Anti-Thrombotics Flashcards
What are the uses of Aspirin?
1- Anti-platelet (low doses)
2- anti-inflammatory
3- anti-pyretic
4- analgesic
How long does the effect of aspirin last?
life-span of platelet (7-10 days)
What is aspirins mechanism of action?
Blocks COX1 & 2 which will block thromboxane A2
What are Aspirin’s adverse effects?
- bleeding
- dyspepsia
- precipitation of asthma
Aspirin is contraindicated with what drug?
increases risk of bleeding with anticoagulants
during an ischemic stroke of transient ischemic attack, what drug should be used in combination with aspirin?
Dipyridamole
What is the mechanism of action of dipyridamole?
inhibits adenosine uptake
what drug is dipyridamole contraindicated with?
atenolol: increases risk of hypertension
Which drug prevents the binding of fibrinogen and is a monoclonal antibody?
Abciximab
What is abciximab used for and how is it taken?
Taken as an IV injection to prevent thrombosis
what is the half life of clopidogrel & ticagrelor?
6 hours
What are the adverse effects of ADP INHIBITORS?
bleeding & diarrhea
what drug decreases the efficacy of clopidogrel?
omeprazole
What are the first line drugs for acute coronary syndrome?
Aspirin & ticagrelor
if aspirin is contraindicated in a patient, what drug should be used in acute coronary syndrome?
clopidogrel
what are the first line drugs in a transient ischemic attack?
Clopidogrel and ticagrelor
if the first line drugs were not enough in a transient ischemic attack, what drugs should be used next?
Aspirin and dipyridamole
How is heparin obtained?
mast cells from porcine intestine or bovine lung
what are the 2 types of heparin? and what is their antidote?
UFH & LMWH
Protamine sulfate
UFH inhibits which factors? How is it taken
9, 10, 11, 12
IV
what is the half life of LMWH and UFH?
LMWH: 4 hours
UFH: 30 mins
APTT should be monitored while taking what drug?
UFH
LMWH inhibits what factor?
10
which drug is used in renal failure and high risk of bleeding?
UFH
What is LMWH (enoxiparin - dalteparin) used for?
- venous thromboembolism
- prophylaxis
- acute coronary syndrome
What are the adverse effects of Heparin?
- Bleeding
- Heparin induced thromboembolism
- Osteoporosis
LESS IN LMWH
What drug is UFH contraindicated with and why?
Candesartan: increases risk of hyperkalemia
What is the half life of Warfarin?
36hrs
Warfarin interferes with which coagulation factors?
(1972) 2 - 7 - 9 - 10
prothrombin time and INR should be monitored while taking which drug?
WARFARIN
What are the clinical uses of Warfarin?
- venous thromboembolism
- Atrial fibrillation
- Valvular heart disease
- prosthetic valve replacement
What are the adverse effects of warfarin?
bleeding
nausea
vomiting
What drug is contraindicated with Warfarin?
Amiodarone: increases anticoagulation
What are the antidotes for warfarin?
- Vitamin K
- FFP
- Prothrombin complex concentrate
What factors do Dabigatran & Apixaban inhibit?
Dabi: factor II
API: Xa
what are the advantages of NOACS?
- rapid onset
- wide therapeutic index
- convenient
- lower risk of bleeding
What are the disadvantages of NOACS?
- expensive
- rapid decrease of efficacy with missed dose
- difficult to monitor
- no immediate antidote
