Question 1

Thrombolytic drugs may be helpful in treating an acute cerebrovascular accident (stroke)if&#10;A) they are administered 8 to 10 hours after the onset of symptoms&#10;B) they are administered orally&#10;C) the stroke is ischemic in nature&#10;D) all the above are true

Accepted Answer

Thrombolytic drugs are only helpful in treating ischemic strokes since they dissolve blood clots in the affected blood vessels. They need to be administered as soon as possible, ideally within the first few hours of symptom onset. Oral administration is not effective in treating stroke, and the window for administering thrombolytic drugs is usually within the first 4.5 hours. Thus, options A and B are incorrect. Therefore, the best choice is C.

Question 2

Which of the following drug strategies would NOT be indicated in conditions like deep vein thrombosis (DVT)?&#10;A) drugs that increase the ability of antithrombin to inhibit the activity of several clotting factors (e.g., heparin)&#10;B) drugs that inhibit vitamin K metabolism in the liver (e.g., warfarin)&#10;C) drugs that inhibit fibrinolysis (e.g., aminocaproic acid [Amicar], tranexamic acid [Cyklokapron])&#10;D) drugs that directly inhibit the active form for clotting factor X (e.g., fondaparinux [Arixtra], rivaroxaban [Xarelto])&#10;E) drugs that directly inhibit thrombin activity (e.g., lepirudin [Refludan], dabigatran [Pradaxa])

Accepted Answer

Drugs that inhibit fibrinolysis, such as aminocaproic acid and tranexamic acid, would not be indicated in the treatment of deep vein thrombosis (DVT) because they prevent the breakdown of clots, which is the opposite of what is desired in the treatment of DVT. The goal in DVT treatment is to prevent clot extension and promote clot resolution, not to inhibit the breakdown of clots.

Question 3

Drug management in hemophilia consists of giving drugs that&#10;A) inhibit thrombin formation.&#10;B) inhibit Vitamin K activity&#10;C) increase fibrinolysin activity&#10;D) inhibit platelet function.&#10;E) treatment consists of administering the missing clotting factor(s)

Accepted Answer

Hemophilia is a genetic disorder where there is a deficiency or absence of clotting factors, primarily Factor VIII or Factor IX. Therefore, the best choice for drug management in hemophilia is to administer the missing clotting factors. This can be done prophylactically or on demand to prevent or treat bleeding episodes. Options A, B, C, and D are not appropriate treatments for hemophilia.

Question 4

Low molecular weight heparins such as enoxaparin are often preferred to more traditional (unfractionated)heparin because low molecular weight heparins&#10;A) can be administered subcutaneously&#10;B) usually do not need to be administered as frequently as traditional heparin&#10;C) provide more predictable anticoagulant effects&#10;D) all the above are true&#10;E) none of the above are true

Accepted Answer

Low molecular weight heparins like enoxaparin can be administered subcutaneously, have less frequent dosing requirements and provide more predictable anticoagulant effects when compared to traditional unfractionated heparin. Therefore, all the choices mentioned in the question are true.

Question 5

Patients who develop muscle pain and weakness when taking lipid lowering drugs such as atorvastatin (Lipitor)and simvastatin (Zocor)&#10;A) should continue on the lipid lowering drugs because these muscle symptoms are usually not severe&#10;B) should continue on the lipid lowering drugs but resolve the muscle pain through strenuous resistance exercises&#10;C) should continue on the lipid lowering drugs but take an analgesic such as aspirin to control the pain&#10;D) should be removed immediately from the drug because these symptoms may represent potentially serious myopathies&#10;E) these drugs are not associated with muscle pain or weakness

Accepted Answer

Patients who develop muscle pain and weakness while taking lipid lowering drugs should be removed immediately from the drug because these symptoms may represent potentially serious myopathies, including rhabdomyolysis. This is a rare but potentially life-threatening condition that can result in kidney failure and even death. It is important to consult a healthcare provider if any muscle symptoms develop while taking these drugs.

Question 6

Because of its ability to inhibit platelet activity,aspirin is used to prevent&#10;A) myocardial infarction&#10;B) ischemic stroke&#10;C) hemorrhagic stroke&#10;D) all the above are true&#10;E) A and B only are true

Accepted Answer

Aspirin's ability to inhibit platelet activity is effective in preventing both myocardial infarction and ischemic stroke, but it is not recommended for use in preventing hemorrhagic stroke. Therefore, option E, which includes only choices A and B, is the best answer.

