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Pharm U2 > 9) Thrombosis > Flashcards

9) Thrombosis Flashcards

1
Q

What is the class for Unfractionated heparin

A

Indirect thrombin inhibitors

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2
Q

What is the mechanism for Unfractionated heparin

A

Bind antithrombin, potentiating formation of antithrombin-coagulation factor complex (Xa, IIa)

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3
Q

What are the therapeutics for Unfractionated heparin

A

Prevention and treatment of venous thromboembolism

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4
Q

What are the important side effects for Unfractionated heparin

A

HIT, bleeding

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5
Q

What are the other side effects for Unfractionated heparin

A

Osteoporosis

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6
Q

What are the miscellaneous for Unfractionated heparin

A

Given parenterally; monitored via PTT (want 2-2.5X normal value); reversed by protamine

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7
Q

What is the class for Dalteparin (Fragmin)

A

Indirect thrombin inhibitors

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8
Q

What is the mechanism for Dalteparin (Fragmin)

A

LMWH that inhibits thrombin less effectively than Xa

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9
Q

What are the therapeutics for Dalteparin (Fragmin)

A

Prevent thrombosis and embolism from clots

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10
Q

What are the important side effects for Dalteparin (Fragmin)

A

Bleeding

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11
Q

What are the miscellaneous for Dalteparin (Fragmin)

A

Monitored by heparin assay (anti-factor Xa); longer half-life than heparin (1-2/day); reversed by protamine

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12
Q

What is the class for Enoxaparin (Lovenox)

A

Indirect thrombin inhibitors

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13
Q

What is the mechanism for Enoxaparin (Lovenox)

A

LMWH that inhibits thrombin less effectively than Xa

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14
Q

What are the therapeutics for Enoxaparin (Lovenox)

A

Drug of choice in pregnancy; prevention and treatment of venous thromboembolism

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15
Q

What are the important side effects for Enoxaparin (Lovenox)

A

HIT; bleeding; osteoporosis and thrombocytopenia uncommon

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16
Q

What are the miscellaneous for Enoxaparin (Lovenox)

A

Can be monitored by heparin assay (anti-factor Xa); longer half-life than heparin (1-2/day); reversed by protamine

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17
Q

What is the class for Tinzaparin (Innohep)

A

Indirect thrombin inhibitors

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18
Q

What is the mechanism for Tinzaparin (Innohep)

A

LMWH that inhibits thrombin less effectively than Xa

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19
Q

What are the important side effects for Tinzaparin (Innohep)

A

HIT; osteoporosis and thrombocytopenia uncommon

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20
Q

What are the other side effects for Tinzaparin (Innohep)

A

Bleeding

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21
Q

What are the miscellaneous for Tinzaparin (Innohep)

A

Monitored by heparin assay (anti-factor Xa); longer half-life than heparin (1-2/day); reversed by protamine

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22
Q

What is the class for Fondaparinux (Arixtra)

A

Indirect thrombin inhibitors

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23
Q

What is the mechanism for Fondaparinux (Arixtra)

A

Synthetic polysaccharide that binds active site of antithrombin; inhibits Xa

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24
Q

What are the therapeutics for Fondaparinux (Arixtra)

A

Given for HIT

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25
Q

What are the other side effects for Fondaparinux (Arixtra)

A

Bleeding

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26
Q

What are the miscellaneous for Fondaparinux (Arixtra)

A

No antidote

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27
Q

What is the class for Warfarin (Coumadin)

A

Vitamin K antagonist

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28
Q

What is the mechanism for Warfarin (Coumadin)

A

Blocks vitamin K-dependent gamma-carboxylation of factors II, VII, IX, X, Protein C and S (does not affect already synthesized factors)

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29
Q

What are the therapeutics for Warfarin (Coumadin)

A

Long-term anticoagulation

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30
Q

What are the important side effects for Warfarin (Coumadin)

A

Thrombosis (Protein C depression)

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31
Q

What are the other side effects for Warfarin (Coumadin)

A

Bleeding

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32
Q

What are the miscellaneous for Warfarin (Coumadin)

A

Metabolism enhanced by drugs that induce P450 activity (e.g., barbiturates); monitored by PT/INR; reversed by vitamin K and factor concentrates; contraindicated in pregnancy (teratogen)

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33
Q

What is the class for Bivalirudin (Angiomax)

A

Direct thrombin inhibitor

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34
Q

What is the mechanism for Bivalirudin (Angiomax)

A

Inactivate fibrinogen-bound AND unbound thrombin; irreversible

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35
Q

What are the therapeutics for Bivalirudin (Angiomax)

A

Percutaneous coronary intervention (PCI)

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36
Q

What are the important side effects for Bivalirudin (Angiomax)

A

Bleeding

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37
Q

What are the miscellaneous for Bivalirudin (Angiomax)

A

Administered parenterally; monitored by PTT; no antidote

38
Q

What is the class for Argatroban (Acova)

A

Direct thrombin inhibitor

39
Q

What is the mechanism for Argatroban (Acova)

A

Inactivate fibrinogen-bound AND unbound thrombin

40
Q

What are the therapeutics for Argatroban (Acova)

A

Percutaneous coronary intervention (PCI); HIT

41
Q

What are the important side effects for Argatroban (Acova)

42
Q

What are the miscellaneous for Argatroban (Acova)

A

Administered parenterally; monitored by PTT; no antidote

43
Q

What is the class for Dabigatran (Pradaxa)

A

Direct thrombin inhibitor

44
Q

What is the mechanism for Dabigatran (Pradaxa)

A

Inactivate fibrinogen-bound AND unbound thrombin; competitive (reversible)

45
Q

What are the therapeutics for Dabigatran (Pradaxa)

A

DVT / PE; AFib

46
Q

What are the important side effects for Dabigatran (Pradaxa)

47
Q

What are the miscellaneous for Dabigatran (Pradaxa)

A

Oral; no antidote; renal fixed dose clearance

48
Q

What is the class for Rivaroxaban (Xarelto)

A

Direct Xa inhibitor

49
Q

What is the mechanism for Rivaroxaban (Xarelto)

A

Reversible bind active site of Xa

50
Q

What are the therapeutics for Rivaroxaban (Xarelto)

A

DVT / PE prophylaxis

51
Q

What are the important side effects for Rivaroxaban (Xarelto)

52
Q

What are the miscellaneous for Rivaroxaban (Xarelto)

A

Oral; no antidote; renal fixed dose clearance

53
Q

What is the class for Apixaban (Eliquis)

A

Direct Xa inhibitor

54
Q

What is the mechanism for Apixaban (Eliquis)

A

Reversible bind active site of Xa

55
Q

What are the therapeutics for Apixaban (Eliquis)

A

DVT / PE prophylaxis

56
Q

What are the important side effects for Apixaban (Eliquis)

57
Q

What are the miscellaneous for Apixaban (Eliquis)

A

Oral; no antidote; renal fixed dose clearance

58
Q

What is the class for Alteplase

A

Fibrinolytic

59
Q

What is the mechanism for Alteplase

A

Lyse already formed clots by activating circulating plasminogen

60
Q

What are the therapeutics for Alteplase

A

Acute MI, acute stroke, central DVT, multiple PE

61
Q

What is the class for Reteplase (Retavase)

A

Fibrinolytic

62
Q

What is the mechanism for Reteplase (Retavase)

A

Lyse already formed clots; more clot specific, less systemic activation

63
Q

What are the therapeutics for Reteplase (Retavase)

A

Acute MI, acute stroke, central DVT, multiple PE

64
Q

What is the class for Tenecteplase (TNKase)

A

Fibrinolytic

65
Q

What is the mechanism for Tenecteplase (TNKase)

A

Lyse already formed clots; more clot specific, less systemic activation

66
Q

What are the therapeutics for Tenecteplase (TNKase)

A

Acute MI, acute stroke, central DVT, multiple PE

67
Q

What is the class for Aspirin

A

Antiplatelet

68
Q

What is the mechanism for Aspirin

A

Irreversibly inhibits platelets, preventing thromboxane A2 formation

69
Q

What are the therapeutics for Aspirin

A

Often as “baby aspirin” to prevent and treat MI and stroke

70
Q

What is the class for Dipyridamole (Persantine)

A

Antiplatelet

71
Q

What is the mechanism for Dipyridamole (Persantine)

A

PDE inhibitor –> increase in platelet cAMP

72
Q

What are the therapeutics for Dipyridamole (Persantine)

A

Weak antiplatelet effect

73
Q

What are the miscellaneous for Dipyridamole (Persantine)

A

Given parenterally

74
Q

What is the class for Clopidogrel (Plavix)

A

Antiplatelet

75
Q

What is the mechanism for Clopidogrel (Plavix)

A

Inhibits platelet ADP receptors

76
Q

What are the therapeutics for Clopidogrel (Plavix)

A

Prevent & treat ACS, stroke, peripheral vascular disease, angina, stent

77
Q

What are the important side effects for Clopidogrel (Plavix)

A

Bleeding; TTP (rare)

78
Q

What are the miscellaneous for Clopidogrel (Plavix)

A

Reversed by platelet transfusion

79
Q

What is the class for Abciximab (Reopro)

A

Antiplatelet

80
Q

What is the mechanism for Abciximab (Reopro)

A

Monoclonal antibody against GP IIb/IIIa

81
Q

What are the important side effects for Abciximab (Reopro)

A

May elicit immune response

82
Q

What are the miscellaneous for Abciximab (Reopro)

A

Given parenterally

83
Q

What is the class for Eptifibatide (Integrilin)

A

Antiplatelet

84
Q

What is the mechanism for Eptifibatide (Integrilin)

A

Fibrinogen analog which competes with endogenous fibrinogen for IIb/IIIa

85
Q

What are the important side effects for Eptifibatide (Integrilin)

A

Bleeding; ACS; PCI

86
Q

What are the other side effects for Eptifibatide (Integrilin)

A

Thrombocytopenia

87
Q

What are the miscellaneous for Eptifibatide (Integrilin)

A

Given parenterally

88
Q

What is the class for Tirofiban (Aggrastat)

A

Antiplatelet

89
Q

What is the mechanism for Tirofiban (Aggrastat)

A

Fibrinogen analog which competes with endogenous fibrinogen and vWF for IIb/IIIa

90
Q

What are the important side effects for Tirofiban (Aggrastat)

A

Bleeding; NSTE-ACS

91
Q

What are the miscellaneous for Tirofiban (Aggrastat)

A

Given parenterally; immediate effect

Pharm U2 (11 decks)

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