Therapeutics: PAD

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Author:
kyleannkelsey
ID:
267533
Filename:
Therapeutics: PAD
Updated:
2014-03-23 01:45:54
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Therapeutics PAD
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Therapeutics: PAD
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Therapeutics: PAD
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  1. What is the 1st line drug for PAD?
    ACEI
  2. What benefits does ACEI have in PAD?
    Increases pain free walking
  3. What treatment would you use for a patient with PAD and is Asymptomatic (ABI<0.9)?
    ASA 75-325 mg/day
  4. If a PAD patient has Raynaud’s, what drugs are recommended?
    Peripheral vasodilatory CCBs = amlopidine or nifedipine
  5. If a patient has Critical leg ischemia, what PAD drugs should you avoid?
    BBs (reduce CO further)
  6. What treatment would you use for a patient with symptomatic PAD
    • Preferred: ASA 75-325 mg/day
    • Alternative: Clopidogrel 75 mg/day
    • High CV risk: ASA + clopidogrel
  7. What treatment would you use for a patient with Refractory IC PAD?
    • Add: cilostazol 100 BID
    • Potential 2nd line agent: pentoxifylline 400mg TID
  8. Cilostazol (Pletal) has what MOA?
    • PDE inhibitor
    • Suppresses platelet aggregation
    • Direct artery vasodilator
  9. What are the Adverse effects of Cilostazol (Pletal)?
    HA (in 1/3 of patients), diarrhea, edema, palpitations, dizziness, other GI
  10. What are the Contraindications of Cilostazol (Pletal)?
    • Heart failure
    • Drug interactions ( CYP3A4 metabolized)
  11. Cilostazol (Pletal) cannot be used in what group of patients?
    HF
  12. When should you take Cilostazol (Pletal)?
    • Take it 30 minutes before or 2 hours after eating
    • B/c fat increases its absorption
  13. Can Cilostazol (Pletal) be taken with aspirin or clopidogrel?
    Yes
  14. How do we treat acute critical leg ischemia in PAD?
    • Systemic anticoagulation: UFH
    • Reperfusion therapy
    • Surgery
    • Catheter-based thrombolytics
  15. What dose of UFH would be used for acute critical leg ischemia in PAD?
    80 units/kg bolus (max 10,000 units) and 18 units/kg/hr CI (2,300 U/hr max)
  16. After a stent, bypass or angioplasty of PAD, what are the options for treatment?
    ASA 81 mg QD and/or Clopidegrel 75 mg/day (1 year)
  17. How should you treat a patient with Asymptomatic PAD?
    ASA 81 mg
  18. How should you treat a patient with Symptomatic CAD?
    • Clopidegrel 75 mg/day
    • ASA-ER dipyrimadole 25/200 mg BID
    • ASA 81 mg/day
    • (In order of presference)

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