Antiplatelet Pharmacology Quiz
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Questions and Answers

What is the primary purpose of antiplatelets?

  • Enhance blood clotting
  • Promote blood flow
  • Prevent platelet plug formation (correct)
  • Degrade existing clots

    • Venous thrombosis is caused by atherosclerosis.

    False (B)

    What are the two main types of pathologic clots?

    Venous thrombosis and arterial thrombosis

    A condition where a blood clot travels to the lungs is called a __________.

    <p>pulmonary embolism</p> Signup and view all the answers

    Match the following types of clots with their descriptions:

    <p>Deep Vein Thrombosis (DVT) = Clot in a deep vein, usually in the lower leg Pulmonary Embolism (PE) = Clot traveling to an artery in the lungs Coronary Thrombosis = Clot in an artery of the heart Stroke = Clot in an artery of the brain</p> Signup and view all the answers

    What typically starts arterial thrombosis?

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

    Hemostasis refers to the process of inducing excessive bleeding.

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

    What is the term used for blood clots that impair blood flow?

    <p>Thrombosis</p> Signup and view all the answers

    Which of the following is NOT an antiplatelet medication?

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

    Glycoprotein IIb/IIIa is also known as Integrin αIIbβ3.

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

    What is the primary function of glycoprotein IIb/IIIa in platelets?

    <p>Adhesion and aggregation of platelets</p> Signup and view all the answers

    Aspirin inhibits the synthesis of __________ to prevent platelet aggregation.

    <p>Thromboxane A2</p> Signup and view all the answers

    Match the glycoprotein IIb/IIIa inhibitors with their types.

    <p>Abciximab = Monoclonal antibody Tirofiban = Non-peptide antagonist Eptifibatide = Peptide antagonist</p> Signup and view all the answers

    How many copies of αIIbβ3 are typically present on the surface of one platelet?

    <p>80,000 – 100,000 (A)</p> Signup and view all the answers

    PDE inhibitors function by promoting platelet aggregation.

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

    Purinergic receptor inhibitors target the __________ receptor to inhibit platelet activation.

    <p>ADP</p> Signup and view all the answers

    Which drug acts by irreversibly modifying the platelet ADP receptor?

    <p>Clopidogrel (A), Prasugrel (B), Ticlopidine (C)</p> Signup and view all the answers

    Prasugrel is activated by carboxyesterase CES1 followed by CYP2C19.

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

    What is the expected lifespan of platelets exposed to clopidogrel?

    <p>Approximately 10 days</p> Signup and view all the answers

    The black box warning for clopidogrel relates to ______% of the US population with low CYP2C19 activity.

    <p>2-14</p> Signup and view all the answers

    Match the following drugs with their activation pathways:

    <p>Clopidogrel = CYP2C19 oxidation Prasugrel = Ester hydrolysis by CES2 Ticlopidine = Irreversible binding to P2Y12 receptor CYP2C19 = Activation of clopidogrel</p> Signup and view all the answers

    Which of the following statements is true about clopidogrel and prasugrel?

    <p>Both require biotransformation to inhibit platelet aggregation. (B), Only clopidogrel is affected by CYP2C19. (D)</p> Signup and view all the answers

    Concomitant use of omeprazole or esomeprazole is advised with clopidogrel.

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

    Which enzyme leads to more active drug formation for prasugrel?

    <p>CES2</p> Signup and view all the answers

    Which enzyme primarily metabolizes prasugrel to its active form?

    <p>CYP3A4 (B)</p> Signup and view all the answers

    Ticagrelor requires hepatic activation to become effective.

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

    What type of antagonism do prasugrel, clopidogrel, ticagrelor, and cangrelor exert at the P2Y12 receptor?

    <p>Antagonists</p> Signup and view all the answers

    Cangrelor is administered via __________ injection.

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

    Match the following drugs with their characteristics:

    <p>Prasugrel = Requires CYP metabolism Ticagrelor = Does not require hepatic activation Cangrelor = IV only and very short acting Clopidogrel = Prodrug requiring CYP2C19</p> Signup and view all the answers

    Which of the following statements about prasugrel and ticagrelor is true?

    <p>Prasugrel is a prodrug requiring metabolic activation. (B)</p> Signup and view all the answers

    Cilostazol is classified as a COX inhibitor.

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

    What is the FDA approval year for ticagrelor?

    <p>2011</p> Signup and view all the answers

    What effect does aspirin have on platelet aggregation?

    <p>It inhibits platelet aggregation. (A)</p> Signup and view all the answers

    Aspirin is the only NSAID that inhibits platelet aggregation.

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

    Which receptor do clopidogrel and ticlopidine bind to?

    <p>P2Y12 receptor</p> Signup and view all the answers

    The therapeutic effect of glycoprotein IIb/IIIa antagonists is to inhibit __________ which prevents platelet aggregation.

    <p>aggregation</p> Signup and view all the answers

    Match the medications to their characteristics:

    <p>Aspirin = Inhibits thromboxane A2 biosynthesis Clopidogrel = Binds to P2Y12 receptor Prasugrel = Thienopyridine class drug Glycoprotein IIb/IIIa antagonists = Inhibit platelet aggregation directly</p> Signup and view all the answers

    What is the primary action of dipyridamole?

