Adverse Effects of Clopidogrel
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Questions and Answers

Which organ is primarily responsible for metabolizing acetaminophen?

  • Liver (correct)
  • Lungs
  • Heart
  • Kidneys

What is the most beneficial antidote for acetaminophen overdose?

  • Ibuprofen
  • Aspirin
  • Acetylcysteine (correct)
  • Morphine

What percentage of acetaminophen is excreted in urine as non-toxic glucuronate and sulfate conjugates?

  • 94% (correct)
  • 25%
  • 10%
  • 50%

In patients with renal impairment, why may there be an accumulation of acetaminophen in the kidneys?

<p>Due to slower elimination (D)</p> Signup and view all the answers

What is the duration of action of IV injection Ofirmev, which contains acetaminophen?

<p>3-4 hours (A)</p> Signup and view all the answers

What is the purpose of Analgesic Antipyretic as mentioned in the text?

<p>To decrease pain and fever (C)</p> Signup and view all the answers

What is a potential adverse reaction to acetaminophen mentioned in the text?

<p>Myocardial damage (D)</p> Signup and view all the answers

Which group of drugs can either increase or decrease the effects of acetaminophen?

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

What could be a sign for healthcare professionals to stop the administration of acetaminophen?

<p>Development of rash (D)</p> Signup and view all the answers

What is the therapeutic serum level range for salicylate as mentioned in the text?

<p>100-300 mcg/mL (B)</p> Signup and view all the answers

What is the mechanism of action for aspirin?

<p>Inhibits the synthesis of thromboxane A2 to inhibit platelet aggregation (A)</p> Signup and view all the answers

What is a common side effect of aspirin specifically mentioned in the text?

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

What is a significant contraindication for children and teenagers related to aspirin?

<p>Flu-like symptoms (D)</p> Signup and view all the answers

How does ibuprofen differ from aspirin in terms of its pharmacokinetics?

<p>Eliminated mainly through renal excretion unlike aspirin (C)</p> Signup and view all the answers

What is a recommendation for older adults when taking ibuprofen?

<p>Use gastroprotective agents if at risk for upper GI bleeding (D)</p> Signup and view all the answers

What is the maximum daily dosage for patients with hepatitis?

<p>2g (A)</p> Signup and view all the answers

Which adverse effect is NOT associated with Ibuprofen use?

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

What is the main mechanism of action of Ibuprofen?

<p>Inhibits prostaglandin synthesis (D)</p> Signup and view all the answers

What is the role of beta-lactamase inhibitors in antibiotic therapy?

<p>Counteract resistance by bacteria (D)</p> Signup and view all the answers

Which clotting factors are inhibited by Warfarin in the liver?

<p>Factor VII and IX (D)</p> Signup and view all the answers

What is the primary adverse effect associated with warfarin therapy?

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

Which organ eliminates warfarin from the body?

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

What is the black box warning for warfarin issued by the US FDA related to?

<p>Risk of hemorrhage (B)</p> Signup and view all the answers

In which population group is caution warranted when using alteplase?

<p>Older patients (65–80 years of age) (C)</p> Signup and view all the answers

What is the main action of alteplase in the body?

<p>Lyses unwanted fibrin blood clots (A)</p> Signup and view all the answers

What is one of the most common adverse effects associated with clopidogrel?

<p>Pruritus (D)</p> Signup and view all the answers

Which enzyme is responsible for metabolizing clopidogrel, potentially leading to poor or ultrarapid metabolism?

<p>CYP2C19 (A)</p> Signup and view all the answers

What is a contraindication for the use of clopidogrel?

<p>Active bleeding conditions like peptic ulcer disease (D)</p> Signup and view all the answers

What is the primary action of heparin in the body?

<p>Inactivating clotting factors IX, X, XI, and XII (D)</p> Signup and view all the answers

For what condition is low-dose heparin prophylactically used?

<p>Deep vein thrombosis (B)</p> Signup and view all the answers

What is a major limitation of traditional anticoagulants mentioned in the text?

<p>Narrow therapeutic window with wide individual dose variability (C)</p> Signup and view all the answers

Why is heparin considered the anticoagulant of choice during pregnancy and lactation?

<p>It does not cross the placental barrier or get secreted in breast milk (C)</p> Signup and view all the answers

What is the recommended interval for monitoring platelet counts during heparin therapy?

<p>Every 2 to 3 days (A)</p> Signup and view all the answers

When should a healthcare provider consider discontinuing heparin therapy based on platelet counts?

<p>If platelet count falls below 100,000 per microliter (A)</p> Signup and view all the answers

What is the recommended therapeutic range for maintaining activated partial thromboplastin time (aPTT) during heparin therapy?

<p>45 to 70 seconds (C)</p> Signup and view all the answers

Why is it necessary to minimize intramuscular injections in patients receiving systemic thrombolytic therapy?

<p>To prevent bleeding, bruising, or hematomas (B)</p> Signup and view all the answers

What is a key reason for checking INR, aPTT, platelet count, and fibrinogen before initiating thrombolytic therapy?

<p>To establish baseline values and identify possible blood coagulation disorders (A)</p> Signup and view all the answers

How does clopidogrel exert its antiplatelet effects?

