WorksheetsAcute Coronary Syndromes
Total questions: 16
Worksheet time: 31mins
Which of the following medications work by blocking the binding of fibrinogen, von Willebrand factor, and other ligands at the glycoprotein IIb/IIIa receptor?
Eptifibatide
Fondaparinux
Bivalirudin
Ticagrelor
Vorapaxar
Which of the following medications is an intravenous P2Y12 inhibitor?
Clopidogrel
Tenecteplase
Cangrelor
Prasugrel
Which of the following side effects is common with Brilinta?
Puffy eyes
Tachyarrhythmias
Hepatic impairment
Dyspnea
A patient with a STEMI arrives at a hospital without PCI facilities. The patient should receive a fibrinolytic if PCI is not possible within what period of time from first medical contact?
30 minutes
60 minutes
120 minutes
4.5 hours
STEMI patients are not candidates for fibrinolytic therapy
GL is placed on aspirin 81 mg PO daily and ticagrelor _____________ after PCI with placement of 2 stents. Fill in the blank.
30 mg PO daily
60 mg daily
90 mg daily
90 mg twice daily
What causes an acute coronary syndrome?
Rupture of the interventricular septum between the right and left ventricle
Abnormal electrical impulse conduction through the heart causing reduced myocardial oxygen supply
Reduced blood flow to the heart caused by plaque buildup in the coronary arteries
Clot formation in the deep veins of the pelvis or legs
Reduced blood flow to the brain caused by plaque buildup in the carotid arteries
All of the following are antiplatelet agents that can be used in the treatment of an acute coronary syndrome EXCEPT:
Eptifibatide
Dalteparin
Clopidogrel
Ticagrelor
Aspirin
JA is a 60 year-old male (6’1”, 275 pounds) who presents to the ED with an NSTEMI. He was given aspirin 325 mg in the field and was started on a nitroglycerin drip at 100 mcg/min. His oxygen saturation is 94% and he received morphine sulfate 2 mg IV x2 in the past 30 minutes. He is transferred to the cardiac catheterization laboratory and angioplasty confirmed a 90% blockage of his left anterior descending artery. The cardiac interventionalist wants to start P2Y12 inhibitor therapy prior to the PCI. Which of the following regimens would be most appropriate in this patient?
Brilinta 90 mg PO x1
Brilinta 80 mg PO x1
Effient 60 mg PO x1
Plavix 900 mg PO x1
Effient 10 mg PO x1
Which of the following are true regarding clopidogrel? (Select all that apply)
It should be discontinued 12 hours prior to major surgery
It is metabolized to its active form by CYP 2C19
The typical maintenance dose is 300 mg daily
It binds irreversibly to the platelet
It increases bleeding risk
AB has been taking ticagrelor 90 mg BID for 3 months. Which of the following new orders should not be filled by the pharmacist?
Aspirin 325 mg daily
Enoxaparin 1mg/kg every 12 hours
Metoprolol XL 50 mg daily
Warfarin 2 mg daily
The provider orders ReoPro. What is the appropriate generic substitution?
Eptifibatide
Aletplase
Abciximab
Tirofiban
SA is a 61 year-old female (5’3”, 115 pounds) who presents to the ED with a NSTEMI. Her PMH is significant for DM, HTN, multiple TIAs and a hip fracture. She was given aspirin 325 mg in the field and was started on a nitroglycerin drip at 50 mcg/min. Her oxygen saturation is 92% and she has received morphine sulfate 1 mg IV x1 in the past 30 minutes. She is transferred to the cardiac cath lab and angioplasty confirmed an 85% blockage of her left marginal artery. The cardiac interventionalist wants to start P2Y12 inhibitor therapy prior to the PCI. Which of the following regimens is most appropriate in this patient?
Effient 60 mg PO x1
Effient 5 mg PO x1
Brilinta 180 mg PO x1
Activase 90 mg IV x1
Brilinta 90 mg PO x1
PT was diagnosed with an acute STEMI. The physician is determining if she is a candidate for fibrinolysis. Which of the following is an ABSOLUTE contraindication to fibrinolysis?
Blood pressure of 165/98
A prior intracranial hemorrhage
Hypersensitivity to soy products
Concurrent use of aspirin
Ischemic stroke 4 years ago
A patient at the hospital is receiving nitroglycerin for chest pain. What are the advantages/reason for using nitroglycerin in a patient with chest pain? (Select all that apply)
Relieves chest pain
Helps with fibrinolysis
Reduces preload
Dilates coronary arteries and increases blood flow
Increase blood pressure
AM is a 58 year-old female, who had a silent heart attack. She does not smoke, but lives with her husband who smokes 2 PPD. Her PCP prescribed her Zocor about 1 year ago, but she never filled the prescription. She checks her BP sometimes and the “top number is usually 150-160 and the bottom number is usually 90-100.” Her mother passed away at age 61 due to colon cancer and her father passed away at age 80 with COPD. What are her risk factors for coronary heart disease? (Select all that apply)
Family History
Diabetes
Dyslipidemia
Age
Hypertension
What is the primary reason for using aspirin in a patient with chest pain?
Provide moderate degree of analgesia
Prevent flushing
Increase mortality in patients with STEMI
Break down the clot
Inhibit platelet aggregation
