ACS

Question 1

risk factors for ACS

Answer 1

males > 45, females >55
smoking
HTN
known CAD
dyslipidemia
DM
chronic stable angina
lack of excerise
excessive ETOH
first degree relative w/ coronary event males before 55 females before 65

Question 2

Drugs to give for ACS
Mona-GAP-BA

Answer 2

1st :morphine, O2, nitrates, ASA
2nd: GPIIb/IIIa, anticoags, P2Y12
within 24H: beta blockers, ACEi

Question 3

P2Y12 inhibitors: prodrugs that irreversibly bind to receptor

Answer 3

clopidogrel and prasugrel

Question 4

clopidogrel (Plavix) warnings

Answer 4

effectiveness depends on cyp 2C19 activity, contraindicated in active bleeds, TTP

Question 5

prasugrel (Effient) warnings

Answer 5

dispense in original container, not recommended in pts > 75 unless high risk (MI, or DM), no not use if CABG, TTP

Question 6

ticagrelor (Brilinta) warnings

Answer 6

after ASA loading dose, do not use ASA doses >100, avoid in CABG, severe hepatic impairment, bradyarrhythmias, TTP, increase uric acid, increase Scr

Question 7

Plavix DDI

Answer 7

Avoid with cyp2C19 inhibitors eso and omeprazole
can increase effects of repaglinide which causes hypoglycemia

Question 8

fibrinolytics MOA

Answer 8

fibrinolysis by binding to fibrin and converting plasminogen to plasmin

Question 9

fibrinolytics MOA

Answer 9

Only for STEMI within 30 mins of arrival from door to needle