PAT 202: WEEK 1-4 PHARMACOTHERAPY EXAM
QUESTIONS WITH VERIFIED ANSWERS
Ticagrelor - Answers - Antiplatelets
Ticagrelor indications for use - Answers - - reduces risk of thromboembolic events in
ACS
- with PCI, reduces risk of stent thrombosis
Ticagrelor mechanism of action - Answers - - blocks ADP receptors on platelets →
prevents signal and platelet activation ⭢ ↓platelet aggregation
TICAGRELOR DESIRED EFFECTS - Answers - ↓ cardiovascular death, MI and stroke
Ticagrelor adverse effects - Answers - - bleeding (can be serious/fatal)
- dyspnea
Acetylsalicylic Acid classification - Answers - Cyclooxygenase (COX) Inhibitors
Also is a = Antiplatelet / NSAID
Acetylsalicylic Acid Indication for use - Answers - - antiplatelet (unique to this NSAID) - -
significant anticoagulant activity
- secondary prevention of vascular events - risk reduction of recurrent vascular events
(thrombosis) in those with hx of ACS, ischemic stroke, peripheral vascular disease
- mild to moderate pain & inflammation, fever
PAT201
- TIAs, ischemic stroke, acute coronary syndrome (ACS), secondary prevention of
vascular events
- Recall: also used for its
- analgesic
- anti-inflammatory
- antipyretic properties
Acetylsalicylic Acid Mechanism of Action - Answers - inhibits cyclooxygenase (COX)
enzyme pathway preventing production of prostaglandin & synthesis of thromboxane A2
- COX irreversibly inhibited for lifespan of platelet (7-10 days)
,Acetylsalicylic Acid desired effect - Answers - inhibits platelet aggregation (effect on -
platelets almost immediate)
- secondary prevention of thrombotic events
Acetylsalicylic Acid adverse effect - Answers - - gastric discomfort
- bleeding
- ↑ clotting time
- salicylism (can occur with high dosing) - tinnitus, dizziness, headaches, sweating
PAT201
- GI bleeds
- bruising
- N/V
- Reye's syndrome (children)
Alteplase (tPA) classification - Answers - Thrombolytics: Tissue Plasminogen Activator
(tPA)
For maximum effectiveness:
Must be given within 6 hours of the onset of symptoms of MI and within 3 hours of
thrombotic CVA
Alteplase indication for use - Answers - - MI and CVA related to clots (thrombotic)
- off-label use: restore IV catheter patency
Alteplase mechanism of action - Answers - - identical to human tPA enzyme
- mimics body's process of clot destruction - **converts plasminogen to plasmin**
(enzyme that breaks down fibrin in clot) → dissolves thrombi
Alteplase desired effect - Answers - PAT201
**re-establishes bld flow to prevent further damage
- re-establishes bld flow to blood-starved tissues
- limits or prevents cell death
- causes clots to dissolve
- coronary artery opens allowing perfusion of myocardium
Alteplase adverse effect - Answers - - severe risk of bleeding
- spontaneous ecchymoses,
- hematomas
- epistaxis,
- intracranial bleeding
PAT201
- internal & superficial bleeding
, - intracranial hemorrhage
- nose bleeds
Alteplase - Contraindications: - Answers - Clients with active bleeding or with history of
recent trauma
**Do NOT give if risk of bleeding is greater than the potential benefit!
Heparin classification - Answers - Anticoagulants
Natural substance found in liver and lining of blood vessels. Its normal function is to
prolong coagulation time, preventing excessive clotting within blood vessels.
