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PCOL 2 > anticoagulants > Flashcards

anticoagulants Flashcards

1
Q

Heparin (Chemistry)

A

Sulfated glycosaminoglycan

a. unfractionated
b. low –MW

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2
Q

Warfarin (Chemistry)

A

Coumarin

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3
Q

Heparin (ROA)

A

Parenteral (IV or SC)

Not IM - produce hematoma

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4
Q

Warfarin (ROA)

A

Oral, IV

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5
Q

Heparin (Uses)

A

Post MI
Prevention of DVT and PE

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6
Q

Warfarin (Uses)

A

Prevention of DVT and PE
Atrial fibrillation
Atificial heart valves

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7
Q

Heparin (Mechanism)

A

Activates antithrombin

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8
Q

Warfarin (Mechanism)

A

Inhibits Vit. K synthesis

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9
Q

Heparin (Target)

A

1.5 - 2.5x control

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10
Q

Warfarin (Target)

A

INR 2-3

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11
Q

Heparin Side Effects

A

Bleeding
Allergy
Thrombocytopenia

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12
Q

Warfarin Side Effects

A

Bleeding
Teratogenic

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13
Q

Heparin Monitoring

A

Activated partial thromboplastin time

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14
Q

Warfarin Monitoring

A

Prothrombin time (expressed as INR)

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15
Q

Heparin Antidote

A

Protamine sulfate (1mg/100 units)

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16
Q

Warfarin Antidote

A

Vitamin K

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17
Q

Unfractionated heparin MW

A

5,000-30,000 Daltons

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18
Q

Low molecular weight heparins (LMWH)

A

Enoxaparin
Dalteparin
Tinzaparin

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19
Q
  • Longer half life
  • Less bleeding, routine aPTT unnecessary
A

Low Molecular Weight Heparins (LWMH)

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20
Q

Mixture of sulfated glycosaminoglycosan
(heparin, dermatan, chondroitin)

A

Danaparoid Na

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21
Q

Danaparoid Na is a mixture of sulfated glycosaminoglycosan:

A

Heparin
Dermatan
Chondroitin

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22
Q

Note: Heparin is a preferred drug given to a pregnant woman, It does not cross the placenta.

23
Q

Heparin and Related Agents

A
  • Unfractionated Heparin
  • Low Molecular Weight Heparins
  • Danaparoid Na
  • Fondaparinux Na
24
Q

Coumarin Derivatives

A
  • Warfarin sodium
  • Dicumarol
25
It dissolves clot - converts plasminogen----plasmin (fibrinolytic)
Thrombolytics (Enzymes)
26
Types of Thrombolytics
- Streptokinase - Tissue Plasminogen Activators
27
It is a protein from streptococci
Streptokinase
28
Uses of Streptokinase
- MI, DLVT (deep venous thrombosis) , PE (pulmonary embolism)
29
Side Effects of Streptokinase
Hemorrhage Allergy
30
Examples of Tissue Plasminogen Activators
Alteplase Reteplase Streptokinase
31
Uses of TPA
- MI, DLVT, PE
32
It only binds to plasminogen bound to fibrin
Tissue Plasminogen Activators
33
Side Effect of TPA
Hemorrhage
34
It inhibits platelet aggregation and prolongs bleeding time
Antiplatelets
35
Uses of Antiplatelets
Prevention of MI, Stroke
36
It prevents thromboxane synthesis by inhibiting cyclooxygenase
Aspirin
37
Uses of Aspirin
Prevention of MI, Stroke
38
Side Effects of Aspirin
GI Ulcer Bleeding
39
It blocks ADP(adenosine diphosphate) receptor in the platelet cell membrane
Thienopyridines
40
Uses of Thienopyridines
Prevention of MI, Stroke
41
Side Effects of Clopidogrel
Nausea Vomiting Diarrhea Hemorrhage
42
Side Effects of Ticlopidine
Neutropenia
43
It inhibits adenosine reuptake----decrease platelet aggregation It inhibits phosphodiesterase-----Inc. cGMP---vasodilation
Dipyridamole
44
It is for patients undergoing percutaneous coronary intervention (angioplasty)
Glycoprotein IIb/ IIIa inhibitors
45
Examples of Glycoprotein IIb/ IIIa inhibitors
Abciximab Eptifibatide Tirofiban
46
Side Effects of Glycoprotein Inhibitors
Bleeding
47
Glycoprotein IIB/IIA Inhibitors Use
To decrease the incidence of hemorrhage
48
Vitamin K and its synthetic derivatives
Vitamin K1 (phytonadione) - fat soluble Vitamin k3 (menadione) - fat soluble Vitamin K4 (menadiol) -water soluble
49
Vitamin K MOA
Promotes the synthesis of Factors II, VII ,IX and XI
50
Factor II
Prothrombin
51
Factor VII
Proconvertin
52
Factor IX
Plasma Thromboplastin Component
53
Factor XI
Stuart Factor
54
It is the drug of choice for the treatment of anticoagulant overdose and HDN (hemorrhagic disease of newborn) because it has the same degree of activity with the naturally occurring vitamin and have better margin of safety.
Vitamin K1 (Phytonadione)

PCOL 2 (11 decks)

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