Anti-coagulants Flashcards
Low dose ASA
selective for COX1, preserves PGI2
ASA low dose effect
inhibits platelet aggregation
ASA mid dose effect
Antipyretic, analgesic
ASA high dose effect
Anti-inflammatory
salicylism (toxicity)
CNS effects: confusion, tinnitus, dizziness, metabolic: respiratory ALKALOSIS, metabolic ACIDOSIS, renal
If use warfarin + NSAID risk
BLEEDING!
MOA: ADP receptor inhibitor
Clopidogrel/Plavix
MOA: More selective in reducing CV w/ ATHEROSCLEROSIS
Clopidogrel/Plavix
MOA: Blocks P2Y1/P2Y12
Clopidogrel/Plavix
MOA: GPIIb/IIIa receptor
Abciximab
-parin MOA
activation of antithrombin III
Heparin form complexes w/
Factors: IIa, IXa, Xa
Zero order kinetic
Heparin
Inhibits X from activating prothrombin > thrombin
Enoxaparin
Initial Tx of PE/PVT
-parins
Use Heparin (HMWT) for pts
over 300 lbs
SE: THROMBOCYTOPENIA, OSTEOPOROSIS, prolonged bleeding
-Parins
MOA: vitamin K antagonist
Warfarin
Warfarin forms complexes w/
II, VII, IX, V
Slow onset of action
Warfarin
PROPHYLAXIS of PE/DVT
Warfarin
Warfarin CI:
Protein C deficiency Preggo! CYP3A4 drugs: Barbs Rifampin!
Direct thrombin inhibitor
Dabigatran, -irudins
Prevent stroke and blood clots in pts w/ abnormal heart rhythms
Dalbigatran/-irudin family!
Dabigatran antidote
idarucizumab
Direct Factor Xa inhibitors
-XA-ban! suffix
Reduce stroke in patients w/ A-fib, tx DVT/PE after parenteral anticoagulant
-Xabans family!
Xabans interactions
CYP3A4
rapid lysis of thrombi
-plase suffix or Urokinase
t-PA derrivatives
-plase, urokinase
coronary artery thrombosis (MI)
-plase, urokinase drugs
fribronolytic inhibitor
aminocaproic acid
competitively inhibits plasminogen activation
aminocaproic acid
CARBOXYLATES II, VII, IX, X
Vitamin K1
Vitamin K1 AKA
phytonadione
Vit K deficiency or excess warfarin
Vitamin K1
Heparin Neutralizer
Protamin sulfate
Antithrombin III acts on
IXa, Xa, IIa
Villa
IX > IXa, X > Xa
recurrent MI, thromboembolic events after MI
Warfarin
In protein C deficiency, start warfarin w/
heparin first!
Heparin antidote
Protamine
SEVERE dvt tx
Fibrinolytics
ascending thrombophlebitis of iliofemoral vein SEVERE LE EDEMA
fibrinolytics
Primary Hemostasis
Oprelvekin/IL-11
Secondary Hemostasis
replace vWD; -plase; IXa/X monoclonal ABs, fibronolytic inhibitors, Vit K1
Formoterol, Salmeterol risk
Black box if not used w/ Steroids!
-terol
target B2 receptors > bronchodilation!
Albuterol, Levalbuterol
SABA
Formoterol
LABA
Salmeterol
LABA
Olodaterol
ULABA
Vilanterol
ULABA
COPD use
ULABA
SE: dysphonia, hoarseness, oropharyngeal candidiasis
Inhalant corticosteroids
SEVERE ACUTE or SEVERE CHRONIC
prednisone, methylprednisone use 5 day or tapered dose
SE: pituitary adrenal suppression
-prednisone
Block ACh at M3 receptor
-tropium
additive effects, used as adjunct to B2 agonists and steroids
muscarinic antagonists/-tropiums
inhibits 5-lipoxygenase
Leukotriene Sx Inhibitor/Zileuton
Leukotriene Antagonists
-lukasts
block at LTD4
-lukasts
Exercise induced asthma
Montelukast
Allergic rhinitis
Montelukast
Phosphodiesterase inhibitor
-phyllines
SE: toxicities > excitatory effects in heart
-phyllines
MOA: reduces serum IgE
Omalizumab