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Clinical Case 1
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Objectives:
  • Describe the mechanism by which glycoprotein IIa/IIIb inhibitors function?
  • Determine who is an appropriate candidate for the use of glycoprotein IIa/IIIb inhibitor therapy?


1

You are seeing a patient in the ED with chest pain. The ECG shows elevated ST segments in leads V1, V2, and V3 with reciprocal changes inferiorly. You have run through the "standard" medications but the patient continues to have pain. You call a cardiologist, who suggests the use of a glycoprotein IIb/IIIa inhibitor. Which of the following best reflects the action of the glycoprotein IIb/IIIa inhibitors?
A)They act primarily on the coronary arteries to increase blood flow by direct vasodilatation.
B)They decrease myocardial oxygen demand.
C)They inhibit platelets by inhibiting thromboxane formation.
D)They prevent the binding of von Willebrand factor and fibrinogen to platelets.
2

Which of the following is true about the glycoprotein IIb/IIIa inhibitors?
A)They are best used in patients who are not candidates for PTCA and stenting.
B)They cause no increase in the rate of intracranial bleeding.
C)They are useful in all groups of patients with acute coronary syndrome.
D)They are most effective in patients going to PTCA and/or stenting.





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