58 Questions
What is the potential outcome of venous thrombosis known as?
Pulmonary Embolism
Which gene mutation is commonly associated with an increased risk of venous thrombosis in Caucasians?
Factor V gene mutation
What diagnostic method is used for detecting pulmonary embolism and other vascular abnormalities?
Doppler ultrasound
Which laboratory test is recommended for monitoring unfractionated heparin (UFH) and low molecular weight heparins (LMWHs)?
Anti-Xa level test
What is the Leiden mutation associated with in terms of clotting risk?
Increased risk of venous thrombosis
Which factor is not typically tested in laboratory evaluation for thrombotic disorders?
Brain natriuretic peptide (BNP)
Which of the following drugs has efficacy for non Q wave, Non STEMI, and unstable angina?
Tirofiban
Which enzyme is needed to activate clopidogrel, and is estimated to be low in 2-14% of the US population?
CYP 2C19
What is the timeframe within which platelet aggregation is restored after cessation of eptifibatide infusion?
6 hours
Which drug is a nonpeptide IIbIIIa inhibitor given before and after angioplasty or atherectomy?
Tirofiban
What is the mechanism of action of eptifibatide and tirofiban in inhibiting platelet aggregation?
Antiplatelet effect
What is the main concern regarding the adverse effects of Aspirin?
Gastric and duodenal ulcers
Which drug interaction with Aspirin can lead to increased bleeding?
Angiotensin-converting enzyme inhibitors (ACEIs)
What is the major metabolic pathway for Aspirin?
Salicyl phenolic glucuronide
Which group of individuals is NOT recommended to receive Aspirin according to the text?
Children less than 12 years old
What is a common adverse effect associated with Aspirin use in asthmatics?
Tinnitis
What is one of the therapeutic uses of Aspirin as mentioned in the text?
Secondary prevention of coronary events like stroke and MI
What is the main function of Abciximab (ReoPro) in preventing platelet aggregation?
Inhibiting the activation of GPIIb
Why must GP IIB/IIIA receptor antagonists like Tirofiban be given by continuous infusion?
Because of their short half-lives
Which of the following statements about Dipyridamole is TRUE?
It may be used for myocardial stress testing
How does aspirin-dipyridamole (Aggrenox®) help in preventing CVA after stroke/TIA?
By inhibiting thromboxane A2 activation
Which factor may reverse the effects of an overdose of Abciximab (ReoPro)?
Aminophylline
Why should Abciximab (ReoPro) not be used if CrCl is less than 10mL/min?
Concerns about renal clearance
What is the function of PRAXBIND (IDARUCIZUMAB)?
Reversing complete anticoagulation caused by Pradaxa
Which adverse reaction is associated with the administration of PRAXBIND?
Hypokalemia
What is the primary target of Vorapaxar (Zontivity)?
Platelet aggregation
Why is Vorapaxar contraindicated in patients with a history of intracranial bleeds or stroke?
To avoid thromboembolic risk
How does the half-life of Vorapaxar compare to that of PRAXBIND (IDARUCIZUMAB)?
PRAXBIND has a longer half-life
Which type of drug interaction affects the exposure of Vorapaxar?
Potent CYP3A4 inducers
What is the main function of Tissue Factor Pathway Inhibitor?
Prevents activation of factors IX and X
Which platelet receptor is involved in platelet adhesion to exposed collagen?
GpIb
What stimulates the formation of a primary hemostatic plug on the platelet surface?
ADP
Which molecule is important for platelet aggregation along with ADP and thrombin?
Thromboxane A2 (TxA2)
Which enzyme is synthesized by endothelial cells and activates the extrinsic clotting cascade?
Tissue factor (factor III)
What is the role of GpIIb-IIIa receptors in platelet aggregation?
Bind fibrinogen
What is the main metabolic pathway for Clopidogrel (Plavix)?
Liver excretion
Which CYP2C19 inhibitor can decrease the action of Clopidogrel on platelets?
Cimetidine
What is the main therapeutic use of Prasugrel (Effient)?
Prevention of thrombotic events after TIA
Which adverse effect is a black box warning associated with the use of Prasugrel?
Fatal bleeding
Why should Prasugrel be avoided in patients with cerebrovascular disease or aged over 75?
Reduced effectiveness on platelets
What class of drugs should be monitored when initiating treatment with Prasugrel to avoid adverse effects?
Statins
Which drug is used for prevention of CVA after stroke/TIA and may be used for myocardial stress testing?
Dipyridamole
Why must GP IIB/IIIA receptor antagonists be given by continuous infusion?
To ensure consistent platelet inhibition
Which drug is a Fab fragment of a human monoclonal antibody with a duration of action lasting 18-24 hours?
Abciximab
What happens if major bleeding occurs while using Abciximab (ReoPro)?
Platelet transfusion may reverse aggregation defect
What is the primary mechanism of action of GP IIB/IIIA receptor antagonists like Eptifibatide and Tirofiban?
Binding to glycoprotein receptor IIbIIIa preventing aggregation
Why should Aspirin-Dipyridamole (Aggrenox®) not be used if CrCl is less than 10mL/min?
Reduced efficacy due to impaired clearance
Why should Betrixaban not be used in patients with non-valvular atrial fibrillation?
Increased risk of stroke
Which medication is used as an antidote for Betrixaban (Bevyxxa) in case of overdose?
Andexxa
What is the recommended duration of Betrixaban (Bevyxxa) therapy for deep vein thrombosis (DVT) prophylaxis?
35-42 days
Which medication should have its dose reduced when co-administered with P-glycoprotein inhibitors like quinidine and ketoconazole?
Betrixaban
What is the effective half-life of Betrixaban (Bevyxxa)?
19-27 hours
How long does it take for PRAXBIND (IDARUCIZUMAB) to achieve complete anticoagulation reversal?
4 hours
Which adverse reaction is NOT associated with the administration of PRAXBIND (IDARUCIZUMAB)?
Thromboembolism
What is the primary target of Vorapaxar (Zontivity)?
PAR-1
Which enzyme is estimated to be low in 2-14% of the US population and is needed to activate clopidogrel?
CYP2C19
What is a potential side effect of Vorapaxar (Zontivity) administration?
Hypokalemia
What is the circulating half-life of Vorapaxar (Zontivity)?
~3 days
Test your knowledge on concepts related to hemostasis (LOVE=HEMOSTASIS) and thrombosis (VIRCHOW’S TRIAD) including hypercoagulability, mutations in factor V gene, and acquired thrombosis risk factors.
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