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Pharmacology > 08.1 Antiplatelet, Anticoagulant & Thrombolytic Therapy > Flashcards

08.1 Antiplatelet, Anticoagulant & Thrombolytic Therapy Flashcards

1
Q

What woud you use for an arterial (white) clot?

A

Antiplatelets + Thrombolysis

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2
Q

What would you use for a venous (red) clot?

A

Anticoagulation

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3
Q

What is Virchow’s triad?

A

Flow
Endothelial damage
Blood Constituents

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4
Q

What are some examples of anticoagulants?

A

Warfarin

Heparin

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5
Q

How does warfarin work?

A

Antagonises Vit K to prevent synthesis of factors II (prothrombin), VII, IX and X

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6
Q

Why is warfarin initially procoaguable?

A

Blocks protein C + S

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7
Q

What are some ADRs of warfarin?

A

Bleeding

Teratogenic

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8
Q

What can potentiate warfarin?

A

Inhibiting hepatic metab (CYP inhibitors)
Inhibiting platelet fuction (aspirin)
Reducing vit K from gut bacteria (cephalosporins)
Displacement from plasma proteins (NSAIDs)

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9
Q

What can inhibit warfarin?

A

CYP inducers

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10
Q

How is warfarin reversed?

A

Vit K administration - slow

Frozen fresh plasma/clotting factors - fast

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11
Q

How does heparin work?

A

Unfractionated - stimulates antithrombin III and inhibits 10a
LMWH - inhibits 10a

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12
Q

What are some ADRs of heparin?

A

Bleeding/bruising
Thrombocytopaenia
Osteoporosis (long term)

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13
Q

How is heparin reversed?

A

Protamine sulphate

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14
Q

What are some examples of antiplatelets?

A

Aspirin, clopidogrel, dipyridamole

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15
Q

How does aspirin work?

A

Inhibits COX and therefore platelet thomboxane A2 decreases

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16
Q

How does dipyridamole work?

A

Inhibits phosphodiesterase and therefore thromboxane A2 decreases

17
Q

How does clopidogrel work?

A

Antagonises ADP receptor (a stimuli for platelet aggregation)

18
Q

What are some examples of thrombolytic therapy?

A

Alteplase
Reteplase
Streptokinase

19
Q

How does alteplase work?

A

Generates plasmin which breaks down fibrin clots

20
Q

How does streptokinase work?

A

Activates plasminogen

21
Q

What is peculiar and important about use of streptokinase?

A

Can only be used once as the body forms antibodies against it

22
Q

When can thrombolysis be used?

A

In an MI if PCI is unavailable
In ischaemic stroke
Major DVT + PE

23
Q

What are some ADRs of thrombolysis?

A

Haemorrhage (GI/cerebral)
Hypotension
Hypersensitivity

Pharmacology (24 decks)

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