30. Which of the following statements about glycoprotein IIb/IIIa receptor antag

Question

30. Which of the following statements about glycoprotein IIb/IIIa receptor antagonists is true?

a. Abciximab should not be administered through the same line as furosemide because it is not physically compatible.

b. Eptifibatide should be used only in people with ACS for whom PCI is planned.

c. Eptifibatide does not require a loading dose like abciximab and tirofiban.

d. Tirofiban needs to be administered with heparin in order to provide optimal effects.

31. What clotting factor do thrombolytic drugs target?

a. Fibrin

b. Plasmin

c. Plasminogen

d. Thrombin

32. Which thrombolytic has the least fibrin specificity?

a. Alteplase

b. Reteplase

c. Streptokinase

d. Tenecteplase

33. Which thrombolytic agent has the greatest plasminogen activator inhibitor-1 (PAI-1) resistance and therefore lowest theoretical systemic bleeding risk?

a. Alteplase

b. Reteplase

c. Streptokinase

d. Tenecteplase

34. A 59-year-old woman presents to the emergency department for new-onset left-sided weakness that began 6 hours ago. She has a history of hypertension and coronary artery disease. Her medication list includes atenolol 50 mg/day and aspirin 81 mg/day. Her vital signs are blood pressure 160/92 mmHg, heart rate 92 beats per minute, respiratory rate 14 breaths per minute, and temperature 98.8 °F. The medical team assesses this patient for treatment with a thrombolytic and asks your opinion. Which of the following is the best reply given this information?

a. Treat with a thrombolytic.

b. Do not treat with a thrombolytic because the onset of her stroke symptoms was too long ago.

c. Do not treat with a thrombolytic because her blood pressure is too high.

d. Do not treat with a thrombolytic because she takes aspirin.

Explanation / Answer

30. Answer is A.

31.Answer A-Fibrin

32.Answer C-Streptokinase. Alteplace, Reteplace and tenecteplace are belongs to tissue plasminogen activator category which has relatively high fibrin specificity.

33. Answer D-Tenecteplase.

34.Answer A- Treat with a thrombolytic. The use of tissue plasminogen activator (rtPA) within 3 hours after onset of an ischemic stroke is an established therapy. The use of intravenous rtPA beyond a time window of 3 hours after stroke is still a matter of debate. It appears unjustified to limit the thrombolytic therapy to just 3 hours. Because of lack of approval for 3-6 hours, thrombolytic therapy within this time window should be done only as a part of an institutional protocol after collecting extensive information from patient and relatives.

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