Anticoagulant and Thrombolytic Agents Flashcards
Asprin
nonsteroidal anti-inflammatory drug
blocks platelet cyclo-oxygenase (COX)1 which causes inhibition of thromboxane A2 (TXA2)
Effect is irreversible
Primarily used to treat hypercoagulable states or states of increased platelet reactivity
Clopidogrel
Thienopyridine class drug
Blocks adenosine diphosphate (ADP) induced platelet aggregate through binding the platelet P2Y12 receptor
Primarily used to treat hypercoagulable states or states of increased platelet reactivity
Does not remove already formed blood clots
Heparins
Naturally occurring - stored within mast cells and released into vasculature at sites of tissue injury
Drug - Unfractionated heparin: heparin sulfate
can be reversed using protamine sulfate
Drug - low molecular weight heparins: Dalteparin and enoxaparin
Does not dissolve preexisting blood clots
Enoxaparin
Low molecular heparin
Associated with fewer bleeding events, more predictable absorption and can be given less frequently than UFH
Inhibits factor Xa
Incompletely reversed by protamine sulfate
Heparin sulfate
Unfractionated heparin
Binds to antithrombin and inhibits factors IIA, IXa, Xs, XIa, and XIIa
can be reversed using protamine sulfate
Direct Factor Xa Inhibitors
Rivaroxaban and apixaban
Does not require antithrombin for factor Xa inhibition and clinical effects
Does not dissolve blood clots that have already formed
Rivaroxaban
Trade name: Xarelto
Direct Factor Xa inhibitor
Oral anticoagulant used to prevent or treat thrombosis in high risk patients
Contraindicated in patient with uncontrolled pathologic bleeding, severe hepatic disease, hepatic disease associated with coagulopathy or with significant renal impairment
Thombolytics
Drugs: streptokinase, urokinase, tissue plasma activator (t-PA)
Not widespread in vetmed
Should be administered as early as possible to be most effective
contraindicated or inappropriate in situations of known coagulopathy, states of active bleeding, cardiac thrombi, neoplasia that invades the vasculature and infective endocarditis
Complication associated with thrombolytic agents: Bleeding