Chapter 8. Peripheral Arterial Disease
A 42-year-old smoker with hypertension, diabetes, hypercholesterolemia, and peripheral arterial disease (PAD) complains of pain in his calves when he walks two to three blocks. What therapy might offer him the greatest benefit in symptom reduction and in overall mortality?
a. Limb revascularization procedure
Answer c is correct. Tobacco cessation is the most important intervention to improve cardiovascular morbidity and mortality in high-risk patients and to improve claudication symptoms.
Answer a is incorrect. A limb revascularization procedure is indicated with an acute arterial occlusion that threatens limb viability.
Answer b is incorrect. Cilostazol may help with claudication symptoms but will not affect cardiovascular mortality.
Answer d is incorrect. Pravastatin will not help with claudication symptoms.
Which of the following are contraindications to the use of aspirin? Select all that apply.
b. Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs)s
d. A 30-year-old man with influenza
Answer a is correct. Asthma is a contraindication to the use of aspirin.
Answer b is correct. Hypersensitivity to NSAIDs is a contraindication to the use of aspirin.
Answer c is correct. Nasal polyps are a contraindication to the use of aspirin.
Answer d is incorrect. Aspirin is contraindicated in adolescents younger than 16 years with chickenpox, influenza or flu-like symptoms.
Which of the following is recommended as an alternative antiplatelet therapy for patients with peripheral artery disease (PAD) who do not tolerate aspirin?
a. Pentoxifylline 400 mg twice daily
b. Clopidogrel 225 mg daily
c. Clopidogrel 75 mg daily
d. Pentoxifylline 400 mg three times daily
Answer c is correct. The recommended dosage of clopidogrel in the treatment of PAD is 75 mg daily orally.
Answer b is incorrect. The recommended dosage of clopidogrel in the treatment of PAD is 75 mg daily orally.
Answer a and d are incorrect. The use of pentoxifylline in the treatment of PAD is for symptoms of claudication, not to reduce cardiovascular risk. It is not a replacement for aspirin in patients who do not tolerate aspirin and no longer recommended for ...