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 (C)</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 (A)</p> Signup and view all the answers

What is the primary target for fondaparinux inactivation?

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

Which type of cells does heparin bind to?

<p>Endothelial cells (C)</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> (D)</p> Signup and view all the answers

Heparin is usually given by which route of administration?

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

How does fondaparinux differ from LMWH in terms of inactivation?

<p>Fondaparinux inactivates factor Xa only (B)</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 (D)</p> Signup and view all the answers

How is heparin mainly cleared from the body?

<p>By cellular uptake by mononuclear cells (D)</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 (A)</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 (C)</p> Signup and view all the answers

Why is LMWH preferred over heparin for certain indications?

<p>LMWH inactivates factor Xa better than thrombin (D)</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 (A)</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' (A)</p> Signup and view all the answers

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

<p>[Subcutaneously] (C)</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 (A)</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 (A)</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 (D)</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 (B)</p> Signup and view all the answers

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

<p>Intracranial hemorrhage and fatal bleeding (D)</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 (A)</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 (C)</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 (B)</p> Signup and view all the answers

What distinguishes the pharmacokinetics of heparin from LMWH/fondaparinux?

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

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

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

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

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

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

<p>Binds irreversibly to platelet P2Y12 ADP receptor (B)</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 (A)</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 (C)</p> Signup and view all the answers

Which adverse effect is associated with clopidogrel use?

<p>Thrombotic thrombocytopenic purpura (D)</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 (A)</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 (C)</p> Signup and view all the answers

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