Heparin indication for use - Answers - - acute thromboembolic disorders including DVT,
- PE,
- UA,
- evolving MI
- prophylaxis for clotting
Heparin Mechanism of action - Answers - - binding of heparin to antithrombin III
inactivates several clotting factors and inhibits thrombin activity
Heparin desired effect - Answers - - prevents the enlargement of existing clots
- prevents formation of new clots
Heparin adverse effect - Answers - - abnormal bleeding & serious hemorrhaging
- heparin-induced thrombocytopenia
- caused by abnormal antibodies that
activate platelets, causing clots to form
and depleting platelet counts in blood
Protamine Sulfate classification - Answers - Antidote For Heparin Therapy
***Reverses anticoagulant activity of heparin
Protamine Sulfate indication for use - Answers - - if serious hemorrhage occurs
- onset of action → 5 minutes
Protamine Sulfate Mechanism of action - Answers - - binds to heparin to form stable ion
pair that does not have anticoagulant activity
Protamine Sulfate desired effect - Answers - - neutralizes anticoagulant activity of
heparin
- makes heparin ineffective
Protamine Sulfate adverse effect - Answers - - severe respiratory distress
QUESTIONS WITH VERIFIED ANSWERS
Ticagrelor - Answers - Antiplatelets
Ticagrelor indications for use - Answers - - reduces risk of thromboembolic events in
ACS
- with PCI, reduces risk of stent thrombosis
Ticagrelor mechanism of action - Answers - - blocks ADP receptors on platelets →
prevents signal and platelet activation ⭢ ↓platelet aggregation
TICAGRELOR DESIRED EFFECTS - Answers - ↓ cardiovascular death, MI and stroke
Ticagrelor adverse effects - Answers - - bleeding (can be serious/fatal)
- dyspnea
Acetylsalicylic Acid classification - Answers - Cyclooxygenase (COX) Inhibitors
Also is a = Antiplatelet / NSAID
Acetylsalicylic Acid Indication for use - Answers - - antiplatelet (unique to this NSAID) - -
significant anticoagulant activity
- secondary prevention of vascular events - risk reduction of recurrent vascular events
(thrombosis) in those with hx of ACS, ischemic stroke, peripheral vascular disease
- mild to moderate pain & inflammation, fever
PAT201
- TIAs, ischemic stroke, acute coronary syndrome (ACS), secondary prevention of
vascular events
- Recall: also used for its
- analgesic
- anti-inflammatory
- antipyretic properties
Acetylsalicylic Acid Mechanism of Action - Answers - inhibits cyclooxygenase (COX)
enzyme pathway preventing production of prostaglandin & synthesis of thromboxane A2
- COX irreversibly inhibited for lifespan of platelet (7-10 days)
,Acetylsalicylic Acid desired effect - Answers - inhibits platelet aggregation (effect on -
platelets almost immediate)
- secondary prevention of thrombotic events
Acetylsalicylic Acid adverse effect - Answers - - gastric discomfort
- bleeding
- ↑ clotting time
- salicylism (can occur with high dosing) - tinnitus, dizziness, headaches, sweating
PAT201
- GI bleeds
- bruising
- N/V
- Reye's syndrome (children)
Alteplase (tPA) classification - Answers - Thrombolytics: Tissue Plasminogen Activator
(tPA)
For maximum effectiveness:
Must be given within 6 hours of the onset of symptoms of MI and within 3 hours of
thrombotic CVA
Alteplase indication for use - Answers - - MI and CVA related to clots (thrombotic)
- off-label use: restore IV catheter patency
Alteplase mechanism of action - Answers - - identical to human tPA enzyme
- mimics body's process of clot destruction - **converts plasminogen to plasmin**
(enzyme that breaks down fibrin in clot) → dissolves thrombi
Alteplase desired effect - Answers - PAT201
**re-establishes bld flow to prevent further damage
- re-establishes bld flow to blood-starved tissues
- limits or prevents cell death
- causes clots to dissolve
- coronary artery opens allowing perfusion of myocardium
Alteplase adverse effect - Answers - - severe risk of bleeding
- spontaneous ecchymoses,
- hematomas
- epistaxis,
- intracranial bleeding
PAT201
- internal & superficial bleeding
, - intracranial hemorrhage
- nose bleeds
Alteplase - Contraindications: - Answers - Clients with active bleeding or with history of
recent trauma
**Do NOT give if risk of bleeding is greater than the potential benefit!
Heparin classification - Answers - Anticoagulants
Natural substance found in liver and lining of blood vessels. Its normal function is to
prolong coagulation time, preventing excessive clotting within blood vessels.
Heparin indication for use - Answers - - acute thromboembolic disorders including DVT,
- PE,
- UA,
- evolving MI
- prophylaxis for clotting
Heparin Mechanism of action - Answers - - binding of heparin to antithrombin III
inactivates several clotting factors and inhibits thrombin activity
Heparin desired effect - Answers - - prevents the enlargement of existing clots
- prevents formation of new clots
Heparin adverse effect - Answers - - abnormal bleeding & serious hemorrhaging
- heparin-induced thrombocytopenia
- caused by abnormal antibodies that
activate platelets, causing clots to form
and depleting platelet counts in blood
Protamine Sulfate classification - Answers - Antidote For Heparin Therapy
***Reverses anticoagulant activity of heparin
Protamine Sulfate indication for use - Answers - - if serious hemorrhage occurs
- onset of action → 5 minutes
Protamine Sulfate Mechanism of action - Answers - - binds to heparin to form stable ion
pair that does not have anticoagulant activity
Protamine Sulfate desired effect - Answers - - neutralizes anticoagulant activity of
heparin
- makes heparin ineffective
Protamine Sulfate adverse effect - Answers - - severe respiratory distress
