Myocardial infarction
A 58-yr-old business executive is brought to the emergency department 2 h after the onset of severe chest pain during a vigorous tennis game. She has a history of poorly controlled mild hypertension and elevated blood cholesterol but does not smoke. ECG changes confirm the diagnosis of myocardial infarction. The decision is made to attempt to open her occluded artery.
Questions and tasks
1. Which of the following drugs accelerates the conversion of plasminogen to plasmin?
a) aminocaproic acid
b) heparin
c) lepirudin
d) reteplase
e) warfarin
2. If a fibrinolytic drug is used for treatment of this woman`s acute myocardial infarction, which of the following adverse drug effects is most likely to occur?
a) acute renal failure
b) development of antiplatelet antibodies
c) encephalitis secondary to liver dysfunction
d) hemorrhagic stroke
e) neutropenia
3. If this patient undergoes a percutaneous coronary angiography procedure and placement of a stent in a coronary blood vessel, she may be given eptifibatide. Which of the following most accurately describes the mechanism of eptifibatide anticlotting action?
a) activation of antithrombin III
b) blockade of post-translational modification of clotting factors
c) inhibition of thromboxane production
d) irreversible inhibition of platelet ADP receptors
e) reversible inhibition of glycoprotein IIb/IIIa receptors