General Surgery — Flashcards

Flashcard 411: If clopidogrel must be stopped for surgery, it should be stopped _____ prior

Answer: 7 days

Flashcard 412: Prasugrel works by _____ which stops platelet activation and aggregation

Answer: irreversibly blocking the P2Y12 ADP receptor

Flashcard 413: If aspirin must be stopped for surgery, it should be stopped _____ prior

Answer: 7 days

Flashcard 414: The reversal agent of low molecular weight heparin is _____

Answer: IV protamine sulfate

Extra: Note: Protamine sulfate completely neutralizes Unfractionated Heparin (UFH) but only partially neutralizes (approx. 60-80%) the anti-Xa activity of Low Molecular Weight Heparin (LMWH).

Flashcard 415: Clopidogrel works by inhibiting _____ which stops platelet activation and aggregation

Answer: ADP binding to P2Y12 receptor

Flashcard 416: DOACs can be restarted _____ after surgery

Answer: 12-24 hours

Extra: For procedures with low bleeding risk, DOACs are typically restarted 24 hours post-operatively. For high bleeding risk procedures, consider delaying 48-72 hours.

Flashcard 417: Antiplatelet medication (e.g., Aspirin) should be continued through surgery if there is a high _____ risk (e.g., recent coronary stent). Contrastingly, anticoagulants (e.g., Warfarin) are the medications typically temporarily replaced by heparin bridging.

Answer: thrombosis

Extra: In surgical patients, Aspirin is often continued if the risk of a major adverse cardiac event (MACE) outweighs the risk of surgical bleeding. True 'bridging' with heparin is indicated for patients on long-term anticoagulation (Warfarin) with a high risk of thromboembolism (e.g., mechanical heart valves, high-risk AF).

Flashcard 418: If prasugrel must be stopped for surgery, it should be stopped _____ prior

Answer: 7 days

Flashcard 419: Unfractionated heparin should be stopped _____ prior to surgery

Answer: 6 hours

Flashcard 420: Low-molecular-weight heparin should be stopped _____ prior to surgery

Answer: 24 hours