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MOHD3: Exam 2 > Anticoagulants > Flashcards

Anticoagulants Flashcards

1
Q

Unfractionated Heparin

A

Anticoagulant
Template mechanism, inhibits thrombin (IIa) via antithrombin. IV or SQ
Unpredictable bio availability - need to monitor via APTT

Short Half life
Can reverse via protamine
Can use in pregnancy
Risk HIT: platelet activation by Abs against heparin -PF4 complex. Occurs 5-10d after, DVT, PE, MI, stroke, Skin necrosis.

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2
Q

Low Molecular Weight Heparin

A

Anticoagulant
Newer, smaller
Inhibit Xa
not as unpredictable - do NOT monitor with APTT, can monitor was assay , renal metabolism

Short Half life
Can reverse via protamine
Can use in pregnancy
Less Risk HIT: platelet activation by Abs against heparin -PF4 complex. Occurs 5-10d after, DVT, PE, MI, stroke, Skin necrosis.

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3
Q

Fondaparinux

A

Synthetic LMWH, doesn’t cross-react with HIT Abs - use to treat HIT.

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4
Q

Warfarin

A

Anticoagulant
Vit K antagonist - inhibit vit K epoxide reductase, inhibit glutamic carboxylation - inhibit synthesis of factors 2, 7, 9, 10. Inhibit synth of Prot C and S

Slow onset, Monitor with INR of PT, many interactions, Narrow therapeutic window, polymorphic
Teratogenic
Purple toe syndrome (rare)

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5
Q

argatroban

A

Anticoagulant
Direct Thrombin (IIa) Inhibitor
Parenteral - IV
Treat HIT, short half life

Liver metabolism

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6
Q

lepirudin

A

Anticoagulant
Direct Thrombin (IIa) Inhibitor
Parenteral - IV
Treat HIT, short half life

Renal metabolism
Made from leaches

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7
Q

bivalirudin

A

Anticoagulant
Direct Thrombin (IIa) Inhibitor
Parenteral - IV
Treat HIT, short half life

Renal metabolism
Made from leaches

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8
Q

dabigatran

A 
Anticoagulant 
Direct Thrombin (IIa) Inhibitor
Oral 
Treat HIT, short half life
Fast onset, no monitoring, No antidote!

80% renal metabolism

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9
Q

rivaxaban

A 
Anticoagulant 
Direct Factor Xa  Inhibitor 
short half life
Fast onset, no monitoring, No antidote! 
Less renal metabolism
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10
Q

apaxiban

A 
Anticoagulant 
Direct Factor Xa  Inhibitor 
short half life
Fast onset, no monitoring, No antidote! 
Less renal metabolism
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11
Q

Aspirin

A

Anti - Platelet
Inhibits COX I , II –> decreases synthesis of thromboxane A2 which is a platelet agonist
Prevents arterial thrombosis
Bad: GI ulcers, allergy, Reye’s Syndrome in kids

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12
Q

clopidegrel

A

Anti - Platelet
P2Y12 Receptor Antagonist - block activation of platelets by decreasing ADP activation of P2Y12 receptor
Oral
High affinity –> essentially irreversible

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13
Q

ticlopidine

A

Anti - Platelet
P2Y12 Receptor Antagonist - block activation of platelets by decreasing ADP activation of P2Y12 receptor
Oral
High affinity –> essentially irreversible

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14
Q

prasugrel

A

Anti - Platelet
P2Y12 Receptor Antagonist - block activation of platelets by decreasing ADP activation of P2Y12 receptor
Oral
High affinity –> essentially irreversible

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15
Q

ticagrelor

A

Anti - Platelet
P2Y12 Receptor Antagonist
Oral

Noncompetitive inhibitor of receptor –> reversible

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16
Q

abciximab

A

Anti - Platelet
Glycoprotein IIb/IIIa Antagonist: inhibit binding of fibrinogen to platelet receptor IIb/IIIa
IV
bad: thrombocytopenia

17
Q

tirofiban

A

Anti - Platelet
Glycoprotein IIb/IIIa Antagonist: inhibit binding of fibrinogen to platelet receptor IIb/IIIa
IV
bad: thrombocytopenia

small molecule

18
Q

eptifibitide

A

Anti - Platelet
Glycoprotein IIb/IIIa Antagonist: inhibit binding of fibrinogen to platelet receptor IIb/IIIa
IV
bad: thrombocytopenia

cyclic heptapeptide

19
Q

dipyradmole

A 
Anti - Platelet
Multiple mechanims: stimulate prostacyclin synthesis, inhibit adenosis deaminase and phosphodiesterase
Vasodilator 
Oral or IV
Used in combo with Aspirin
20
Q

streptokinase

A

Fibrolytic Agent: activate plasminogen which degrades fibrin

IV or catheter
NOT fibrin specific (also cleaves fibrinogen)

derived from beta-hemolytic streptococus
bad: allergic Abs, hypotension

21
Q

urokinase

A

Fibrolytic Agent: activate plasminogen which degrades fibrin

IV or catheter
NOT fibrin specific (also cleaves fibrinogen)

protease, cleaves plasminogen to plasmin

22
Q

t-PA

A

Fibrolytic Agents: activate plasminogen which degrades fibrin
= tissue plasminogen activator
IV
Class of drugs: alteplase, reteplase, tenecteplase
Fibrin specific!!!
short half life - use with heparin

MOHD3: Exam 2 (6 decks)

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