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Cardio Exam 2 > Anti-platelet/Anti-coagulant > Flashcards

Anti-platelet/Anti-coagulant Flashcards

1
Q

dabigatran category of drug

A

oral direct acting thrombin inhibitor

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2
Q

drug interactions with warfarin

A
  • NSAIDS - Amiodarone - Cimetidine
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3
Q

UFH/LMWH MOA

A
  • inhibits factors Xa and thrombin by acting on anti-thrombin
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4
Q

when do we give fibrinolytic drugs?

A
  • immediately to treat STEMIS
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5
Q

enoxaparin is given how?

A
  • subQ
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6
Q

half life of factor 10a

A
  • 40 hours
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7
Q

warfarin/coumadin category of drugs

A

oral indirect acting vitamin K inhibitors

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8
Q

P2Y12 inhibitors MOA

A
  • irreversibly block ADP receptor binding for platelets - non competitive antagonists
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9
Q

MOA of warfarin

A
  • vitamin K reductase inhibitor
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10
Q

what is an alternative to heparin in patients with HIT?

A
  • argatroban
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11
Q

how do we manage until warfarin kicks in?

A
  • heparin bridging
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12
Q

argatroban category of drug given how

A

-direct acting thrombin inhibitor - IV

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13
Q

COX1/2 inhibitors used to treat

A
  • unstable angina - MI - stroke
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14
Q

P2Y12 inhibitors used to treat

A
  • MI - stroke
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15
Q

how must GPIIb/IIIa inhibitors be given?

A
  • IV
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16
Q

before warfarin effects begin, what must happen?

A
  • affected coagulation factors must degrade
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17
Q

diet and warfarin

A
  • variability in diet makes warfarin dosing problematic - dependent on vitamin K intake
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18
Q

half life of factor 7a

A
  • 6 hours
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19
Q

what proteins is vitamin K responsible for

A
  • 2 - 7 - 9 - 10 - proteins C and S
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20
Q

GPIIb/IIIa inhibitors MOA

A
  • prevent activated platelets from sticking together
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21
Q

Abciximab class of drug

A
  • GPIIb/IIIa inhibitor
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22
Q

what part of heparin binds to the anti-thrombin

A
  • the pentasaccharide
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23
Q

toxicities of COX 1/2 inhibitors

A
  • gastric damage
24
Q

when do we give Streptokinase or alteplase

A
  • immediately to treat pulmonary emboli
25
Q

fondaparinux MOA

A
  • inhibits factor Xa by acting on anti-thrombin
26
Q

half life of factor 2a (thrombin)

27
Q

UFH toxicities

A
  • heparin-induced thrombocytopenia
28
Q

unfractionated heparin and enoxaparin category of drug

A
  • indirect acting thrombin and factor Xa inhibitors
29
Q

half life of factor 9a

30
Q

role of Alteplase and Streptokinase how must they be administered

A
  • proteins that convert inactive plasminogen into active plasmin - IV because they are large molecules
31
Q

fondaparinux category of drug given how

A
  • indirect acting factor Xa inhibitor - SubQ
32
Q

fibrinolytics should definitely not be used for

A
  • strokes caused by cerebral hemorrhage - those patients who for blood clotting is good
33
Q

unfractionated heparin is given how?

A
  • IV - SubQ - too large a molecular size
34
Q

COX1/2 inhibitors MOA

A
  • inhibit COX synthesis of TXA2
35
Q

Pharmacokinetics issues with wafarin

A
  • slow onset of action - may take up to a week to reach therapeutic levels - polymorphism issues - variability in diet
36
Q

When can we also give alteplase

A
  • immediately to treat stroke
37
Q

aspirin class of drug

A
  • COX1/2 inhibitor
38
Q

how Amiodarone and Cimetidine interact with warfarin

A
  • decrease warfarin metabolism - increase INR
39
Q

Tirofiban class of drug

A
  • GPIIb/IIIa inhibitor
40
Q

how does heparin-induced thrombocytopenia occur

A
  • platelet coated with immune complex and heparin - platelet removed by splenic macrophages
41
Q

Eptifibitide class of drug

A
  • GPIIb/IIIa inhibitor
42
Q

how NSAIDS impact warfarin

A
  • kick warfarin off albumin - increase free warfarin - increase bleeding risk
43
Q

clopidogrel class of drug

A
  • P2Y12 inhibitors
44
Q

platelet activation is what phase of hemostasis?

A
  • primary hemostasis
45
Q
  • apixaban, rivaroxaban, edoxaban category of drug
A

oral direct acting factor Xa inhibitor

46
Q

GPIIb/IIIa inhibitors used to treat

A
  • angioplasty - stent placement
47
Q

what is fondaparinux really?

A
  • only the pentasaccharide portion of heparin
48
Q

Warfarin toxicities

A
  • birth defects - fetal warfarin syndrome - category X toxin
49
Q

thrombin activation is what phase of hemostasis?

A
  • secondary hemostasis
50
Q

Pharmacokinetics issues with P2Y12 inhibitors

A
  • given in the prodrug form first - must be activated by CYP2C19 - slow metabolizers (activators) will have reduced therapeutic effects
51
Q

role of TXA2

A
  • platelet activation and aggregation
52
Q

which polymorphisms affect warfarin dosing?

A
  • VKORC1 - CYP2C9
53
Q

Name the 1° Hemostasis Inhibitors by Category

A

(1) COX1/2 Inhibs: Aspirin
(2) P2Y12 Inhibs: Prasugrel, Clopidogrel, Ticagrelor
(3) GIIb/IIIa Inhibs: Abciximab, Tirofiban, Eptifibatide

54
Q

Name the Parenterally administered 2° Hemostasis Inhibitors by group

A

Parenterally Administered:

Direct Acting Thrombin Inhibs: Argatroban (IV), Bivalirudin (IV)

Direct Acting Factor Xa Inhibs: none

Indirect Acting Thrombin Inhibs: UFH (IV, SubQ)

Indirect Acting Factor Xa Inhibs: Fondaparinux (SubQ), Enoxaparin (SubQ)

55
Q

Name the Orally administered 2° Hemostasis Inhibitors by group

A

Direct Acting Thrombin Inhibs: Dabigatran

Direct Acting Factor Xa Inhibs: Apixaban, Rivaroxaban

Indirect Acting Vit. K Reductase Inhibs: Warfarin/Coumadin

Cardio Exam 2 (29 decks)

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