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Questions and Answers
What is the primary mechanism of action of aspirin in dual antiplatelet therapy?
In which of the following situations is dual antiplatelet therapy typically contraindicated?
What is the primary benefit of dual antiplatelet therapy in patients with acute coronary syndrome?
What is the typical duration of dual antiplatelet therapy after acute coronary syndrome or percutaneous coronary intervention?
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What is the primary risk of dual antiplatelet therapy?
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What is the purpose of regular platelet function tests in dual antiplatelet therapy?
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Study Notes
Definition and Purpose
Dual antiplatelet therapy (DAPT) is a combination of two antiplatelet medications, typically aspirin and a P2Y12 inhibitor, used to prevent platelet activation and thrombosis.
Mechanism of Action
- Aspirin: inhibits thromboxane A2 production, preventing platelet activation
- P2Y12 inhibitor (e.g., clopidogrel, prasugrel, ticagrelor): blocks P2Y12 receptor, preventing ADP-mediated platelet activation
Indications
- Acute coronary syndrome (ACS)
- Percutaneous coronary intervention (PCI)
- Coronary artery stenting
- Cardiac surgery
Benefits
- Reduced risk of cardiovascular death, myocardial infarction, and stroke
- Improved outcomes in patients with ACS and PCI
Risks and Side Effects
- Increased risk of bleeding
- Gastrointestinal bleeding and ulceration
- Thrombocytopenia
Duration of Therapy
- Typically 12 months after ACS or PCI
- May be extended or shortened based on individual patient needs and risk factors
Monitoring and Titration
- Regular platelet function tests to ensure adequate platelet inhibition
- Adjust medication dosages as needed to achieve optimal platelet inhibition
Contraindications
- Active bleeding or high risk of bleeding
- Pregnancy or breastfeeding
- Allergy or intolerance to aspirin or P2Y12 inhibitors
Definition and Purpose
- Dual antiplatelet therapy (DAPT) combines two antiplatelet medications to prevent platelet activation and thrombosis.
- Typically consists of aspirin and a P2Y12 inhibitor.
Mechanism of Action
- Aspirin inhibits thromboxane A2 production, preventing platelet activation.
- P2Y12 inhibitors (e.g., clopidogrel, prasugrel, ticagrelor) block P2Y12 receptors, preventing ADP-mediated platelet activation.
Indications
- Acute coronary syndrome (ACS)
- Percutaneous coronary intervention (PCI)
- Coronary artery stenting
- Cardiac surgery
Benefits
- Reduces risk of cardiovascular death, myocardial infarction, and stroke
- Improves outcomes in patients with ACS and PCI
Risks and Side Effects
- Increases risk of bleeding
- Causes gastrointestinal bleeding and ulceration
- May cause thrombocytopenia
Duration of Therapy
- Typically 12 months after ACS or PCI
- May be extended or shortened based on individual patient needs and risk factors
Monitoring and Titration
- Regular platelet function tests ensure adequate platelet inhibition
- Medication dosages are adjusted as needed to achieve optimal platelet inhibition
Contraindications
- Active bleeding or high risk of bleeding
- Pregnancy or breastfeeding
- Allergy or intolerance to aspirin or P2Y12 inhibitors
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Description
Learn about the mechanisms and indications of dual antiplatelet therapy, a combination of aspirin and a P2Y12 inhibitor, used to prevent platelet activation and thrombosis in cardiovascular diseases.