    <p>Inhibits platelet aggregation (D)</p> Signup and view all the answers

    Cilostazol is a phosphodiesterase 3 (PDE3) inhibitor that decreases platelet aggregation.

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

    What does PDE inhibition in relation to cilostazol increase that helps inhibit platelet activation?

    <p>Cyclic guanosine monophosphate (cGMP)</p> Signup and view all the answers

    Dipyridamole also inhibits the reuptake of ________ into platelets, red blood cells, and endothelial cells.

    <p>adenosine</p> Signup and view all the answers

    Match the following drugs with their primary mechanism of action:

    <p>Dipyridamole = Inhibits cAMP breakdown Cilostazol = Inhibits PDE3 Vorapaxar = Inhibition of protease-activated receptor-1 Adenosine = Promotes vasodilation and platelet inhibition</p> Signup and view all the answers

    What effect does dipyridamole have when given at high doses over a short time?

    <p>Causes blood vessel dilation (A)</p> Signup and view all the answers

    Vorapaxar acts as a PDE inhibitor.

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

    What type of activity does dipyridamole potentiate?

    <p>Antiaggregating action of prostacyclin (PGI2)</p> Signup and view all the answers

    Study Notes

    Hemostasis (Blood Clotting)

    • Hemostasis is a delicate balance, preventing blood loss from a disrupted intravascular space but allowing unrestricted flow under normal circumstances
    • Four physiological processes occur:
      • Vascular constriction (slowing blood flow to the damaged site)
      • Platelet plug formation (clot formation)
      • Fibrin formation (clot formation)
      • Fibrinolysis (clot degradation after the damaged site is healed)
    • Endogenous clots need to be degraded after formation
    • The processes are connected and occur simultaneously with multiple reinforcements

    Inhibitors of Blood Clot Formation

    • Antiplatelets prevent the platelet plug
    • Antithrombotics prevent the fibrin clot

    Enhancers of Blood Clot Degradation

    • Thrombolytics will be covered in P3 (acute, hospital use, intravenous)

    Hemostasis - Definition

    • Hemostasis is the process for maintaining circulatory system integrity following blood vessel damage, maintaining a delicate balance between clotting and bleeding
    • Hemostatic clots are localized to the vessel wall and do not greatly impede blood flow
      • These are "good" clots and prevent unwanted bleeding
    • Pathologic clots impair blood flow and often cause complete vessel occlusion
      • Also called thrombosis
      • These are "bad" (pathologic) clots

    Types of Pathologic Clots

    • Two main types of pathologic clots:
      • Venous thrombosis:
        • A clot blocks a vein
        • Carries un-oxygenated blood back to the heart
        • Flow is rather slow
        • Typically started by endothelial damage and contains mostly fibrin
        • Deep Vein Thrombosis (DVT) occurs in deep veins, often in the lower leg, thigh, pelvis, or arms with IV lines
        • Pulmonary Embolism (PE) occurs when a DVT clot breaks loose and travels to an artery in the lungs
          • DVT and PE together are called Venous Thromboembolism (VTE)
      • Arterial thrombosis:
        • A clot blocks an artery that carries oxygen-rich blood away from the heart
        • Flow is rather fast
        • Typically started by atherosclerosis and contains platelets and fibrin
        • Coronary thrombosis occurs in an artery in the heart and causes a heart attack (MI) or myocardial infarction or angina
        • Stroke occurs when arterial thrombosis happens in an artery in the brain

    Drugs Altering Blood Clot Formation and Degradation

    • Inhibitors of clot formation:
      • Antiplatelets: prevent platelet activation and/or aggregation
        • COX inhibitors (irreversible), decreases Thromboxane A₂ synthesis (Aspirin)
        • Glycoprotein IIb/IIIa antagonists (abciximab, tirofiban, eptifibatide)
        • Purinergic receptor antagonists (ADP-receptor, P2Y12): (clopidogrel, prasugrel, ticagrelor, cangrelor)
        • Phosphodiesterase 3 inhibitor (cilostazol)
        • Adenosine Reuptake inhibitor and PDE inhibitor (dipyridamole)
        • Inhibition of protease-activated receptor-1 (vorapaxar)
    • Anticoagulants: prevent fibrin formation (next slidepack)

    ###Platelet Activation & Aggregation and Drugs causing antiplatelet effect

    • Many mechanisms exist

    Additional Information

    • Students should watch the videos provided after the lecture to understand the topics
    • These videos come from a group sponsored by Bayer Pharmaceutical called ThrombosisAdvisor.com

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    Related Documents

    BPS 338 - Antiplatelets Lecture Notes Sp2024 PDF

    Description

    Test your knowledge on antiplatelet medications and blood clotting processes with this quiz. It covers key concepts such as thrombosis, hemostasis, and the roles of glycoprotein IIb/IIIa and PDE inhibitors in platelet function. Perfect for students and professionals in the medical field.

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