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Pharm Block 2 > Anticoagulants > Flashcards

Anticoagulants Flashcards

1
Q

binds with antithrombin 3 and forms a complex irreversible inactivates thrombin and factor Xa

A

unfractioned heparin

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2
Q

monitored by aPTT (measures function of intrinsic pathway of coagulation cascade

A

unfractioned heparin

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3
Q

not a clot buster, it will prevent the fibrin clots from forming

A

heparin

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4
Q

treats

1) DVT prophylaxis
2) acute DVT
3) prophylaxis and acute pulmonary embolism
4) acute MI to prevent extension and formation

A

Heparin

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5
Q

1) bleeding
2) induced thrombocytopenia (swell foot) - occurs when Ab armada against heparin complex to platelet factor 4
3) hyperaldosteronism
4) hypoaldosteronism causes hyperkalemia
5) osteoporosis

A

heparin ADR

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6
Q

results in paradoxical thrombosis in the setting of thrombocytopenia

A

HIT

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7
Q

reverses the anticoagulant effect of unfractioned heparin

A

protamine sulfate

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8
Q

binds to antithrombin 3: forms complex inhibits factor Xa with less of an effect on thrombin

A

LMWH

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9
Q

does not require PTT monitoring
has prolonged half life
protamine sulfate less effective
eliminated renally and can stay in system if there is renal insufficiency

A

LMWH

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10
Q

safe in pregnancy

A

heparin

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11
Q

lowest risk of HIT

A

fondaparinux

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12
Q

binds to antithrombin 3 with higher specificity; inhibits factor Xa with less effect on thrombin

A

fondaparinux

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13
Q

blocks vitamin k epoxide reductase; preventing factors 2 7 9 10 form being produced and also proteins C and S

A

warfarin

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14
Q

promotes gamma carboxylation

A

vit K

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15
Q

occurs at glutamic acid residue on factors 2 7 9 10

A

gamma carboxylation

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16
Q

1st clotting factor to be reduced when starting warfarin

A

factor 8

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17
Q

onset 8-12 hrs
full clinical effect takes 3 days
oral admin
long half life

A

warfarin

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18
Q

monitor using PT and INR

A

warfarin

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19
Q

goal INR is _____ for prevention and treatment of thrombosis

A

2-3

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20
Q

treats

1) long term anticoagulation in a fib
2) dvt prophylaxis

A

warfarin

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21
Q

crosses placental barrier and can cause a hemorrhagic disorder or prevent carboxylation reactions in bone

A

ADR warfarin

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22
Q

anticoagulation protein C is reduced early in warfarin therapy - hypercoagulable state initially

A

ADR warfarin

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23
Q

induces skin necrosis due to hypercoagulable state

A

warfarin

24
Q

coadmic of heparin when starting warfarin prevents the early hypercoagulable state

A

heparin bridge

25
Q

warfarin anticoagulation can be reversed with

A

Vit K

26
Q

immediate reversal treatment of warfarin anticoagulation

A

fresh frozen plasma

27
Q

increase rifampin, phenobarbital, phenytoin

A

decrease effects of warfarin

28
Q

decrease antibiotics, antifungals, SSRIs

A

increase effects of warfarin

29
Q

direct thrombin inhibitors

A

argatroban
dabigatran
bivalirudin

30
Q

directly bind to and irreversibly inhibit thrombin
do not require antithrombin 3
monitor by aPTT

A

direct thrombin inhibitors

31
Q

100% metabolized in liver
half life 40-50 min
used in HIT and renal failure

A

argatroban

32
Q 
renal elimination 
oral med
does not require monitoring
used in A fib
rapidly reversed by idarucizumab (monoclonal Ab)
A

dabigatran

33
Q

can replace heparin
treats HIT
20% renal elimination(rest metabolic)

A

bivalirudin

34
Q

specific irreversible thrombin (2a) inhibitor from leech saliva

A

hirudin

35
Q

IV
renal elimination
use to treat HIT

A

lepirudin

36
Q

direct factor Xa inhibitors

A

rivaroxaban and other xabans

37
Q

does not require monitoring
half life - ~10 hrs
no antidote
given in fixed doses

A

rivaroxaban and other xabans

38
Q

used to prevent DVTs

prevention of stroke and systemic embolism in non valvular atrial fib

A

rivaroxaban and other xabans

39
Q

dont use in kidney or liver dysfunction
25-50% renal metabolism
use P450 and P glycoprotein for metabolism and excretion

A

rivaroxaban and other xabans

40
Q

lyse thrombi by catalyzing the formation of the endogenous fibrinolytic plasmin from plasminogen

A

fibrinolytics

41
Q

not clot specific
helps activate plasminogen to plasmin
antigenic (derived by streptococci)

A

streptokinase

42
Q

clot specific
acting mainly on fibrin bound plasminogen
natural activator

A

alteplase (tPA)

43
Q

antidotes in excessive bleeding

A

antifibrinolysins (aminocaproic and tranexamic acids)

44
Q

decreases TXA2
irreversibly inhibits COX 1 in platelets - decreases activation
low doses prevent MI and recurrence; prophylaxis in Atrial arryh and TIAs

A

aspirin

45
Q

stop before surgery and pregnancy

increases GI bleeding 2x over placebo

A

aspirin

46
Q

block ADP receptors on platelets - decrease activation (irreversibly)

A

clopidogrel
prasugrel
ticagrelor

47
Q

alternatives to ASA in TIAs, post MI, and unstable angina

A

clopidogrel
prasugrel
ticagrelor

48
Q

ADR

1) hemorrhage
2) leukopenia
3) thrombocytopenia purpura

A

clopidogrel
prasugrel
ticagrelor

49
Q

most effective anti platelet and a monoclonal Ab

A

Abciximab

50
Q

antagonists that bind to glycoprotein 2b/3a receptors - decrease aggregation by preventing the cross linking reaction
inhibit final common pathway

A

Abciximab
eptifibatide
tirofiban

51
Q

used mainly in acute coronary syndrome and postangioplasty

A

Abciximab
eptifibatide
tirofiban

52
Q

mimic Glanzmanns thrombasthenia and bernard soulier syndrome

A

Bp 2b/3a receptor blockers

53
Q

inhibit adenosine uptake to RBC = increase adenosine in blood

A

dipyridamole

54
Q

inhibits cGMP phosphodiesterase activity , increasing cGMP - vasodilation

A

dipyridamole

55
Q

combine with aspirin to treat TIA; no effect alone

A

dipyridamole

56
Q

cAMP phosphodiesterase 3 inhibit - increase cAMP - platelet aggregation inhibit and vasodilation

A

cilostazol

57
Q

treats intermittent claudication (leriche syndrome)

A

cilostazol

Pharm Block 2 (22 decks)

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