Anti Coagulation Flashcards
Which factors are affected by Heparin?
12, 11, 10, 9, 2A(thrombin)
Which factors are Vit K dependent?
2, 7, 9, 10
What is the prototypical parenteral anticoagulant?
Heparin
What is the prototypical oral anticoagulant?
Warfarin
What is heparins MOA?
Inactivation of clotting factors
What is warfarins MOA?
Decreases synthesis of clotting factors
What is aspirins MOA?
Decrease plateley aggregation
What is Thombolytic drugs prototype?
Streptokinase
What is streptokinases MOA?
Fibrinolysis
What is the effect that differentiates warfarin and heparin from aspirin?
Aspirin prevents arterial thrombus, warfarin and heparin prevent venous thrombosis
What is heparin a mixture of?
Sulfated mucopolysaccharides
How can heparin be administered?
IV or deep SQ
What blood test monitors heparins affects?
PTT
What are the ADEs for heparin
Hemorrhage
HIT
Osteoperosis
Mineralcorticoid deficiency
What is heparins antidote?
Protamine sulfate
Whats the in depth heparin HMW MOA?
Enhances the action of antithrombin III
inhibits IIa, 9, 10, 11, 12
Binds to AT-III and causes a conformational change
What is the in depth heparin LMWH MOA?
Mainly inhibits factor 10
What do heparins not affect?
Thrombin bound to fibrin or Xa bound to platelets
Can you use heparin in pregnant patients?
Yes
What is the alternative anticoagulant to switch to in the case of HIT?
Lepirudin or danaparoid
What drug increases warfarin activity through inhibiting S warfarin and displace albumin bound warfarin?
Sulfinpyrazone
What decreases warfarin activity?
Barbs, phenytoin, Vit K, and Chole’s
What is the oral direct factor X inhibitor?
Rivaroxaban (Xarelto)
What are the properties to know about rivaroxaban?
Does not require monitoring and has rapid onset of action
How is Rivaroxaban metabolized?
CYP3A4
What are the specific uses of Rivaroxaban?
Prevents embolic stroke
Prevents venous thromboembolism after knee/hip replacement
What is the prototype drug for antiplatelets?
Aspirin
Whats the broad clinical use for antiplatelelts?
Prevents arterial thrombus
What are the antiplatelet drugs?
Aspirin,
clopidogrel, Ticlopidine
Eptifibatide
Dipyridamole
What is aspirins moa?
Inhibts COX by acetylation of COX
What is Ticlopidine and Clopidogrels MOA?
Blocks platelet ADP receptor and prevents activation and aggregation
What are ticlopidine and clopidogrel both considered?
Pro drugs
What activates clopidogrel?
CYP2C19 and Omeprazol
What is clopidogrel used in combination with?
Aspirin
What is the Glycoproetin IIb-IIIa receptor inhibitor
Eptifibatide
Abcizimab
Tirofiban
What is Glycoproetin IIb-IIIa receptors function?
Receptor for fibrinogen and platelet adhesion
When should fibrinolytic drugs be used?
Within 3 hours
What are the fibriolytic drugs to know?
Stretokinase
TPA
Urokinase
What us urokinases function?
Directly activates plasminogen
What is urokinases side effects?
Fever, immune response
What is TPAs MOA?
Activates fibrin bound plasminogen
What is two key things to know about TPA?
No immune reaction
Thromboembolic stroke
What are the drugs for bleeding disorder?
Vit K
Plasma fractions
Fibrinolytic inhibitors-Aminocaproic acid
Apoprotin
