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pharmacology > anti- platelet/ coagulant and thrombolytic agents > Flashcards

anti- platelet/ coagulant and thrombolytic agents Flashcards

1
Q

the mechanism of action for the antiplatelet drugs
and it plays an important role in

A

inhibit the platelet aggregation.
prevent atherosclerotic and thrombosis

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2
Q

the classification of antiplatelet depends on

A

mechanism of action :
1- thromboxane A2 synthesis inhibitor
2- phosphodiesterase inhibitor
3- adenosine diphosphate (ADP)antagonist
4-glycoprotein receptor antagonist

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3
Q

thromboxane A2 synthesis inhibitor works on

A

COX1

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4
Q

thromboxane A2 synthesis inhibitor ex.

A

aspirin

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5
Q

the inhibition of cox 1 caused by thromboxane A2 synthesis inhibitor does last until

A

7-10 days caused it is irreversible so new one need to be formed

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6
Q

the dose needed to produce the effect for thromboxane A2 synthesis inhibitor

A

75mg/day

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7
Q

thromboxane A2 synthesis inhibitors are used to reduce

A

the incidence of stroke and MI

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8
Q

phosphodiesterase inhibitor ex

A

dipyridamole

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9
Q

phosphodiesterase inhibitor mechanism

A

increase cAMP which in turn reduce the aggregation of platelet

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10
Q

which drug is used for transient ischemic and stroke attack

A

phosphodiesterase inhibitor (dipyridamole) low risk of bleeding than aspirin

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11
Q

adenosine diphosphate (ADP)antagonist ex.

A

ticlopidine , clopidogrel

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12
Q

the mechanism of adenosine diphosphate (ADP)antagonist

A

they inhibit GP IIb/IIIa receptor

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13
Q

the therapeutic use of adenosine diphosphate (ADP)antagonist
and for who

A

decrease the incident of thrombotic stroke
for who can not tolerate aspirin

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14
Q

the adverse effects of adenosine diphosphate (ADP)antagonist

A

ticlopidine -> neutropenia , thrombocytopenia , aplastic anemia
therefore the clopidogrel in main agent

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15
Q

glycoprotein receptor antagonist ex.

A

abciximab and eptifibatide

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16
Q

what is the abciximab

A

monoclonal antibody binds irreversibly to GP IIb IIIa receptor

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17
Q

the route of administration and the use of abciximab

A

IV
used after coronary artery procedure

18
Q

what is the eptifibatide

A

synthetic inhibitor for GP IIb IIIa receptor

19
Q

the main side effect for glycoprotein receptor antagonist

A

BLEEDING

20
Q

thrombolytic drugs mechanism is

A

rapid lysis of already formed clots

21
Q

what is the mechanism of thrombolytic drugs

A

activation of proenzyme plasminogen to PLASMINO which catalyze the degradation of fibrin

22
Q

thrombolytic drugs ex.

A

alteplase (second generation)
streptokinase and urokinase (first generation)

23
Q

alteplase (second generation) AKA:

A

plasminogen activator

24
Q

streptokinase and urokinase (first generation) used to treat

A

MI, pulmonary embolism, acute ischemic stroke

25
Q

the adverse effect of thrombolytic drugs

A

bleeding in the GIT and cerebral hemorrhage

26
Q

Anticoagulant drugs reduce

A

Cutting ability of blood

27
Q

What is the most common anticoagulant?

A

Heparin, warfarin

28
Q

What is the drug of choice for rapid anticoagulant affect

A

Warfarin heparin

29
Q

LMWHs ex.

A

Tinzaparin , enoxaparin, dalteparin , fondaparinux

30
Q

What is the short fragments of heparin is called?

A

Low molecular weight heparin

31
Q

What is the molecular weight for LMWH and heparin

A

LMWH -> 1k-10k
Heparin -> 15k

32
Q

Hebron and all other LMWH call biologically drive from
Where as

A

Animal tissue
Whereas fundaparinux is synthesize

33
Q

What is the administration of heparin? And what is the administration that contraindicated? And why? 

A

Parenterally
Intravenously or subcutaneous
IM is contradicted because it causes hematoma formation

34
Q

What is the mechanism of action of heparin?

A

1- Find two antithrombin III -> induce conformational change that interact with coagulation factors
2- catalyze inhibition of thrombin
-> heparin -cofactor II and Xa
-> LMWH - cofactor Xa

35
Q

Pharmacokinetics of a heparin

A
  • Not absorbed from GIT
  • Given intravenously or subcutaneously
  • Produce immediate action if it’s given intravenously
  • delay happened to 60 minutes if it’s given subcutaneously
36
Q

Pharmacokinetics of warfarin

A

Absorbed rapidly, and completely from the G.I. system
Given oral or rectal administration

37
Q

Anticoagulant test and antidote of heparin

A

APTT
Antidote, protamine sulfate

38
Q

Anticoagulant test and antidote of warfarin

A

INR
Antidote, vitamin K

39
Q

What is the adverse affect of heparin?

A

Bleeding
Thrombocytopenia
Hypersensitive reaction
Hyperaldosteronism
Hyperkalemia

Alopecia after 5 to 10 days

( Osteoporosis
Diminished renal function —> for longer than three months)

spontaneous fractions, if it’s used for more than six months

40
Q

Advantage of LMWH

A

Better bioavailability
Longer duration
Predictable plasma level
Lower risk of bleeding
Lower incidence of thrombocytopenia

41
Q

LMWH contraindication

A

Renal failure patient

42
Q

Therapeutic uses for heparin and LMWH

A

Prevention and treatment of Venus thrombosis and pulmonary embolism

Prevention of thrombosis after myocardial infarction

Treatment of patient with unstable angina and MI

pharmacology (5 decks)

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