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IHO final > Anticoag drugs > Flashcards

Anticoag drugs Flashcards

1
Q

What is the MOA of ADP receptor antagonists?

A
  • Irreversible ADP receptor antagonists that prevent activation of the ADP receptor
  • Bleeding, n, d, rash and severe leukopenia
  • TTP in Ticlopindine (has more AE’s)
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2
Q

What is Ticlopidine?

A

ADP receptor antagonist

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3
Q

What is Clopidogrel?

A

adp receptor antagonist

- uses CYP2c19

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4
Q

What is Prasugrel?

A

adp receptor antagonist

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5
Q

What are the gpIIB/IIIa receptor inhibitor drugs?

A

T- Tirofiban
E- Eptifibatide
A- Abciximab
- can lead to bleeding and thrombocytopenia

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6
Q

What is Tirofiban?

A

GPIIb/IIIa receptor inhibitors

- non-peptide competitive inhibitor

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7
Q

What is Eptifibatide?

A

GPIIb/IIIa receptor inhibitors

- fibrinogen analogue

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8
Q

What is Abciximab?

A

GPIIb/IIIa receptor inhibitors

-humanized MAB against receptor

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9
Q

What is Dipyridamole and what is its MOA?

A

Increased cAMP in 2 ways:

  1. phosphodiesterase 3 inhibitor (prevents breakdown)
  2. Adenosine reuptake inhibitor (longer activation)
  • Increase cAMP inhibits platelet activation
  • use with aspirin and warfarin
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10
Q

What are the 2 divisions of the thrombin inhibitors?

A

Direct and indirect

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11
Q

What are the indirect thrombin inhibitors?

A

Unfractionated heparin (HMW)
LMW heparin
Fondaparinux (synthetic)

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12
Q

What are the direct thrombin inhibitors?

A

B- Bivalifudine
A- Argatroban
D- Dabigatran

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13
Q

What is the the MOA indirect thrombin Inhibitors?

A

Bind to antithrombin to have their efficacy

- this effects and decreases both thrombin and Xa

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14
Q

Where is heparin from and how does it act?

A

Pigs

  • it is size dependent and is variable response
  • 1 HW and 4 LW 1/2 time
  • 30% and 90% bioavailability
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15
Q

what is the advantage of monitoring in LMW vs High?

A

There is no need for monitoring of most patients

- HMW need aPTT and PTT

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16
Q

whats the difference between aPTT and PTT?

A

aPTT is activated by addition of Factor XII as well as the phospholipids that are added to the PTT

  • causes it the clot faster
  • usual time is 2-4 minutes
  • measures intrinsic
17
Q

What would it mean if aPTT is elevated and PT(INR) is normal?

A

something wrong with the intrinsic pathway

  • could be 1,2,5,8,10,11,12 factors
  • used to monitor heparin effectiveness
18
Q

What are some facts about INR (PT)?

A

clots in 12-14 seconds if you add thromboplastin

  • if this is prolonged with normal aPTT then you have a problem with the extrinsic pathway
  • measures 1,2,5,7, and 10

BEST For WARFARIN monitoring and 7 status

19
Q

Heparin induced thrombocytopenia happens more in what sex?

A

women- crazy haha

- IgG abs against complexes with platelet factor 4

20
Q

How doe oral anticoagulants work and what are they?

A

Warfarin

  • blocks synthesis of Vitamin dependent clotting factors
  • blocks VCOR1C which is epoxide reductase and reduces Vitamin K to its useful form
  • War has vitamin K for antidote
21
Q

What factors rely on Vitamin K reduced form?

A

2,7,9,10, C and S

Inhibits K-dependent Gamma carboxylation which is what directly uses the reduced form of vit K (Pyhtonadione)

22
Q

What are some Direct Xa inhibitors

A

Rivarxaban

  • more rapid and shorter 1/2 than warfarin and less drug/drug interactions
  • No antidote if you OD however***
23
Q

What would you order to monitor Warfarin?

A

PT (INR)

- measures the extrinsic pathway

24
Q

What liver enzyme does Warfarin interact with?

A

CYP29C

- S is more acitive enantiomer

25
Q

What is Pharmacokinetics?

A

Patient Kills

  • Body effects on drug
  • ADME (absorption, distribution, metabolism, and excretion)
26
Q

What is Pharmacodynamics?

A

Biochemical and physiologic effects of drugs on the their mechanisms

27
Q

What is tPA?

A

Tissue plasminogen activators

- increases plasminogen breakdown to plasmin which breaks down fibrin (clots)

28
Q

What are the 3 tPA’s?

A

T- Tenecteplase
A- Alteplase
R- Reteplase
- only thrombolytics approved for stroke

29
Q

What is Aminocaproic acid?

A

Potent inhibitor of fibrinolysis

- basically tPA antidote

IHO final (7 decks)

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