Hosam Mohamed-
aspirin, 324mg; P2Y12 inhibitor
What medications do we use Pre-PCI in STEMI patients?
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anticoagulant; optional Gllb/IIIa inhibitor
What medications do we use during PCI in STEMI patients?
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delays absorption; decreases GI bleeding
Why do we use enteric-coated tablets in ASA therapy?
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a
Which P2Y12 inhibitor has the least bleeding risk?
a) clopidogrel
b) prasugrel
c) ticagrelor
d) cangrelor
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b
Which P2Y12 inhibitor is ONLY indicated post PCI?
a) clopidogrel
b) prasugrel
c) ticagrelor
d) cangrelor
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b
Which requires CYP3A4 & CYP2B6 to be activated?
a) clopidogrel
b) prasugrel
c) ticagrelor
d) cangrelor
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pts >75; weigh < 60 kg
Who is Prasugrel not recommended in? (2)
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clopidogrel=5 days; Prasugrel= 7 days
How long do we maintain Clopidogrel & Prasugrel prior to PCI treatment?
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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?
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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
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a
What is our first-line treatment for anti-coagulants?
a) UFH
b) LMWH
c) Fondaparinux
d) Bivalirudin
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b
What is our second-line option for anti-coagulant use?
a) UFH
b) LMWH
c) Fondaparinux
d) Bivalirudin
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to prevent reocclusion of the artery
Why do we use Heparin during STEMI?
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patients has hx of HIT
When do we use Direct Thrombin inhibitors with STEMI PCI?
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visible clot, complex anatomy, cardiogenic shock, bailout situation
When do we use Glycoprotein IIb/IIIa inhibitors? (4)
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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)
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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)
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a,c
Which are easiest to administer?
a) tenecteplase
b) alteplace
c) reteplace
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a
Which has the least amount of noncerebral bleeding?
a) tenecteplase
b) alteplace
c) reteplace
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b
Which has a short half-life & requires long infusion?
a) tenecteplase
b) alteplace
c) reteplace
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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)
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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)
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>180; >110
What BP reading can we use Fibrinolytics in?
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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
