Anticoagulants Flashcards
Name the 5 drugs in the indirect thrombin inhibitor class.
unfractionated heparin, dalteparin, enoxaparin, tinzaparin and fondaparinux
What is the mechanism of action of warfarin?
Blocks vitamin K-dependent gamma-carboxylation of factors II, VII, IX, X, Protein C and S
Name the 4 drugs in the direct thrombin inhibitor class of drugs and what their mechanism of action is.
lepirudin, bivalirudin, argatroban and dabigatran; Irreversibly inactivate fibrinogen-bound and unbound thrombin
Which of the direct thrombin inhibitors is given orally?
dabigatran; the rest are parenteral
Do the direct thrombin inhibitors have an antidote and how are they monitored?
no antidote, monitored by PTT
Which class of drugs do Rivaroxaban and Apixaban belong to and what is their mechanism of action?
direct Xa inhibitor; reversibly bind the active site of Xa
How are the Direct Xa inhibitors given and is there an antidote?
oral; no antidote
Name the 4 drugs in the fibrinolytic class.
streptokinase, urokinase, reteplase, and tenecteplase
What is the mechanism of action of the firbrinolytics and which ones are more clot specific? (streptokinase, urokinase, reteplase, and tenecteplase)
lyse already formed clots by activating circulating plasminogen; reteplase and tenecteplase are more clot specific
What are the fibrinolytics used to treat? (streptokinase, urokinase, reteplase, and tenecteplase)
Acute MI, acute stroke, central DVT, multiple PE
Name the drug class that the following 6 drugs belong to: Aspirin, Dipyridamole, Clopidrogel, Abciximab, Eptifibatide, Tirofiban
antiplatelets
What is the mechanism of action of unfractionated heparin and what is it used for?
Bind antithrombin, potentiating formation of antithrombin-coagulation factor complex (Xa, IIa); prevention and tx of venous thrombosis
What is the mechanism of action of salteparin, enoxaparin and tinzaparin and what are the side effects?
LMWH that inhibits thrombin less effectively than Xa; bleeding, HIT
What is the mechanism of action of fondaparinux and what are the side effects?
Synthetic polysaccharide that binds active site of antithrombin and inhibits Xa; bleeding
What is the name of the antidote that can be given for heparin or LMWH?
Protamine
Of the indirect thrombin inhibitors which one can be monitored by PTT and which are monitored by heparin assay?
Heparin- PTT
LMWH- Heparin assay
What is a common side effect of all indirect thrombin inhibitors and vitamin K antagonists?
Bleeding
Which of the indirect thrombin inhibitors is used during pregnancy?
Enoxaparin
Which of the indirect thrombin inhibitors is used for HIT patients?
Fondaparinux
What are the possible side effects of Heparin?
HIT and osteoporosis
What is warfarin used to treat and what are some of the side effects?
long term anticoagulation; thrombosis and bleeding
How can metabolism of warfarin be enhanced?
by drugs that induce P450 activity
Which of the following inhibits platelets by preventing thromboxane A2 formation? Aspirin, Dipyridamole, Clopidrogel, Abciximab, Eptifibatide, Tirofiban
Aspirin
Which of the following is a PDE inhibitor leading to an increase in platelet cAMP? Aspirin, Dipyridamole, Clopidrogel, Abciximab, Eptifibatide, Tirofiban
Dipyrimadole
Which of the following inhibits platelet ADP receptors? Aspirin, Dipyridamole, Clopidrogel, Abciximab, Eptifibatide, Tirofiban
Clopidrogel
Which of the following is a monoclonal antibody against GP2b3a? Aspirin, Dipyridamole, Clopidrogel, Abciximab, Eptifibatide, Tirofiban
Abciximab
Which of the following is a fibrinogen analog that competes with endogenous fibrinogen for GP2b3a? Aspirin, Dipyridamole, Clopidrogel, Abciximab, Eptifibatide, Tirofiban
Eptifibatide
Which of the following is a fibrinogen analog that competes with endogenous fibrinogen for vWF and GP2a3b? Aspirin, Dipyridamole, Clopidrogel, Abciximab, Eptifibatide, Tirofiban
Tirofiban
How can the effects of clopidrogel be reversed and what is a side effect?
platelet transfusion; TTP
Which of the antiplatelet drugs is commonly used to prevent and treat MI and stroke?
aspirin (“baby aspirin”)
Name the antiplatelet drugs that are given parenterally.
dipyrimadole, abciximab, eptifibatide and tirofiban
Which of the following antiplatelet drugs may elicit an immune response? Aspirin, Dipyridamole, Clopidrogel, Abciximab, Eptifibatide, Tirofiban
Abciximab
