Perspective of cardiologists on the continuation or discontinuation of antiplatelet therapy before dental treatment: a questionnaire-based study

Self-Instruction Exercise No. 359
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Exercise No. 359
Subject Code: 016
Pharmacotherapeutics

The 15 questions for this exercise are based on the article, “Perspective of cardiologists on the continuation or discontinuation of antiplatelet therapy before dental treatment: a questionnaire-based study”, on pages 64-68. This exercise was developed by Merlin Ohmer, DDS, FAGD, in association with the General Dentistry Self-Instruction committee.

Reading the article and successfully completing this exercise will enable you to understand:

  • the clinical implications of antiplatelet therapy;
  • when and how to consult the patient’s cardiologist; and
  • the effects of antiplatelet therapy on dental patients.

Answers for this exercise must be received by October 31, 2015.
  1. Platelets are involved in all of the following except one. Which is the exception?

    A. myocardial infarction
    B. hemostasis
    C. stroke
    D. phagocytosis

  2. Anticoagulants are used to

    A. prevent hemorrhage.
    B. increase healing.
    C. prevent swelling.
    D. prevent thrombi.

  3. Drugs used in antiplatelet therapy include all of the following except one. Which is the exception?

    A. aprotinin
    B. aspirin
    C. warfarin
    D. clopidogrel

  4. There is little consequence to stopping anticoagulant therapy. Rarely is a physician consultation necessary.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  5. What percentage of cardiologists surveyed recommend stopping antiplatelet therapy prior to dental extraction?

    A. 20
    B. 40
    C. 60
    D. 80

  6. If discontinuation of antiplatelet therapy is recommended, the majority of cardiologists surveyed recommend discontinuing exactly _______ days prior to surgery.

    A. 2
    B. 3
    C. 5
    D. 7

  7. INRs must be obtained on anticoagulant patients. An ECG is also recommended.

    A. Both statements are true.
    B. The first statement is true;the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  8. Aspirin functions by

    A. reversibly affecting cyclooxygenase.
    B. irreversibly affecting acetic acid production.
    C. causing increased platelet aggregation.
    D. inhibiting thromboxane production.

  9. Dipyridamole acts

    A. by causing vasoconstriction.
    B. as a phosphotriesterase accelerator.
    C. as an adenosine reuptake inhibitor.
    D. in ADP depletion.

  10. Aspirin is reported to increase bleeding time by ______%.

    A. 50
    B. 100
    C. 150
    D. 200

  11. What percentage of patients on aspirin therapy have an abnormal bleeding time?

    A. 20-25
    B. 30-35
    C. 40-45
    D. 50-55

  12. A study by Ardekian et al indicated a ____% reported incidence of bleeding problems after dental extraction.

    A. 0
    B. 10
    C. 15
    D. 20

  13. Aspirin’s effect on platelets is seen within ____ hour(s) following ingestion.

    A. 1
    B. 2
    C. 3
    D. 4

  14. The average platelet lifespan is ____ days.

    A. 3-5
    B. 7-10
    C. 12-15
    D. 18-21

  15. The incidence of prolonged bleeding complications postextraction in patients on antiplatelet therapy is __________%.

    A. 0
    B. 0.2-2.3
    C. 2.5-4.7
    D. 4.9-7.1

Evaluation
Please respond to the statements below, using the following scale:
1 Poor; 2 Below average; 3 Average; 4 Above average; 5 Excellent
Practicality of the content 1 2 3 4 5
Benefit to your clinical practice 1 2 3 4 5
Quality of illustrations 1 2 3 4 5
Clarity of objectives 1 2 3 4 5
Clarity of exercise questions 1 2 3 4 5
Relevance of exercise questions 1 2 3 4 5
 
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