Anti-thrombotics (year 2)

Question 1

what is a thrombus?

Answer 1

solid clot in vessel

Question 2

what is a thrombus made of? (3)

Answer 2

platelets
fibrin
trapped blood cells

Question 3

what is required for a thromboembolism?

Answer 3

blood flow abnormalities
endothelial damage
hypercoagulability

Question 4

what could cause endothelial damage?

Answer 4

trauma
catheterisation
neoplasia
parasites
amyloidosis

Question 5

what could cause abnormal blood flow?

Answer 5

hypoperfusion
hypovolaemia
heart failure
vasoconstriction
prolonged immobility

Question 6

what are arterial thrombosis predominately made by?

Answer 6

platelets

Question 7

what are venus thrombosis predominately made by?

Answer 7

fibrin

RBCs

Question 8

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

Answer 8

thrombolytic

preventative

Question 9

what approaches to thrombolytic therapy is there?

Answer 9

rt-PA
streptokinase
urokinase
surgical extraction

Question 10

what approaches are there to preventive thrombosis therapy?

Answer 10

anti-PLT drugs
heparins
vitamin K antagonists

Question 11

what is the full name of rt-PA drugs?

Answer 11

recombinant tissue plasminogen activators

Question 12

what is the mode of action of rt-PA?

Answer 12

enhance transformation of plasminogen to plasmin

Question 13

what is a risk of using rt-PA?

Answer 13

risk of spontaneous bleeding

Question 14

when should rt-PA be given?

Answer 14

within hours of the clot forming

Question 15

what is the mechanism of action of streptokinase?

Answer 15

enhances plasmin formation

Question 16

what is a possible disadvantage of using streptokinase?

Answer 16

possible antibodies if animal previously infected with streptococci

Question 17

what is the mode of action of urokinase?

Answer 17

activate plasminogen into plasmin

Question 18

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

Answer 18

more risk of systemic bleeding

Question 19

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

Answer 19

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

Question 20

what is an example of a COX-inhibitor?

Answer 20

aspirin

Question 21

what is an example of an ADP receptor antagonist?

Answer 21

clopidogrel

Question 22

what is the mechanism of action of aspirin?

Answer 22

irreversible acetylation of platelet COX receptor

Question 23

what does aspirin reduce the synthesis of?

Answer 23

thromboxane A2

Question 24

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

Answer 24

anti-prostaglandine

anti-inflammatory

Question 25

what is the mechanism of action of clopidogrel?

Answer 25

irreversibly block link between ADP and platelet receptor

Question 26

where must clopidogrel metabolised?

Answer 26

cytochrome p450 in liver

Question 27

what is heparin used for?

Answer 27

venous thrombosis

Question 28

what are the classes of heparin (2)

Answer 28

unfractionated | low molecular weight

Question 29

what is the mode of action of unfractionated heparin?

Answer 29

blocks fibrin formation and platelet activation (inhibit coagulation cascade)

Question 30

what is the name of a vitamin K antagonist?

Answer 30

warfarin