Anticlotting agents

Question 1

Types of anticlotting drugs?

Answer 1

1. Anticoagulants
2. Thrombolytics
3. Antiplatelet drugs

Question 1

Anticoagulants drugs?

Answer 1

How do drugs weigh?

1. Heparin
2. Direct thrombin inhibitors
3. Direct factor Xa inhibitors
4. Warfarin

Question 2

Thrombolytics

Answer 2

1. t-PA derivatives
2. .Streptokinase
3. Urokinase

Question 3

Antiplatelet drugs?

Answer 3

1. Aspirin
2. GPIIb/IIIa inhibitors
3. ADP inhibitors
4. PDE/adenosine uptake inhibitors

Question 4

Heparin and pregnancy?

Answer 4

Heparin can not be used in pregnancy

Question 5

Two classes of heparin drugs?

Answer 5

1. Unfractionated heparin
2. Low-molecular-weight fractions of heparin

Question 6

Unfractioned thrombin inhibitor

1. In/direct thrombin inhibitor
2. Acidity
3. Monitoring
4. Antidote
5. Selectivity

Answer 6

1. Indirect thrombin inhibitor
2. Highly acidity
3. Monitored by an a PPT test
4. Antidote: Protamine sulphate
5. Less selectivity

Question 7

Unfractioned thrombin inhibitor neutralisation and how?

Answer 7

It is highly acidic thus it is neutralised by a basic molecule

Question 8

Unfractioned thrombin inhibitor Admin and which admin do we not use and why?

Answer 8

IV or SC

Not IM because that increases the risk of hematoma

Question 9

Unfractioned thrombin inhibitor antidote and mechanism?

Answer 9

Protamine Sulphate

Partially reverses teh action of Low-molecular-weight but no effect on fondaparinu

Question 10

Unfractioned thrombin inhibitor S/E?

Answer 10

Osteoporosis
Heparin-induced thrombocytopenia(HIT)

Question 11

Low-molecular weight fractions of heparin drugs?

Answer 11

TED PARIN

Tinzaparin
Enoxaparin
Dalteparin

Question 12

Low-molecular weight fractions of heparin MOA

Answer 12

exert their anticoagulant activity by activating antithrombin (earlier called antithrombin III), which accelerates the inactivation of coagulation enzymes thrombin (factor IIA), factor Xa and factor IXA.

Question 13

LMW-heparin

1. Admin and frequency
2. Bioavailability
3. DOA
4. Antidote

Answer 13

1. Admin and frequency : SC and 1 or 2 time daily
2. Bioavailability–increased
3. DOA-increased
4. Protamine Sulphate

Question 14

Fondaparinux MOA?

Answer 14

By selectively binding to ATIII, Fondaparinux potentiates (about 300 times) the neutralization of Factor Xa by ATIII. Neutralization of Factor Xa interrupts the blood coagulation cascade and thus inhibits thrombin formation and thrombus development.K

Question 15

Fondaparinux contents?

Answer 15

Contains the biologically active pentasaccharide present in unfractionated and LMW-heparins

Question 16

Fondaparinux admin and frequency?

Answer 16

SC and once

Question 17

LMW-heparin-ATIII and fondaparinux-ATIII complexes?

Answer 17

More selective because they do not affect thrombin

Question 18

LMW-heparin-ATIII and fondaparinux-ATIII complexes HIT and test?

Answer 18

LMW-heparin-ATIII and fondaparinux-ATIII complexes are less likely to case HIT

aPTT test is not required since it is not reliable to measure of their anticoagulation effects

Question 19

MOA of heparins?

Answer 19

1. Heparin+ antithrombin(ATIII)
2. Heparin-ATIII Complex
3. Binds to thrombin and factor Xa(irreversible inactivation)
4. Thrombin & factor Xa protolysed
5. Immediate anticoagulantion

Question 20

Clinical uses of heparins?

Answer 20

DVT
Pulmonary emobolism
Acute MI

Question 21

Heparin+ thrombolytics uses?

Answer 21

Revascularisation

Question 22

Heparin + Glycoproteins IIb/IIIa Inhibitor ?

Answer 22

Angioplasty and placement of coronary stents