Question 7

Patient taking statins to improve plasma lipid profiles may be at increased risk for statin-induced myopathy if they&#10;A) are elderly&#10;B) have multiple diseases&#10;C) have frail stature&#10;D) are taking immunosuppressant drugs&#10;E) all the above

Accepted Answer

All of the factors listed (elderly, multiple diseases, frail stature, and taking immunosuppressant drugs) have been associated with an increased risk for statin-induced myopathy. These factors may contribute to decreased muscle function and metabolism, which can increase the risk for muscle damage and myopathy associated with statin use. It is important for healthcare providers to monitor patients taking statins for signs of myopathy and to adjust medication dosages as appropriate to reduce the risk for adverse effects.

Question 8

Oral anticoagulants such as warfarin (Coumadin)decrease the production of several clotting factors in the liver by interfering with the regeneration of&#10;A) tissue thromboplastin&#10;B) tissue plasminogen activator&#10;C) vitamin K&#10;D) vitamin D&#10;E) vitamin C

Accepted Answer

Warfarin (Coumadin) decreases the production of several clotting factors in the liver by interfering with the regeneration of vitamin K, which is essential for the synthesis of these clotting factors.

Question 9

A patient is in the process of having a heart attack due to the sudden formation of an arterial thrombus in his coronary artery.To break up the clot and save the patient's life,the best drug to use is&#10;A) a low-molecular weight heparin (e.g., enoxaparin)&#10;B) a fibrinolytic drug (e.g. streptokinase or tPA)&#10;C) a fibrinolysis inhibitor (e.g., aminocaproic acid)&#10;D) warfarin (Coumadin)&#10;E) vitamin K

Accepted Answer

A fibrinolytic drug such as streptokinase or tPA would be the best choice to break up the arterial thrombus and restore blood flow to the affected area. Heparin may help prevent further clot formation, but it does not break up existing clots. Fibrinolysis inhibitors, such as aminocaproic acid, would actually prevent the breakdown of clots, which is counterproductive in this situation. Warfarin and vitamin K are used to prevent the formation of blood clots over a longer period of time, such as in patients with atrial fibrillation or deep vein thrombosis, and are not appropriate for an acute situation like a heart attack.

Question 10

In a patient with acute deep vein thrombosis (DVT),anticoagulant therapy is typically initiated with _____ to achieve rapid control of clotting,and then switched over to _____ for long-term management or prevention of DVT.

A) heparin; oral anticoagulants
B) oral anticoagulants; thrombin
C) thrombin; tissue plasminogen activator
D) tissue plasminogen activator; fibrinolysis inhibitors
E) oral anticoagulants; heparin

Accepted Answer

Heparin is the preferred initial anticoagulant for acute DVT due to its rapid onset of action, while oral anticoagulants (such as warfarin) are suitable for long-term management or prevention of DVT. Thrombin and tissue plasminogen activator are not typically used for initial anticoagulation or for long-term management of DVT. Fibrinolysis inhibitors are not used for anticoagulation, but are instead used to prevent the breakdown of clots in specific settings (such as during thrombolytic therapy).

Question 11

All of the following drugs will inhibit platelet-induced clots EXCEPT&#10;A) adenosine diphosphate (ADP) receptor blockers such as clopidogrel (Plavix) and ticlopidine (Ticlid)&#10;B) glycoprotein (GP) IIb-IIIa receptor blockers such as abciximab (ReoPro) and eptifibatide (Integrilin)&#10;C) anti-gout drugs such as sulfinpyrazone (Anturane)&#10;D) acetaminophen products such as Tylenol&#10;E) aspirin

Accepted Answer

The answer of All of the following drugs will inhibit...

Question 12

Statin drugs such atorvastatin (Lipitor)and simvastatin (Zocor)inhibit the HMG-CoA reductase enzyme,thereby ______ the production of ______.&#10;A) increasing; cholesterol&#10;B) decreasing; cholesterol&#10;C) increasing; low-density lipoproteins&#10;D) decreasing; high-density lipoproteins&#10;E) increasing; triglycerides

Accepted Answer

The answer of Statin drugs such atorvastatin (Lipitor)and simvastatin (Zocor)inhibit...

Deck 25: Treatment of Coagulation Disorders and Hyperlipidemia