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Pharmacology > Anticoagulants > Flashcards

Anticoagulants Flashcards

1
Q

HEPARIN

A

Idirectly Inibits: Factor IX, X, XI, and XII, and thrombin (II) via Antithrombin III
Only dad can trap the Thrombeaver

Monitor PTT

Toxicity:
Heparin Induced Thrombocytopenia (HIT) — antibodies directed against Platelet Factor 4 (PF4)
Hypoaldosteronism - Potassium retention (Think same as spironolactone)

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2
Q

LMWH

A

Inhibitor of Factor IX & X only
End with -parin
Longer half life

Can still cause HIT, but less likely

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3
Q

PROTAMINE SULFATE

A

Low molecular weight positively charged protein that can directly inhibit Heparin.

Less effective for LMWH and Fondaparinux

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4
Q

FONDAPARINUX

A

Antithrombin III activator — synthetic, very low molecular weight heparin derivative
Only inhibits Factor X

Will not cause HIT
Not sensitive to Protamine Sulfate

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5
Q

HIRUDIN and LEPIRUDIN

A

HIRUDIN — naturally occurring (salivary gland of leech)
LEPIRUDIN — recombinant derivative of hirudin
Both bind and directly inhibit thrombin

Treat HIT

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6
Q

BIVALIRUDIN

A

Synthetic, derived form of hirudin
Also binds and directly inhibits thrombin

Coronary angioplasty - as a substitute for heparin

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7
Q

ARGATROBAN

A

Synthetic L-arginine analogue
Competitively inhibits thrombin

Treat HIT

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8
Q

RIVAROXABAN (Xarelto)

A

Xa Inhibitor

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9
Q

APIXABAN (Elaquis)

A

Xa Inhibitor
Treat Venous Thrombosis
Fixed oral doses with no need for monitoring
Long term anticogulant prophylaxis —> Such as in A. Fib

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10
Q

STREPTOKINASE

A

Nonenzymatic protein derived from Streptococci, binds to plasminogen and induces conformation changes that expose the active site.

Promote clot lysis
Can cause allergic reaction

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11
Q

UROKINASE

A

Serine protease enzyme that activates plasminogen directly

Derived from human fetal kidney cells via recombinant technology

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12
Q

ALTAPLASE
RETEPLASE
TENECTEPLASE

A

Tissue-type Plasminogen Activator (t-PA) - endogenous, with a high binding affinity for fibrin; can produce clot-selective plasminogen activation.

Reteplase and Tenectplase have longer half-lives

Alteplase - catheter coagulation

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13
Q

AMINOCAPROIC ACID

A

Inhibits plasmin-fibrin interaction

Will reverse fibrinolysis drugs - tPA, Streptokinase, Urokinase

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14
Q

TRANSEXAMIC ACID

A

Reverses tPA

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15
Q

WARFARIN

A

Blocks action of EPOXIDE REDUCTASE (VKOR) trapping Vitamin K in its inactive form

No gamma carboxylation
Affects 2, 9, 7, 10, C/S

Monitor PT
LONG Half Life
8-12 hour delay - must start with a more acute anticoagulant then switch to Warfarin

Metabolized by CYP450
Teratogenic - use heparin instead

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16
Q

High Dose Vitamin K

A

Reverse Warfarin therapy

17
Q

Protein C Deficiency

A

Warfarin Skin Induced Necrosis — from early hypercoagulable state

Heparin must be used in addition to prevent this

18
Q

DIPYRAMIDOL, CILOSTAZOL

A

PDE Inhibitors

Increase cAMP

19
Q

Dipyridamole + Warfarin

A

Prosthetic Heart Valves

20
Q

Dipyridamole + Aspirin

A

Prior Stroke

21
Q

ABCIXIMAB

A

GpIIb-IIIa Inhibitor

Monoclonal antibody used in angioplasty, often with aspirin and heparin

22
Q

EPTIFIBATIDE

A

GpIIb-IIIa Inhibitor
Cyclic peptide inhibitor that binds to RGD motifs on alpha2beta3 integrins
Also used for angioplasty

23
Q

TIROFIBAN

A

GpIIb-IIIa Inhibitor

Non-peptide small molecule inhibitor of alpha2beta3 integrin

24
Q

TICLOPIDINE

A

Block ADP receptor P2Y12
Increased cAMP blocks expression of GPIIb-IIIa on cell surface

Can cause Neutropenia and Graulocytopenia

25
Q

CLOPIDOGREL (Plavix)

A

Block ADP receptor P2Y12

Increased cAMP blocks expression of GPIIb-IIIa on cell surface

26
Q

PLASOGREL

A

Block ADP receptor P2Y12

Increased cAMP blocks expression of GPIIb-IIIa on cell surface

27
Q

Clopidogrel + Aspirin

A

Angioplasty

28
Q

ASPIRIN

A

Irreversible COX Inhibitor

Decreases levels of TXA2 and PGI2

TXA2 - normally causes vasoconstriction
PGI2 - levels will recover on endothelial cells

Allergic Symptoms — From synthesis of leukotrienes. Use an ADP Blocker instead

Pharmacology (19 decks)

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