Match the following drug classification with the appropriate drug,

PT stands for prothrombin time, which is a measure of how long it takes the blood to clot.

INR stands for international normalized ratio, which is a way of standardizing the PT results across different laboratories.

Warfarin is a blood thinner that works by inhibiting the production of vitamin K-dependent clotting factors in the liver.

Therefore, warfarin prolongs the PT and increases the INR.The PT/INR test is used to monitor the effectiveness of warfarin therapy and adjust the dose accordingly.

Choice A is wrong because PTT stands for partial thromboplastin time, which is another measure of blood clotting time, but it reflects the activity of different clotting factors than PT.PTT is used to monitor heparin therapy, not warfarin therapy.

Choice C is wrong because aPTT stands for activated partial thromboplastin time, which is a variation of PTT that uses an activator to speed up the clotting time.Like PTT, aPTT is used to monitor heparin therapy, not warfarin therapy.

Choice D is wrong because ACT stands for activated clotting time, which is a measure of the whole blood clotting time.ACT is used to monitor high-dose heparin therapy during certain procedures, such as cardiac bypass surgery or angioplasty.

The normal ranges for these tests may vary depending on the laboratory and the method used, but generally, they are:

• PT: 10 to 13 seconds

• INR: 0.8 to 1.2 (without warfarin) or 2.0 to 3.0 (with warfarin)

• PTT: 25 to 35 seconds

• aPTT: 30 to 40 seconds

• ACT: 70 to 120 seconds

Atorvastatin is a type of statin, which are the most potent antilipidemic agents and have proven to lower the risk of myocardial infarction. Statins work by inhibiting an enzyme called HMG-CoA reductase, which is involved in the synthesis of cholesterol in the liver.By reducing the production of cholesterol, statins lower the levels of low-density lipoprotein (LDL) and triglycerides, and slightly increase the levels of high-density lipoprotein (HDL) in the blood.

Choice B, niacin, is wrong because niacin is not as effective as statins in lowering LDL and preventing cardiovascular events.Niacin is a water-soluble vitamin that can lower LDL and triglycerides, and increase HDL, but it can also cause flushing, itching, and liver toxicity.

Choice C, gemfibrozil, is wrong because gemfibrozil is a type of fibric acid derivative, which are mainly used to lower triglycerides and increase HDL, but have little effect on LDL.

Fibric acid derivatives work by activating a receptor called PPAR-alpha, which regulates the metabolism of lipids in the liver and muscle.Fibric acid derivatives can also increase the risk of gallstones and muscle damage.

Choice D, ezetimibe, is wrong because ezetimibe is a selective cholesterol absorption inhibitor, which blocks the absorption of dietary and biliary cholesterol in the intestine.Ezetimibe can lower LDL by about 15-20%, but it has not been shown to reduce the risk of myocardial infarction on its own.Ezetimibe is usually combined with a statin for better efficacy and safety.

Normal ranges for lipid levels are:

• Total cholesterol: less than 200 mg/dL

• LDL cholesterol: less than 100 mg/dL

• HDL cholesterol: more than 40 mg/dL for men and more than 50 mg/dL for women

• Triglycerides: less than 150 mg/dL