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45 Cards in this Set

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  • Back
Diabetes mellitus, cigarette smoking, lipid abnormalities, and hypertension are the key risk factors for ______
athreosclerosis
The ACCP concluded that all patients with prior non cardioembolic stroke or TIA should receive _____ therapy.
Antiplatelet
In the ESPS-2 Trial, a total of ______ patients received treatment for up tp ___ years.
6602 / 2
Which professional organizations have endorced the FDA's dosing guidelines for aspirin.
ALL
Once platelets become activated, they degranulate and release a number of substances including ADP. What is the function of ADP?
To activate GpIIb/IIIareceptor sites on platelets, revealing binding sites for fibrinogen.
In the endotheial cells of the vessel wall cyclooxagenase (COX)acts upon arachidonic acid to create cyclic endoperoxides. In a normal, uninjured vessel wall, the normal route for thesecyclic endoperoxides is to interact with prostacyclin synthetase to create prostacyclin. What is the role of prostacyclin?
To inhibit platelet activation by stimulating adenyl cyclase and thereby increasing levels of cAMP.
In the stroke subset of patients in the CAPRIE Trial, clopidogrel reduced the risk of stroke compares with aspirin by ____ %
8%
What is the most common cause of ischemic stroke in N. America and Europe
Atherosclerosis
Atrial fibrillation and recent myocardial infarction are the most common causes of _________ stroke.
Cardioembolic
Hypertension has a relative risk for stroke of 2 to 4, which means:
increases risk by 2 to 4
In the endotheial cells of the vessel wall cyclooxagenase (COX)acts upon arachidonic acid to create cyclic endoperoxides. In a normal, uninjured vessel wall, the normal route for thesecyclic endoperoxides is to interact with prostacyclin synthetase to create prostacyclin. What is the role of prostacyclin?
To inhibit platelet activation by stimulating adenyl cyclase and thereby increasing levels of cAMP.
In the stroke subset of patients in the CAPRIE Trial, clopidogrel reduced the risk of stroke compares with aspirin by ____ %
8%
What is the most common cause of ischemic stroke in N. America and Europe
Atherosclerosis
Atrial fibrillation and recent myocardial infarction are the most common causes of _________ stroke.
Cardioembolic
Hypertension has a relative risk for stroke of 2 to 4, which means:
increases risk by 2 to 4
In the endotheial cells of the vessel wall cyclooxagenase (COX)acts upon arachidonic acid to create cyclic endoperoxides. In a normal, uninjured vessel wall, the normal route for thesecyclic endoperoxides is to interact with prostacyclin synthetase to create prostacyclin. What is the role of prostacyclin?
To inhibit platelet activation by stimulating adenyl cyclase and thereby increasing levels of cAMP.
In the stroke subset of patients in the CAPRIE Trial, clopidogrel reduced the risk of stroke compares with aspirin by ____ %
8%
What is the most common cause of ischemic stroke in N. America and Europe
Atherosclerosis
Atrial fibrillation and recent myocardial infarction are the most common causes of _________ stroke.
Cardioembolic
Hypertension has a relative risk for stroke of 2 to 4, which means:
increases risk by 2 to 4
Which antiplatelet is considered to be the "Gold Standard" of therapy for secondary stroke prevention?
Aspirin
One Trial found that doses od ASA at 300 mg/day, were effective as doses of 1,200 mg/day in preventing stroke, MI, or vascular death. However, lower dose resulted in fewer GI side effects. Which Trial was it?
UK-TIA Study
Which trial demonstrated that 75mg/dayof aspirin produced an 18% reduction in risk of stroke or death?
SALT
According to the package insert, to what extent did Aggrenox reduce the risk of stroke compared to Aspirin?
22.1%
Why was the Extended release form of dipyridamole selected for Aggrenox?
To reduce the risk that serum levels of dipyridamole will fall below the therapeutic range toward the end of the dosing.
Why did the ESPS-2 include a placebo arm?
All the above
The PUBLISHED results of ESPS-2 are based on the data collected at all but one of the 60 centersoriginally scheduled to take part in the trial due to:
fradulent data
Based upon the results of CAPRIE, the only patients who clearly benefited from clopidogrel wer thos with a history of _____
PAD
Which of the following agents may interact with Aggrenox
NSAIDS, diuretics, warfarin
In ESPS-2, Aggrenox reduced the risk of experiencing at least one TIA by _____% compared to placebo.
35.9%
What is the primary endpoint for assessing efficacy in ESPS-2?
stroke / deeath / stroke and or death/ all of the above
all of the above
In what patients is Aggrenox contraindicated?
all of the above
What adverse effects are associated with of dipridamole monotherapy?
Headache and diarrhea
Dur to a known effect of dipridamole, caution is advised when Aggrenox is used in patients with severe coronaryt artery disease, unstable angina, or recent heart attack. What effect of dipridamole is the reason for this precaution?
Vasodilation
The primaey endpoint for assessing efficacy in the CAPRIE Trial was:
Composit outcome of aschemic stroke, MI, or vascular death
According to the package insert, among patients receiving the placebo, the risk of stroke recurrence (stroke event rate)durring the 2 years of ESPS-2 was ____. Among those receiving aggrenox, the risk of stroke recurrence was _____.
15.2% and 12.8%
In the CAPRIE Trial, patients with prior stroke had ____reduction in the risk of composite outcome cor clopidogrel compared to aspirin.
7.3%
According to the Package insert, Aggrenox reduces the risk of stroke by ____ compared to placebo.
36.8%
What constituents make up Aggrenox? What dose and form of these ingredients is used?
Satandard release asiprin,25 mg
Extended release dipridamole, 200mg
What was the secondary endpoint of the ESPS-2?
TIA, MI, ischemic events (including stroke, MI, and sudden death) and other vascular events.
Which of these adverse events declined with time in all study groups in ESPS-2?
Headache
Which of the following is an important advantage of using Aggrenox, rather than clopidogrel, for secondary prevention of stroke:
better efficacy
better safety

B and C
Based on the CURE Trial, the indication for plavix now includes:
Acute coronary syndrome (including unstable angina)
What were the criteria for entry into the ESPS-2 trial?
Patients must have had ischemic stroke or TIA within 3 months of entering the trial.
What percentage of patients in ESPS-2 had co-existing cardiovascular disease?
77%