<p>By blocking the ADP receptor on platelet cell surface (C)</p> Signup and view all the answers

What is a characteristic of clopidogrel's pharmacokinetics?

<p>Undergoes extensive first-pass metabolism in the liver (C)</p> Signup and view all the answers

In which patients is caution advised when administering clopidogrel?

<p>Older adults or individuals with hepatic impairment (A)</p> Signup and view all the answers

What is the maximum recommended duration of medication with acetaminophen for children according to the text?

<p>3 days (D)</p> Signup and view all the answers

Which parameter should be assessed in patients taking acetaminophen to monitor for renal toxicity?

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

What is the primary contraindication for children and teenagers related to aspirin use?

<p>Reye's syndrome (C)</p> Signup and view all the answers

What is a common adverse effect associated with hypersensitivity reactions to acetaminophen?

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

What is the maximum dose of acetaminophen that should be administered to adults per day, as specified in the text?

<p>4g (B)</p> Signup and view all the answers

What is the potential tetragons associated with Methotrexate use in children?

<p>Increased risk for acute leukemia (C)</p> Signup and view all the answers

Which factor should be considered in the dosage of Methotrexate for children?

<p>Body surface area (C)</p> Signup and view all the answers

What is a common adverse effect of Methotrexate therapy in older adults?

<p>Nausea and vomiting (D)</p> Signup and view all the answers

Which malignancy is NOT listed as a potential risk for children using Methotrexate?

<p>Sarcomas of muscle and bone (B)</p> Signup and view all the answers

What is a contraindication for Methotrexate use in children?

<p>Brain tumors (B)</p> Signup and view all the answers

Why is aspirin not recommended for children?

<p>It can cause Reye's syndrome (A)</p> Signup and view all the answers

What is a contraindication for using aspirin in patients?

<p>Peptic ulcer disease (B)</p> Signup and view all the answers

What is the primary therapeutic effect of aspirin in patients with cardiovascular conditions?

<p>Preventing stroke (B)</p> Signup and view all the answers

What is the recommended daily dosage of aspirin for children with fever and pain?

<p>$325-650$ mg every 6 hours (A)</p> Signup and view all the answers

What is a potential concern when using amoxicillin-clavulanate (Augmentin) in patients with hepatic injury or destruction?

<p>Development of cholestatic jaundice (D)</p> Signup and view all the answers

Why are elderly patients susceptible to superinfections when given any anti-infective agent?

<p>Impaired renal function (C)</p> Signup and view all the answers

What is a contraindication for the use of penicillins like ampicillin in patients with hepatic impairment?

<p>Development of cholestatic jaundice (D)</p> Signup and view all the answers

Why should dosage adjustments be considered for ampicillin in elderly patients?

<p>Due to decreased renal function (B)</p> Signup and view all the answers

What is a key factor to consider when administering extended-spectrum drugs like piperacillin in critical care units?

<p>Bactericidal activity against a wide range of bacteria (A)</p> Signup and view all the answers

What is a crucial consideration for the use of this medication in children?

<p>Monitoring tests to assess for impaired renal function (B)</p> Signup and view all the answers

Which adverse effect is specifically mentioned as a concern for patients using this medication?

<p>Fluid and electrolyte imbalance (C)</p> Signup and view all the answers

What is a significant contraindication for this medication during pregnancy or lactation?

<p>May lead to fetal loss or malformations (A)</p> Signup and view all the answers

Why is it advised to avoid doses higher than 1g twice a day for patients with renal impairment?

<p>To avoid increased plasma levels due to impaired renal function (B)</p> Signup and view all the answers

What is a potential adverse effect of alternating acetaminophen and ibuprofen every 4 hours over a 3-day period in young children?

<p>Higher incidence of liver damage (C)</p> Signup and view all the answers

What is a contraindication for the use of acetaminophen in older adults?

<p>Chronic alcohol abuse (C)</p> Signup and view all the answers

Which factor should be considered when adjusting the dosage of acetaminophen for patients with renal impairment?

<p>Severity of kidney damage (A)</p> Signup and view all the answers

What is a significant adverse effect associated with prolonged use of ibuprofen in children?

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

In young children, what should healthcare providers consider regarding the duration of action of IV injection Ofirmev containing acetaminophen?

<p>Longer duration compared to adults (C)</p> Signup and view all the answers

What is the main reason why clopidogrel is not considered safe for children?

<p>It has not been established as safe in pediatric patients (C)</p> Signup and view all the answers

Which age group is more likely to experience bleeding and complications from antiplatelet drugs?

<p>Older adults (B)</p> Signup and view all the answers

Why is caution advised when administering clopidogrel to individuals with hepatic impairment?

<p>It may accumulate due to liver metabolism (D)</p> Signup and view all the answers

Which of the following is a potential risk associated with clopidogrel use in older adults?

<p>Greater chance of hemorrhagic stroke (A)</p> Signup and view all the answers

'Thrombotic thrombocytopenic purpura' is a potential serious adverse effect associated with which drug mentioned in the text?

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

'Severe neutropenia' is a side effect that has been reported with the use of:

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

'Pruritus' and 'rash' are common adverse effects associated with the use of:

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

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