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Unit 2: Pharm > Anticoagulants > Flashcards

Anticoagulants Flashcards

1
Q

Name the 5 drugs in the indirect thrombin inhibitor class.

A

unfractionated heparin, dalteparin, enoxaparin, tinzaparin and fondaparinux

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2
Q

What is the mechanism of action of warfarin?

A

Blocks vitamin K-dependent gamma-carboxylation of factors II, VII, IX, X, Protein C and S

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3
Q

Name the 4 drugs in the direct thrombin inhibitor class of drugs and what their mechanism of action is.

A

lepirudin, bivalirudin, argatroban and dabigatran; Irreversibly inactivate fibrinogen-bound and unbound thrombin

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4
Q

Which of the direct thrombin inhibitors is given orally?

A

dabigatran; the rest are parenteral

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5
Q

Do the direct thrombin inhibitors have an antidote and how are they monitored?

A

no antidote, monitored by PTT

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6
Q

Which class of drugs do Rivaroxaban and Apixaban belong to and what is their mechanism of action?

A

direct Xa inhibitor; reversibly bind the active site of Xa

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7
Q

How are the Direct Xa inhibitors given and is there an antidote?

A

oral; no antidote

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8
Q

Name the 4 drugs in the fibrinolytic class.

A

streptokinase, urokinase, reteplase, and tenecteplase

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9
Q

What is the mechanism of action of the firbrinolytics and which ones are more clot specific? (streptokinase, urokinase, reteplase, and tenecteplase)

A

lyse already formed clots by activating circulating plasminogen; reteplase and tenecteplase are more clot specific

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10
Q

What are the fibrinolytics used to treat? (streptokinase, urokinase, reteplase, and tenecteplase)

A

Acute MI, acute stroke, central DVT, multiple PE

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11
Q

Name the drug class that the following 6 drugs belong to: Aspirin, Dipyridamole, Clopidrogel, Abciximab, Eptifibatide, Tirofiban

A

antiplatelets

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12
Q

What is the mechanism of action of unfractionated heparin and what is it used for?

A

Bind antithrombin, potentiating formation of antithrombin-coagulation factor complex (Xa, IIa); prevention and tx of venous thrombosis

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13
Q

What is the mechanism of action of salteparin, enoxaparin and tinzaparin and what are the side effects?

A

LMWH that inhibits thrombin less effectively than Xa; bleeding, HIT

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14
Q

What is the mechanism of action of fondaparinux and what are the side effects?

A

Synthetic polysaccharide that binds active site of antithrombin and inhibits Xa; bleeding

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15
Q

What is the name of the antidote that can be given for heparin or LMWH?

A

Protamine

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16
Q

Of the indirect thrombin inhibitors which one can be monitored by PTT and which are monitored by heparin assay?

A

Heparin- PTT

LMWH- Heparin assay

17
Q

What is a common side effect of all indirect thrombin inhibitors and vitamin K antagonists?

A

Bleeding

18
Q

Which of the indirect thrombin inhibitors is used during pregnancy?

A

Enoxaparin

19
Q

Which of the indirect thrombin inhibitors is used for HIT patients?

A

Fondaparinux

20
Q

What are the possible side effects of Heparin?

A

HIT and osteoporosis

21
Q

What is warfarin used to treat and what are some of the side effects?

A

long term anticoagulation; thrombosis and bleeding

22
Q

How can metabolism of warfarin be enhanced?

A

by drugs that induce P450 activity

23
Q

Which of the following inhibits platelets by preventing thromboxane A2 formation? Aspirin, Dipyridamole, Clopidrogel, Abciximab, Eptifibatide, Tirofiban

A

Aspirin

24
Q

Which of the following is a PDE inhibitor leading to an increase in platelet cAMP? Aspirin, Dipyridamole, Clopidrogel, Abciximab, Eptifibatide, Tirofiban

A

Dipyrimadole

25
Q

Which of the following inhibits platelet ADP receptors? Aspirin, Dipyridamole, Clopidrogel, Abciximab, Eptifibatide, Tirofiban

A

Clopidrogel

26
Q

Which of the following is a monoclonal antibody against GP2b3a? Aspirin, Dipyridamole, Clopidrogel, Abciximab, Eptifibatide, Tirofiban

A

Abciximab

27
Q

Which of the following is a fibrinogen analog that competes with endogenous fibrinogen for GP2b3a? Aspirin, Dipyridamole, Clopidrogel, Abciximab, Eptifibatide, Tirofiban

A

Eptifibatide

28
Q

Which of the following is a fibrinogen analog that competes with endogenous fibrinogen for vWF and GP2a3b? Aspirin, Dipyridamole, Clopidrogel, Abciximab, Eptifibatide, Tirofiban

A

Tirofiban

29
Q

How can the effects of clopidrogel be reversed and what is a side effect?

A

platelet transfusion; TTP

30
Q

Which of the antiplatelet drugs is commonly used to prevent and treat MI and stroke?

A

aspirin (“baby aspirin”)

31
Q

Name the antiplatelet drugs that are given parenterally.

A

dipyrimadole, abciximab, eptifibatide and tirofiban

32
Q

Which of the following antiplatelet drugs may elicit an immune response? Aspirin, Dipyridamole, Clopidrogel, Abciximab, Eptifibatide, Tirofiban

A

Abciximab

Unit 2: Pharm (11 decks)

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