ADP Receptor Antagonists: Clopidogrel and Abciximab
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Questions and Answers

What is the mechanism of action of fondaparinux?

  • It accelerates the normal rate of inactivation of active clotting factors by prothrombin
  • It inactivates factor Xa only (correct)
  • It inactivates both thrombin and Xa equally
  • It serves as a catalytic surface for antithrombin and thrombin
  • How does fondaparinux differ from heparin in terms of selectivity?

  • Heparin inactivates thrombin and Xa equally (correct)
  • Heparin inactivates factor Xa poorly
  • Fondaparinux inactivates thrombin and Xa equally
  • Heparin inactivates factor Xa only
  • How is the onset of anticoagulant effect for fondaparinux described?

  • Is immediately effective upon oral administration
  • Has a delayed onset after SC administration
  • Occurs rapidly within minutes of IV administration (correct)
  • Occurs slowly over hours after IV administration
  • What is the clearance route for LMWH and fondaparinux?

    <p>Cleared by the kidneys</p> Signup and view all the answers

    When are LMWH and fondaparinux usually indicated over heparin?

    <p>In patients requiring rapid onset and short duration of action</p> Signup and view all the answers

    What is the primary target for fondaparinux inactivation?

    <p>Factor Xa</p> Signup and view all the answers

    Which type of cells does heparin bind to?

    <p>Endothelial cells</p> Signup and view all the answers

    LMWH and fondaparinux do not require monitoring because:

    <p><strong>They have a longer half-life than heparin</strong></p> Signup and view all the answers

    Heparin is usually given by which route of administration?

    <p><strong>IV infusion</strong></p> Signup and view all the answers

    How does fondaparinux differ from LMWH in terms of inactivation?

    <p>Fondaparinux inactivates factor Xa only</p> Signup and view all the answers

    What is the primary mechanism through which fondaparinux exerts its anticoagulant effect?

    <p>Enhancing antithrombin activity towards target proteases</p> Signup and view all the answers

    How is heparin mainly cleared from the body?

    <p>By cellular uptake by mononuclear cells</p> Signup and view all the answers

    What distinguishes the pharmacokinetics of LMWH/fondaparinux from heparin?

    <p>They have longer half-lives and are cleared by the kidneys</p> Signup and view all the answers

    What is the primary advantage of using fondaparinux during outpatient transition to warfarin?

    <p>Rapid onset and short duration of action</p> Signup and view all the answers

    Why is LMWH preferred over heparin for certain indications?

    <p>LMWH inactivates factor Xa better than thrombin</p> Signup and view all the answers

    Which of the following statements about the mechanism of fondaparinux is correct?

    <p>Fondaparinux makes the catalytic site of antithrombin more accessible</p> Signup and view all the answers

    'Circulating thrombin only, no clot bound' describes which aspect of fondaparinux's mechanism?

    <p>'Blocks formation of fibrin'</p> Signup and view all the answers

    'Parenteral' anticoagulant refers to medications that are typically administered through which route?

    <p>[Subcutaneously]</p> Signup and view all the answers

    What is one advantage of using LMWH/fondaparinux over heparin in terms of monitoring requirements?

    <p>Do not necessitate regular monitoring for therapeutic effect</p> Signup and view all the answers

    What is the mechanism of action of abciximab (ReoPro®)?

    <p>Blocks platelet aggregation by blocking GPIIb/IIIa receptors</p> Signup and view all the answers

    What is the pharmacokinetics of vorapaxar (Zontivity®)?

    <p>Onset of action within 1 week, effects may last up to 4 weeks after stopping</p> Signup and view all the answers

    What is the primary therapeutic use of abciximab (ReoPro®)?

    <p>Prevent ischemic events in patients with ACS or undergoing PCI</p> Signup and view all the answers

    Which adverse effect is specifically associated with vorapaxar (Zontivity®)?

    <p>Intracranial hemorrhage and fatal bleeding</p> Signup and view all the answers

    How does abciximab (ReoPro®) achieve a long duration of action despite a short half-life?

    <p>Forms irreversible bonds with platelets</p> Signup and view all the answers

    In what way does vorapaxar (Zontivity®) differ from abciximab (ReoPro®) in terms of therapeutic use?

    <p>Vorapaxar reduces thrombotic events in patients post-MI, whereas abciximab prevents ischemic events in patients undergoing PCI</p> Signup and view all the answers

    Which of the following accurately describes the mechanism of action of fondaparinux?

    <p>Indirectly accelerates the inactivation of active clotting factors by antithrombin</p> Signup and view all the answers

    What distinguishes the pharmacokinetics of heparin from LMWH/fondaparinux?

    <p>Heparin requires frequent monitoring unlike LMWH/fondaparinux</p> Signup and view all the answers

    What is the main selective action of fondaparinux compared to heparin and LMWH?

    <p>Inactivates factor Xa only</p> Signup and view all the answers

    During which medical procedures is fondaparinux commonly used to prevent thrombosis?

    <p>Renal hemodialysis</p> Signup and view all the answers

    What is the route of administration for heparin that distinguishes it from LMWH/fondaparinux?

    <p>Intravenous infusion</p> Signup and view all the answers

    Which of the following statements accurately describes the onset of anticoagulant effect in fondaparinux?

    <p>Anticoagulant effect occurs within minutes of subcutaneous administration</p> Signup and view all the answers

    What is the mechanism of action of clopidogrel (Plavix®)?

    <p>Binds irreversibly to platelet P2Y12 ADP receptor</p> Signup and view all the answers

    Which statement regarding clopidogrel's pharmacokinetics is accurate?

    <p>Maximal efficacy occurs 8-11 days after starting therapy</p> Signup and view all the answers

    In which patient population is clopidogrel indicated for use?

    <p>Patients with a history of stroke or myocardial infarction</p> Signup and view all the answers

    Which adverse effect is associated with clopidogrel use?

    <p>Thrombotic thrombocytopenic purpura</p> Signup and view all the answers

    How does clopidogrel compare to aspirin in terms of efficacy and cost?

    <p>Clopidogrel is slightly better in efficacy but much more expensive than aspirin</p> Signup and view all the answers

    What is the primary role of ADP receptor antagonists like clopidogrel in combination with aspirin?

    <p>Prevent coronary stent thrombosis and ACS</p> Signup and view all the answers

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