1 . Which of the following is a prodrug?
A – Ticagrelor
B – Prasugrel
C – Clopidogrel
D – A and B
E – B and C
- Which of the following drug-dose combinations is correct?
A – Clopidogrel: 75 mg BID
B – Ticagrelor: 90 mg BID
C – Prasugrel: 60 mg daily
D – A and B
E – B and C
- Clopidogrel is converted to its active metabolite by the enzyme ________.
A – CYP2C9
B – CYP2C19
C – CYP2D6
D – CYP3A4
E – CYP1A2
- Patient on Plavix 75 mg daily is scheduled for a CABG next month. He should stop Plavix ______ before the surgery.
A – 5 days
B – 7 days
C – 14 days
D – 21 days
E – 28 days
- Which of the following drugs is available in an IV formulation?
A – Clopidogrel
B – Prasugrel
C – Cangrelor
D – Ticagrelor
- What is the brand name of prasugrel?
A – Brillinta
B – Integrilin
C – Plavix
D – Effient
E – Aggrastat
- __________ is a common side effect of ticagrelor.
A – Insomnia
B – Tachycardia
C – Dyspnea
D – Hypotension
E – All of the above
- What is the loading dose of ticagrelor?
A – 60 mg
B – 120 mg
C – 180 mg
D – 300 mg
E – 600 mg
- Prasugrel should be stopped at least ____ days prior to an elective surgery.
A – 2
B – 5
C – 7
D – 10
E – 14
Patient Case:
MJ is a 55 year old male who presented to the ED with chest pain. EKG showed ST segment elevation and he was taken for an emergent PCI.
Ht: 5’ 4” WT: 52kg SCr: 1.3
PMH: Hypertension, Hyperlipidemia, Diabetes, Generalized anxiety disorder
Home medications:
- Lisinopril 40 mg daily
- Atorvastatin 40 mg daily
- Metformin 1000mg BID
- Januvia 100mg daily
- Fluoxetine 40 mg daily
- The team wants to initiate prasugrel. What is the recommended loading dose for prasugrel?
A – 60 mg
B – 80 mg
C – 5 mg
D – 10 mg
E – 20 mg
- What is the recommended maintenance dose for prasugrel?
A – 60 mg
B – 10 mg
C – 40 mg
D – 20 mg
E – 5 mg
- Which of the following home medications may increase MJ’s risk of bleeding?
A – Januvia
B – Fluoxetine
C – Atorvastatin
D – Lisinopril
E – Metformin
Answer Key:
- E. Prasugrel and clopidogrel are both pro-drugs
- B. Ticagrelor maintenance dose is 90mg BID for 1 year and then 60mg BID
- B. CYP 2C19
- A. Clopidogrel and ticagrelor should be stopped 5 days prior to an elective surgery, Prasugrel should be stopped 7 days prior to an elective surgery
- C.
- D
- C. Dyspnea.
- C.
- C
- A
- E 5mg is recommended maintenance dose for patients who weigh less than 60kg
- B SSRIs/SNRIs increase risk of bleeding when given with antiplatelet therapy
