
b) prasugrel
c) ticagrelor
d) cangrelor
b
Which CAN'T be used in patients with a Hx of stroke/TIA?
a) clopidogrel
b) prasugrel
c) ticagrelor
d) cangrelor
a
What is our first-line treatment for anti-coagulants?
a) UFH
b) LMWH
c) Fondaparinux
d) Bivalirudin
b
What is our second-line option for anti-coagulant use?
a) UFH
b) LMWH
c) Fondaparinux
d) Bivalirudin
to prevent reocclusion of the artery
Why do we use Heparin during STEMI?
patients has hx of HIT
When do we use Direct Thrombin inhibitors with STEMI PCI?
visible clot, complex anatomy, cardiogenic shock, bailout situation
When do we use Glycoprotein IIb/IIIa inhibitors? (4)
in combo w/ fibrinolytics, hx of stroke, thrombocytopenia
When CAN'T we use Glycoprotein IIb/IIIa inhibitors? (3)
b
Which Glycoprotein IIb/IIIa inhibitor can cause thrombocytopenia?
a) Eptifibatide
b) Tirofiban
limus + paclitaxel
What are our Drug-Eluding Stents? (4)
fibrinolytic, ASA 324 mg initial dose; 81 mg indefinitely, Plavix 300 mg initial; 75 mg for 1 year, anticoagulant
How do treat a patient if we don't have access to a Cath Lab? (4)
a,c
Which are easiest to administer?
a) tenecteplase
b) alteplace
c) reteplace
a
Which has the least amount of noncerebral bleeding?
a) tenecteplase
b) alteplace
c) reteplace
b
Which has a short half-life & requires long infusion?
a) tenecteplase
b) alteplace
c) reteplace
prior ICH, ischemic stroke within 6 months, cerebral vascular lesion, brain tumor, major surgery < 1 month, GI bleeding < 1 month, bleeding disorder, aortic dissection, active bleeding, non-compressible puncture
When can we ABSOLUTELY not use Fibrinolytics? (10)
TIA within 6 months, oral anti-coags, pregnancy/ 1 week postpartum, advanced liver disease, infective endocarditis, active peptic ulcer, traumatic/prolonged CPR
When CAN we use Fibrinolytics? (7)
>180; >110
What BP reading can we use Fibrinolytics in?
a
Which is the ONLY one that can be used with fibrinolytics?
a) clopidogrel
b) prasugrel
c) ticagrelor
d) cangrelor
c
Which SHOULDN'T be used in patients undergoing PCI?
a) UFH
b) LMWH
c) Fondaparinux
d) Bivalirudin
c
Which is Contraindicated in patients with a GFR < 30 mL/min?
a) UFH
b) LMWH
c) Fondaparinux
d) Bivalirudin