Anti-Coag drugs

Question 1

How is aspirin an anti-coag drug?

Answer 1

Cox1 inhibitor…therefore, inhibits Thromboxane production and Prostaglandin production.

Question 2

How long does the effect of Aspirin on plateletts last?

Answer 2

5-7 days

Question 3

Adverse effects of Aspirin

Answer 3

GI bleeds, hemorrhagic stroke, asthma

Question 4

Contraindications of aspirin?

Answer 4

Coumadin, peptic ulcer disease, aspirin sensitivity

Question 5

Do NSAIDS have antiplatelett effect?

Answer 5

Yes but its temporary and reversible…may actually interefere with aspirin and increase risk for CVD for those taking aspirin to prevent it.

Question 6

Acetaminophen?

Answer 6

Pain and fever reducer but very little anti-inflammatory or anti-platelett effect. Weak COX 1 and 2. Great pain releiver for people on heparin and warfarin

Question 7

Does Aspirin also target COX2

Answer 7

Yes.

Question 8

Do NSAIDs target both COXs?

Answer 8

Yes

Question 9

What does Celecoxib do?

Answer 9

Selectively targets COX2 so no antiplatelett effect, actually pro-thrombotic effect. More risk for CVD.

Question 10

So aspirin and clopidegrel are only used for what?

Answer 10

Anti-platelett

Question 11

How does dipyridamole work?

Answer 11

inhibits platelett aggregation by inhibiting platelett phosphodiesterase.

Question 12

How do platelet phosphodiesterases work?

Answer 12

Phosphodiesterase is an enzyme that degrades cyclic AMP in cells. By inhibiting it, you keep cyclic AMP around longer and plateletss are turned off.

Question 13

Is Dipyridamole a powerful anticoagulant when used alone?

Answer 13

No. Good in combo with aspirin though. Also good with warfarin in pts with heart valves. Good vasodilator

Question 14

Adverse effects of dipyridamole?

Answer 14

GI bleed, headache, dizziness

Question 15

WHat receptor mediates plataelett activation

Answer 15

P2Y12

Question 16

How does Clopidogrel work?

Answer 16

ADP antagonist

Question 17

What is special about clopidogrel?

Answer 17

It is a prodrug that must be activated by CYP2C19

Question 18

What is an ADP inhibitor you can give to someone with a CYP2C19 plymorphism

Answer 18

Prasugrel….it is also an ADP inhibitor that is a prodrug but it is metabolized by Cyp2B6 and 3A4

Question 19

Clopidogrel (Plavix) plus Aspirin?

Answer 19

Can be beneficial for patients that have peripheral artery disease

Question 20

How does Eptifibidate work

Answer 20

Prevents binding of fibrinogen, VWF to IIb and IIIa

Question 21

Abciximab?

Answer 21

blocks GpIIb/IIIa receptor

Question 22

How does streptokinase work?

Answer 22

Activates ciculating fibrin bound plasminogen into plasmin and produces a lytic state.

Question 23

What is the problem with streptokinase

Answer 23

Many abs exist for it. Can develop an immune rxn to it. ONE TIME USE ONLY

Question 24

Urokinase

Answer 24

also a fibrinolytic

Question 25

t-PA

Answer 25

Tissue type plasminogen activator

Question 26

Reteplase

Answer 26

Third generation fibrinolytic

Question 27

COX inhibitors we need to know

Answer 27

Aspirin

Question 28

Phosphodiesterase inhibitors

Answer 28

dipyrimidole

Question 29

P2Y12 or ADP inhibitors

Answer 29

Clapidugrel, Prasugrel

Question 30

Gp IIb/IIIa

Answer 30

Eptifibidate, Abciximab

Question 31

Thrombolytics

Answer 31

Streptokinase, Urokinase, Reteplase, t-PA

Question 32

What is the ADP receptor

Answer 32

P2Y12

Question 33

What does ADP do?

Answer 33

Activates GpIIb/IIIa

Question 34

At Dawn

Answer 34

Cordarelle Patterson Eats At RUby TueSday

Question 35

WHat is the purpose of GpIIB IIIa

Answer 35

Its a fibrionogen receptor that accepts fibrinogen so it can become fibrin and link plateletts together.. So if you block it the clot is not strongt

Question 36

When do you give GpIIbIIIa inhibitors

Answer 36

prior to catheterization and angioplasty to prevent thrombosis

Question 37

When should fibrinolytic agents be used

Answer 37

After Mi, Stroke, Pulmonary embolism, DVT

Question 38

Major toxicity of Fibrinolytics.

Answer 38

Intracranial hemorhage

Question 39

What is urokinase made from

Answer 39

fetal kidney cells

Question 40

Does Urokinase cause allergic rxns?

Answer 40

No