anti- platelet/ coagulant and thrombolytic agents

Question 1

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

Answer 1

inhibit the platelet aggregation.
prevent atherosclerotic and thrombosis

Question 2

the classification of antiplatelet depends on

Answer 2

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

Question 3

thromboxane A2 synthesis inhibitor works on

Answer 3

COX1

Question 4

thromboxane A2 synthesis inhibitor ex.

Answer 4

aspirin

Question 5

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

Answer 5

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

Question 6

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

Answer 6

75mg/day

Question 7

thromboxane A2 synthesis inhibitors are used to reduce

Answer 7

the incidence of stroke and MI

Question 8

phosphodiesterase inhibitor ex

Answer 8

dipyridamole

Question 9

phosphodiesterase inhibitor mechanism

Answer 9

increase cAMP which in turn reduce the aggregation of platelet

Question 10

which drug is used for transient ischemic and stroke attack

Answer 10

phosphodiesterase inhibitor (dipyridamole) low risk of bleeding than aspirin

Question 11

adenosine diphosphate (ADP)antagonist ex.

Answer 11

ticlopidine , clopidogrel

Question 12

the mechanism of adenosine diphosphate (ADP)antagonist

Answer 12

they inhibit GP IIb/IIIa receptor

Question 13

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

Answer 13

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

Question 14

the adverse effects of adenosine diphosphate (ADP)antagonist

Answer 14

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

Question 15

glycoprotein receptor antagonist ex.

Answer 15

abciximab and eptifibatide

Question 16

what is the abciximab

Answer 16

monoclonal antibody binds irreversibly to GP IIb IIIa receptor

Question 17

the route of administration and the use of abciximab

Answer 17

IV
used after coronary artery procedure

Question 18

what is the eptifibatide

Answer 18

synthetic inhibitor for GP IIb IIIa receptor

Question 19

the main side effect for glycoprotein receptor antagonist

Answer 19

BLEEDING

Question 20

thrombolytic drugs mechanism is

Answer 20

rapid lysis of already formed clots

Question 21

what is the mechanism of thrombolytic drugs

Answer 21

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

Question 22

thrombolytic drugs ex.

Answer 22

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

Question 23

alteplase (second generation) AKA:

Answer 23

plasminogen activator

Question 24

streptokinase and urokinase (first generation) used to treat

Answer 24

MI, pulmonary embolism, acute ischemic stroke

Question 25

the adverse effect of thrombolytic drugs

Answer 25

bleeding in the GIT and cerebral hemorrhage

Question 26

Anticoagulant drugs reduce

Answer 26

Cutting ability of blood

Question 27

What is the most common anticoagulant?

Answer 27

Heparin, warfarin

Question 28

What is the drug of choice for rapid anticoagulant affect

Answer 28

Warfarin heparin

Question 29

LMWHs ex.

Answer 29

Tinzaparin , enoxaparin, dalteparin , fondaparinux

Question 30

What is the short fragments of heparin is called?

Answer 30

Low molecular weight heparin

Question 31

What is the molecular weight for LMWH and heparin

Answer 31

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

Question 32

Hebron and all other LMWH call biologically drive from Where as

Answer 32

Animal tissue Whereas fundaparinux is synthesize

Question 33

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

Answer 33

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

Question 34

What is the mechanism of action of heparin?

Answer 34

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

Question 35

Pharmacokinetics of a heparin

Answer 35

- 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

Question 36

Pharmacokinetics of warfarin

Answer 36

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

Question 37

Anticoagulant test and antidote of heparin

Answer 37

APTT Antidote, protamine sulfate

Question 38

Anticoagulant test and antidote of warfarin

Answer 38

INR Antidote, vitamin K

Question 39

What is the adverse affect of heparin?

Answer 39

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

Question 40

Advantage of LMWH

Answer 40

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

Question 41

LMWH contraindication

Answer 41

Renal failure patient

Question 42

Therapeutic uses for heparin and LMWH

Answer 42

Prevention and treatment of Venus thrombosis and pulmonary embolism Prevention of thrombosis after myocardial infarction Treatment of patient with unstable angina and MI