Anticoagulant Medications and Thrombolytic Agents Quiz

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What is the primary indication for using nitroglycerin in the initial 24-48 hours for a patient with AMI and CHF?

To reduce pulmonary congestion

What is a contraindication for the use of nitroglycerin?

Extreme tachycardia (160 bpm)

What is a precaution to consider when administering IV nitroglycerin?

Use glass bottles and special tubing provided by the manufacturer for infusion

What is the maximum adult dosage for sublingual nitroglycerin within a 5-minute interval?

0.4 mg Signup and view all the answers

Which condition is a contraindication for the use of enoxaparin sodium (Lovenox)?

Severe thrombocytopenia (low platelets) Signup and view all the answers

What is the primary function of antiplatelet drugs?

Inhibit platelet aggregation Signup and view all the answers

Which sites does ASA inhibit?

Both Cox-1 and Cox-2 Signup and view all the answers

What is the pharmacological action of nitroglycerin?

Dilates all blood vessels from relaxation of smooth muscle cells on the structure of the veins and arteries Signup and view all the answers

What is the primary effect of nitroglycerin on coronary arteries?

Dilation to allow perfusion to the heart Signup and view all the answers

In what condition does nitroglycerin reduce the spasm of the coronary arteries?

Variant angina Signup and view all the answers

What is the effect of nitroglycerin on reducing the workload of the heart?

Reduces afterload by relaxing arteries Signup and view all the answers

Which medication is a nitrate?

Nitroglycerin Signup and view all the answers

Which medication primarily reduces the spasm of the coronary arteries?

Nitroglycerin Signup and view all the answers

Which vascular bed does nitroglycerin predominantly affect at low doses?

Venous Signup and view all the answers

Which condition is a relative contraindication for the use of tissue plasminogen activator (tPA)?

History of chronic, severe, poorly controlled hypertension Signup and view all the answers

Which condition is a contraindication for the use of tranexamic acid (TXA)?

Active thromboembolic disease (pulmonary embolus) Signup and view all the answers

What is the maximum initial IV bolus dosage of tissue plasminogen activator (tPA) for a patient with STEMI weighing less than 67 kg?

15 mg Signup and view all the answers

What is the primary indication for using tranexamic acid (TXA)?

Bleeding within 3 hours of injury and presenting with a heart rate > 110 bpm Signup and view all the answers

What is the precaution to consider when administering intravenous nitroglycerin?

Active peptic ulcer Signup and view all the answers

Which condition is a relative contraindication for the use of anticoagulants such as Warfarin, Apixaban, Rivaroxaban, Dabigatran?

Recent (within 2 to 4 weeks) internal bleeding Signup and view all the answers

What is the dosage of tranexamic acid (TXA) for a patient older than 16 years presenting with significant traumatic injury and internal bleeding?

1 g IV/IO dilute in 250 mL D5W or 100ml Normal Saline bag and infuse over 10 minutes Signup and view all the answers

What is the primary indication for using tissue plasminogen activator (tPA) in a patient with suspected aortic dissection?

Active bleeding or bleeding diathesis Signup and view all the answers

Which medication is an irreversible inhibitor of COX-1 and COX-2, preventing the formation of TXA2?

Acetylsalicylic acid (ASA) Signup and view all the answers

What is the primary purpose for using Ticagrelor?

Reducing thrombotic cardiovascular events Signup and view all the answers

Which medication is used for lysis of thrombi obstructing coronary and cerebral arteries?

Tenecteplase Signup and view all the answers

What is the mechanism of action of thrombolytic agents like tPA and tenecteplase?

Breaking down clots by activating the fibrinolytic system Signup and view all the answers

What is the dosage of ASA indicated for acute coronary syndromes?

160-325 mg PO Signup and view all the answers

What is the contraindication for using Clopidogrel?

Active bleeding Signup and view all the answers

What is the primary benefit of fibrinolysis using thrombolytic agents?

Breaking down clots to restore blood supply to damaged tissue Signup and view all the answers

What is the main mechanism of action of acetylsalicylic acid (ASA)?

Inhibition of COX-1 and COX-2, preventing the formation of TXA2 Signup and view all the answers

What is the primary indication for the use of Clopidogrel?

Acute Coronary Syndromes (ACS) Signup and view all the answers

What is a contraindication for the use of Ticagrelor?

Diabetic foot infections Signup and view all the answers

What is the main function of thrombolytic agents like tPA and tenecteplase?

Breakdown of clots Signup and view all the answers

What is a specific contraindication for the use of tenecteplase?

Recent internal bleeding Signup and view all the answers

What is the effect of thrombolytic agents on thrombi?

Prevent thrombi from becoming emboli Signup and view all the answers

What is the main concern regarding the use of acetylsalicylic acid (ASA) in certain conditions?

Active GI bleed Signup and view all the answers

Study Notes

Anticoagulant Medications and Thrombolytic Agents: Key Points

Acetylsalicylic acid (ASA) is an irreversible inhibitor of COX-1 and COX-2, preventing the formation of TXA2, and has various benefits and non-benefits.
ASA is indicated for acute coronary syndromes but contraindicated in certain conditions like active GI bleed and hypersensitivity to tartrazine.
ASA dosage is 160-325 mg PO, and it can be given even if the patient has taken ASA before, but non-enteric chewable or soluble aspirin should be used.
Clopidogrel and Ticagrelor are P2Y12 ADP Receptor Antagonists, with Clopidogrel being an irreversible receptor blocker and Ticagrelor being a reversible blocker.
Clopidogrel is indicated for ACS and has contraindications such as active bleeding and precautions in patients with increased risk of bleeding.
Ticagrelor is used for reducing thrombotic cardiovascular events and has contraindications like diabetic foot infections and active bleeding.
Fibrinolysis is the breakdown of clots and thrombolytic agents like tPA and tenecteplase activate the fibrinolytic system to break down clots quickly.
Tenecteplase is indicated for ST elevation or new LBBB in the context of signs and symptoms of AMI and has contraindications like recent internal bleeding and TIA within 6 months.
tPA is used for lysis of thrombi obstructing coronary and cerebral arteries and has contraindications such as prior intracranial hemorrhage and ischemic stroke within 3 months.
Thrombolytic agents activate plasminogen to convert it to plasmin, mimicking the body's clot destruction process, but are non-specific and will dissolve all clots.
The breakdown of clots by thrombolytic agents prevents thrombi from becoming emboli, restoring blood supply to damaged tissue.
Thrombolytic agents have specific indications, contraindications, and precautions that need to be carefully considered before administration.

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