Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PHAR121 > 3.B-Antiplatelets > Flashcards

3.B-Antiplatelets Flashcards

1
Q

What can arterial thrombosis cause?

A

ischemic necrosis of tissue supplied by the artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does arterial thrombosis often result in?

A

MI
stroke
limb gangrene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the appearance of a desired artery?

A

open
no blockage of blood flow
sheet of endothelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What can enter the sub endothelial space of an artery if that artery has been damaged by hypertension?

A

LDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where do atherosclerotic plaques form?

A

arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What causes atherosclerosis?

A

infiltration of the sub-endothelial space by LDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What can happen if an atherosclerotic plaque ruptures?

A

ischemia or infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are platelets?

A

circulating cells that aggregate on damaged blood vessel walls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What do you we mean when we say that a ruptured atherosclerotic plaque “fools” platelets?

A

the rupture makes platelets think there is damage to the vessel wall, resulting in the aggregation of platelets on the wall and blocking blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is ischemia?

A

inadequate blood supply to a tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is infarction? Give an example.

A

a complete version of ischemia, cell death results
ex: myocardial infarction (heart attack)
-death of cardiac muscle as a result of insufficient blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the three possible consequences of ischemia? List the artery being affected.

A

myocardial infarction (heart attack)
-occurs in coronary artery (coronary artery disease)
cerebrovascular accident (stroke)
-occurs in cerebral arteries
peripheral arterial disease
-occurs in arteries of limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some characteristics of platelets?

A

fragments of larger multinucleated cells
no nucleus
contain granules in cytoplasm
contain COX-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the three jobs of platelets?

A

adhere to damaged vessel walls
aggregate to form a platelet plug
activate coagulation cascade & other platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do platelets adhere to injured areas?

A

activation of glycoprotein Ib receptors
-constitutively expressed on platelet surface
-affinity for collagen and vWF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the mechanisms for platelet activation?

A

exposure to subendothelial surfaces
exposure to chemical activators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which receptors emerge once a platelet has become activated?

A

glycoprotein IIb/IIIa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the job of the GP IIb/IIIa receptor?

A

promote platelet aggregation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the main target of the GP IIb/IIIa receptor?

A

fibrinogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the role of fibrinogen?

A

precursor of fibrin
links platelets to ensure aggregation
localizes substrates for clot formation

21
Q

Which granules do activated platelets release? What happens after they are released?

A

ADP and TXA2
activation of resting platelets and initiates coagulation cascade

22
Q

What is the precursor of prostacyclin? Which cells produce prostacyclin?

A

arachidonic acid
endothelial cells

23
Q

What does prostacyclin promote?

A

vasodilation
decreases platelet aggregation

24
Q

What are the products of cyclooxygenase in arteries?

A

arachidonic acid is the precursor to both
COX-1 –> thromboxane A2
COX-2 –> prostacyclin

25
Q

Which enzyme does ASA inhibit?

A

COX-1 and COX-2
50-100x more potent for COX-1 at 81mg

26
Q

What type of inhibitor is ASA?

A

irreversible inhibitor
-platelets cannot regenerate COX
-allows OD dosing

27
Q

What are the ADP receptor antagonists?

A

clopidogrel
prasugrel
ticagrelor

28
Q

True or false: clopidogrel is a prodrug that requires activation in the liver by CYP 2C19

A

true

29
Q

What does clopidogrel do?

A

inhibits ADP receptor
*remember that ADP can activate platelets

30
Q

What kind of inhibitor is clopidogrel?

A

irreversible inhibitor

31
Q

What does prasugrel do?

A

ADP receptor antagonist

32
Q

True or false: prasugrel is a prodrug but it has way more intra-subject variability compared to clopidogrel

A

false
yes its a prodrug but there is less variability than clopidogrel

33
Q

With prasugrel there is concern for serious bleeding in some patients, what are the risk factors?

A

older than 75
less than 60kg

34
Q

What is different about ticagrelor compared to the other ADP receptor antagonists?

A

it is a reversible inhibitor
not a prodrug

35
Q

Where is ticagrelor commonly seen?

A

post-MI

36
Q

What are the common agents to prevent MI/stroke?

A

ASA
clopidogrel
ticagrelor
prasugrel

37
Q

True or false: ASA, clopidogrel, prasugrel, and ticagrelor can reduce the risk of atherosclerotic plaque rupture

A

false
they prevent the consequences following rupture

38
Q

Where are glycoprotein IIb/IIa inhibitors used? What is the dosage form?

A

hospital
parenteral (IV)

39
Q

What are the glycoprotein IIb/IIIa inhibitors?

A

abciximab
eptifibatide
tirofiban

40
Q

What is the role of nitroglycerin in CAD?

A

manage or prevent angina

41
Q

What is angina?

A

pain or discomfort resulting from inadequate supply of blood to cardiac muscle

42
Q

How can preload be decreased with nitroglycerin?

A

nitroglycerin acts on veins, more blood can pool in veins
consequently decreases workload which reduces pain from angina

43
Q

What are all the options for the management/prevention of angina?

A

nitroglycerin spray or patch
beta blockers and non-DHP CCBs
DHP CCB

44
Q

Which tissue is affected by atherosclerosis?

A

arteries

45
Q

What is the final product of the coagulation cascade?

A

fibrin

46
Q

How strong of an effect does ASA 81mg have on prostacyclin?

A

very minimal effect

47
Q

True or false: just like ASA, all NSAIDs are irreversible inhibitors of COX-1 and are indicated for antiplatelet actions?

A

false
most NSAIDs are reversible inhibitors, COX-2 selective, and not indicated for antiplatelet action

48
Q

What would happen to a person with stable angina at rest? What about during exercise?

A

at rest: perfusion of cardiac muscle is adequate, no angina
exercise: perfusion cannot match increased cardiac workload,
angina develops

PHAR121 (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions