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Pharmacology 2 > AGENTS AFFECTING BLOOD CLOTTING > Flashcards

AGENTS AFFECTING BLOOD CLOTTING Flashcards

1
Q

(3) Blood clot categories related medications?

A
  • Prevent clot formation
  • Remove an existing clot - Lyse
  • Promote clot formation
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2
Q

What (2) classes of drugs prevent clot formation?

A
  • Anticoagulants
  • Anti-platelet drugs
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3
Q

What class of drug removes an existing clot?

A

Thrombolytics

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4
Q

What class of drug promotes clot formation?

A

anti-fibrinolytics

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5
Q

What are reversal agents of clotting meds?

A
  • Heparin antagonist
  • Warfarin Na antagonist
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6
Q

The goal of anticoagulants is prevention of the __________ of clot by inhibiting
certain clotting factors

A

formation

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7
Q

Anticoagulants are given __________________ because they have no direct effect on blood clot already formed.

A

prophylactically (preventatively)

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8
Q

Anticoagulants are given for treatment of some existing clots by promoting the _______________ of the clot

A

reabsorption

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9
Q

Anticoagulants promote imbalance of ______________________ towards lysing of a clot

A

feedback mechanism

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10
Q

What specific anticoagulant drug directly blocks existing clotting factors?

A

Heparin

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11
Q

Heparin binds with __________________?

A

Antithrombin III

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12
Q

Binds with Antithrombin III = Blocks
conversion of ___________to ______________

A

Prothrombin to Thrombin

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13
Q

What specific anticoagulant drug block a precursor & prevent factors from being
made?

A

Coumadin (warfarin) - Vitamin K

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14
Q

(2) types of exogenous Heparin (PARENTAL)?

A
  1. Standard Heparin
  2. Low molecular weight heparin
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15
Q

______________ heparin is a mucopolysaccharide found in various body tissues, most abundant in the liver and lung.

A

Endogenous

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16
Q

Exogenous heparin obtained from ________________?

A

animal tissue

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17
Q

Why should exogenous heparin not be administered orally?

A

It is lipophobic, so does not cross cell membranes easily

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18
Q

What are the (2) types of Heparin available?

A
  • Standard heparin
  • Low molecular weight heparin
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19
Q

Which type of heparin is typically given in hospital for prophylactic and active
treatment of clots?

A

Standard heparin (usually given IV, rarely given SubQ)

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20
Q

What type of heparin is used extensively for locking central access lines?

A

Standard heparin

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21
Q

What type of heparin is more extensively used for therapy – home therapy?

A

Low Molecular Weight Heparin

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22
Q

What route is Low Molecular Weight Heparin given?

A

Only SubQ

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23
Q

Standard heparin is highly __________________, metabolized by the liver and excreted by the kidney

A

protein bound

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24
Q

Standard heparin is only given parenterally because it is not absorbed from the GIT. True or false?

A

True

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25
_______________ is a procedure that filters a patient's blood to remove waste and excess fluid when their kidneys are no longer functioning properly
Hemodialysis
26
Heparin therapy inhibits the bodies attempts to create a _______ and tips the net outcome towards ______ of clots
1. clot 2. lysis
27
The existence of a clot induces another opposite reaction that is?
Negative feedback mechanism
28
_____________ is the enzyme that lyses a clot
Plasmin
29
standard _____________ is superior to warfarin to prevent pulmonary complications in cases of thrombophlebitis
Heparin
30
what does TPA stand for?
Tissue plasminogen activator
31
Adverse effects/events of standard heparin are (2)?
- Heparin induced thrombocytopenia - Bleeding (random + generalized)
32
What are we monitoring with regular blood testing in standard heparin?
Platelet count for signs of thrombocytopenia
33
Does standard heparin cross the placenta barrier or enter breast milk?
No
34
Heparin is measured in what unit?
Units
35
What are (2) Antidote/Reversal agents for standard heparin?
- Whole blood and/or plasma - Protamine sulphate (IV slow)
36
Protamine sulphate dissociates the _________________ complex?
heparin- antithrombin
37
Is low molecular weight heparin more or less potent than standard heparin?
More
38
Does low molecular weight heparin have a longer or shorter half-life than standard heparin?
Longer
39
Which type of heparin is safer and effective for management of thromboembolism?
low molecular weight heparin
40
Why is heparin not given IM?
IM IS not done since muscle tissues are very vascular and bleeds easily
41
Heparin is given based on ___________________________?
PTT (partial thromboplastin time)
42
If PTT (partial thromboplastin time) outside therapeutic range, what are your next steps (2)?
Hold next dose & contact prescriber
43
(3) LMW heparin agent names?
- Ardeparin( Normiflo®) - Dalteparin (Fragmin®) - Enoxaparin(Lovenox®)
44
What type of heparin inactivates factor Xa in the cascade?
LMW heparin
45
Heparin adverse reaction in large doses can lead to (2)?
- renal suppression - osteoporosis
46
____________ is an oral anticoagulant that acts on the liver to prevent the synthesis of Vit. K-dependent clotting factors
Warfarin
47
Effect does not occur until _______ days after warfarin is started
3-5 days
48
Warfarin and other anticoagulants are highly __________________?
protein bound
49
What drugs will displace warfarin off their protein receptors?
- salicylates (ASA) - Ibuprofen (Motrin,® Advil®) - Naproxen
50
What are (2) drug Interactions with warfarin?
- Penicillin type drugs - Diet rich in vitamin K or supplements
51
INR stands for?
international normalized ratio - a blood test that measures how long it takes for blood to clot
52
Do not give a dose of warfarin if INR is greater than _______?
3.5 Notify the healthcare prescriber.
53
What are (2) adverse events for warfarin?
- Leucopenia - Fetal abnormality when given in early pregnancy
54
Reversal agent for warfarin is?
Vitamin K
55
_______________ are routinely administer to newborns to prevent hemorrhage.
Vitamin K shots
56
Newer oral anticoagulants that are more selective inhibitors (direct acting) of clotting factors are (3)?
1. Apixaban (Eliquis®) 2. Dabigatran (Pradaxa®) 3. Rivaroxaban (Xarelto®) expensive though!
57
Arterial thrombi are primarily due to _______________?
platelet aggregate
58
venous thrombi are usually composed of (2)?
fibrin and red blood cells
59
What class of drugs are used to reduce the risk of venous thrombi?
Anticoagulants
60
What class of drugs are used to reduce the risk of arterial thrombi?
anti-platelets
61
Is ASA (Aspirin) an anti-platelet drug or anticoagulant drug?
anti-platelets
62
For an MI, aspirin can be used in an emergency. Do they chew or swallow whole?
chew the aspirin (150 mg roughly)
63
What anti-platelet drug is used to prevent thrombus in patients with indwelling devices, TIAs, acute MI, etc?
Aspirin
64
When stimulated, does A1 vasodilate or vasoconstrict?
Vasodilates
65
When stimulated, does A2 vasodilate or vasoconstrict?
Vasoconstricts
66
(4) anti-platelet agents
- Ibuprofen and Other ASA-related drugs - Clopidogrel (Plavix®) - Prasugrel (Effient®) - Ticagrelor (Brilinta®)
67
What class of drugs work directly or indirectly to convert plasminogen to plasmin and used to dissolve thrombi?
Fibrinolytics (thrombolytic agents)
68
Fibrinolytics stimulate the conversion of plasminogen to __________?
Plasmin
69
What is the role of plasmin?
It breaks down fibrin, the structure that makes up thrombus
70
the conversion of plasminogen to plasmin is AKA ______________?
fibrinolysis
71
The goal of fibrinolytics therapy to re-establish ____________ as quickly as possible and limit _________________?
1. blood flow 2. tissue damage
72
fibrinolytics have a high risk for _________________?
Hemorrhage
73
Only use fibrinolytics when a ______ is the confirmed cause of a ischemic event
clot
74
What route are fibrinolytics usually given?
IV
75
_________________ prevents the formation of thrombin.
Anti-thrombin ll
76
________________ which converts to plasmin
Plasminogen
77
conversion to plasmin is facilitated by (4):
- Anti diuretic hormone (ADH) - Norepinephrine (NE) - urokinase - streptokinse
78
Blood plasma contains (2) main factors that inhibit blood clotting:
- Anti-thrombin ll - Plasminogen

Pharmacology 2 (12 decks)

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