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H&C Week 3-4 > 12-06 L3 Blood Clotting Antiplatelets Anticoagulation > Flashcards

12-06 L3 Blood Clotting Antiplatelets Anticoagulation Flashcards

1
Q

unfractionated heprin

MOA

A

acts via enhancement of antithrombin

(irreversibly inactivates Xa and IIa)

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2
Q

antithrombin III

A

is a serine protease inhibitor, clotting factor attacks antithrombin III

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3
Q

What is the drug of choice in anticoagulation for pregnancy?

A

Unfractionated heparin

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4
Q

What do you use to treat sever bleeding caused by heparin?

A
  • Protamin sulfate (basic)
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5
Q

how does heparin cause thrombocytopenia

A

heprain binds to platelet factor 4 complex

immune recognizes it as foregin

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6
Q

LMWH

MOA

A

inhibition of Xa

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7
Q

LMWH

drug of choice for what?

A
  • Prophylaxix
  • treatment of DVT/PE
  • Management of acute coronary syndrome
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8
Q

Wafarin is adminstered how?

A

orally

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9
Q

Warfarin

MOA

A

interferes with the normal posttranslational modification of clotting factors in the liver

(a process that depends on vit. K)

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10
Q

How do you monitor heprin and warfarin?

A
  • heprin: aPTT
  • Warfarin: PT
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11
Q

What is a major countra-indication of warfarin

A
  • Do not use in pregnancy
  • aborption, severe birh defect,
  • UFH or LMWH are alternatives
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12
Q

Warfarin drug interactions

A
  • responsible for more adverse drug interactions than any other drugs (goes to war with all the other drugs)
  • P450 inhibitors: increase activity, e.g ASA
  • P450 activators: decreases activity e.g. barbiturates
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13
Q

Dabigatran

Indication

MOA

A
  • Indication: 1st alternative oral anticoagulant
  • MOA: direct thrombin inhibitor
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14
Q

Fondaparinux (arixtra)

admin

MOA

A
  • Parenteral (subcutaneous) shot
  • selective FXa inhibitor
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15
Q

Streptokinase

MOA

A
  • binds plasminogen
  • exposes active site
  • promotes conversion of additional plasminogen to plasmin
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16
Q

t-PA

MOA

A

serine protease, naturally occuring regulator of thrombolysis

converts plasminogen to plasmin

17
Q

Tenecteplase

(t-PA modified)

A
  • increases activity (K)-H-R-R
  • Increases 1/2 life: T and N mutation
18
Q

What doe you use to manage bleeding caused by t-PA?

what is the MOA of this drug

A

Aminocaproic acid

(binds to plasminogen and plasmin, blocks access of fibrin)

19
Q

Aspirin

MOA

A

irreversible inhibition of COX-1 and AA–> TXA2

20
Q

Clopidogrel

MOA

Pharmacokinetics

A
  • MOA: a pro drug, irreversible inhibition of P2Y12 ADP receptor
  • Pharm: rapid absorptoin, aggregation returns to normal at 5 days post-DC
21
Q

ABCIXIMAB

  • MOA
  • Indication
  • Toxicities
A
  • MOA: monoclonal antibody that reversibly inhibits the binding of fibrin and other ligands to the GP2b/3a receptor
  • Indications: typically used during PCI such as stent placement
  • Toxicities: Bleeding, thrombocytopenia

H&C Week 3-4 (12 decks)

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