Anti-thrombotics (year 2) Flashcards

1
Q

what is a thrombus?

A

solid clot in vessel

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2
Q

what is a thrombus made of? (3)

A

platelets
fibrin
trapped blood cells

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3
Q

what is required for a thromboembolism?

A

blood flow abnormalities
endothelial damage
hypercoagulability

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4
Q

what could cause endothelial damage?

A
trauma
catheterisation
neoplasia
parasites
amyloidosis
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5
Q

what could cause abnormal blood flow?

A
hypoperfusion
hypovolaemia
heart failure
vasoconstriction
prolonged immobility
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6
Q

what are arterial thrombosis predominately made by?

A

platelets

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7
Q

what are venus thrombosis predominately made by?

A

fibrin

RBCs

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8
Q

what are the types of therapy for thrombosis? (2)

A

thrombolytic

preventative

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9
Q

what approaches to thrombolytic therapy is there?

A

rt-PA
streptokinase
urokinase
surgical extraction

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10
Q

what approaches are there to preventive thrombosis therapy?

A

anti-PLT drugs
heparins
vitamin K antagonists

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11
Q

what is the full name of rt-PA drugs?

A

recombinant tissue plasminogen activators

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12
Q

what is the mode of action of rt-PA?

A

enhance transformation of plasminogen to plasmin

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13
Q

what is a risk of using rt-PA?

A

risk of spontaneous bleeding

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14
Q

when should rt-PA be given?

A

within hours of the clot forming

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15
Q

what is the mechanism of action of streptokinase?

A

enhances plasmin formation

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16
Q

what is a possible disadvantage of using streptokinase?

A

possible antibodies if animal previously infected with streptococci

17
Q

what is the mode of action of urokinase?

A

activate plasminogen into plasmin

18
Q

what are the risks of using streptokinase and urokinase over rt-PA?

A

more risk of systemic bleeding

19
Q

what are the types of anti-platelet drugs? (3)

A

COX-inhibitor
ADP receptor antagonist
Gp receptor antagonist (more in human)

20
Q

what is an example of a COX-inhibitor?

A

aspirin

21
Q

what is an example of an ADP receptor antagonist?

A

clopidogrel

22
Q

what is the mechanism of action of aspirin?

A

irreversible acetylation of platelet COX receptor

23
Q

what does aspirin reduce the synthesis of?

A

thromboxane A2

24
Q

what effects other than an anti-thrombotic does aspirin have?

A

anti-prostaglandine

anti-inflammatory

25
Q

what is the mechanism of action of clopidogrel?

A

irreversibly block link between ADP and platelet receptor

26
Q

where must clopidogrel metabolised?

A

cytochrome p450 in liver

27
Q

what is heparin used for?

A

venous thrombosis

28
Q

what are the classes of heparin (2)

A

unfractionated

low molecular weight

29
Q

what is the mode of action of unfractionated heparin?

A

blocks fibrin formation and platelet activation (inhibit coagulation cascade)

30
Q

what is the name of a vitamin K antagonist?

A

warfarin