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Cardio 2 > anticoagulants, antiplatelet, thrombolytics > Flashcards

anticoagulants, antiplatelet, thrombolytics Flashcards

1
Q

UFH uses

A

rapid parenteral anticoagulation

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2
Q

UFH mechanism

A

w/antithrombin III binds and inactivates clotting factors II, X, IX, XII, kallikrein
intrinsic and common pathways

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3
Q

UFH route of administration

A

IV, SQ

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4
Q

UFH monitor tests

A

aPTT 1.5-2.5x control
thrombin time
high doses elevated PT

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5
Q

UFH most notable side effect

A

bleeding, thrombocytopenia

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6
Q

UFH indications

A 
UA/NSTEMI
AMI
PCI
VTE prevention and treatment
DIC
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7
Q

low MW heparin

A

parenteral, prophylaxis, and treatment of MI, DVT, and PE

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8
Q

mechanism of low MW heparin

A

binds antithrombin inhibits X

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9
Q

route of administration low MW heparin

A

SQ

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10
Q

Monitor testsing low MW heparin

A

testing not usually necessary

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11
Q

low MW heparin side effect

A

bleeding

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12
Q

indications for low MW heparin

A 
UA/NSTEMI
AMI
PCI
VTE
prevention and treatment
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13
Q

warfarin uses

A

slow sustained oral anticoagulant

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14
Q

warfarin mechanism

A

inhibits vit K dependent clotting factors II, VII, IX, X, protein C and S
extrinsic and common

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15
Q

warfarin administration

A

PO

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16
Q

warfarin monitor tests

A

PT -> INR (2-3)

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17
Q

warfarin side effects

A

bleeding

drug-drug interactions

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18
Q

warfarin indications

A

VTE

AFib

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19
Q

LMWHs

A

Enoxaparin

-parin

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20
Q

factor X inhibitors

A

fondaparinux
rivoxaban
apixban

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21
Q

dabigatran uses

A

oral anticoagulant
prevention of stroke in non-valvular afib
prevention of stroke in knee and hip replacements

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22
Q

dabigatran mechansims

A

binds directly to thrombin, inhibits clot bound circulationg thrombin, decrease thrombin stimulated platelet aggregation

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23
Q

dabigatran monitor testing

A

none

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24
Q

dabigatran side effects

A

bleeding < warfarin
dyspepsia, gastritis, GI bleeding
very expensive

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25
rivaroxaban uses
oral anticoagulant prevention of DVT in patients w/knee and hip replacement prevention of stroke and DVT in non-valvular afib
26
rivaroxaban mechanisms
binds directly to and inhibits Xa
27
monitor testing rivaroxaban
none
28
rivaroxaban side effects
bleeding >/= enoxaparin | expensive
29
apixaban uses
oral anticoagulant | prevention of stroke and systemic embolism in non-valvular aFib
30
aspirin mechanism
inhibits TXA2 formation blocking platelet aggregation
31
aspirin indications
prophaylaxis and treatment of MI, stroke, PAD
32
Clopidogrel mechanism
blocks platelet aggregation by blocking P2Y12 ADPR
33
clopidogrel indications
prophylaxis of stroke, MI, PAD, and ACS
34
prasugrel mechanism
irreversibly binds P2Y12 ADPR inhbits platelet aggregation
35
prasugrel indications
prophylaxis of thrombotic CV events in patients w/ACS being managed w/PCI
36
dipyridamole mechanisms
blocks platelet aggregation inhibits adenosine uptake and cAMP phosphodiesterase inhibitor
37
dypyridamole indications
prophylaxis of thromboembolism
38
ticlopidine mechanisms
blocks platelet aggregation by blocKing P2Y12 ADPR
39
ticlopidine indications
prophylaxis of recurrent stroke, thrombosis during stent placement, adverse die effects limit use
40
cilostazol mechanism
blocks platelet aggregation causes vasodilation
41
cilostaxol indications
intermittent claudication | PAD
42
pentoxifylline mechanisms
hemorheologic agent | improves blood flow
43
pentoxifylline indicatios
intermittent claudication of limbs PAD efficacy questionable
44
antiplatlet drugs
``` aspirin clopidogrel prasugrel sipyridamole ticlopidine cilostazol pentoxifylline ```
45
GPIIb/IIIa inhibitors
abciximab eptifibatide tirofiban
46
abciximab mechanism
monoclonal Ab vs glycoprotein IIb/IIIa complex
47
epitfibatide and tirofiban mechanism
block fibrinogen binding to IIb/IIIa complex
48
indications for GPIIb/IIIa inhibitors
acute coroary syndromes during percutaneous coronayr intervention (PIC)/angioplasty
49
direct thrombin inhibitors
lepirudin bivalirudin argatroban
50
lepirudin mechanism
direct binding to thrombin
51
lepirudin indications
Tx of heparin induced thrombocytopenia (HIT)
52
bivalirudin mechanisms
direct binding to thrombin
53
bivalirudin indications
percutaneous coronary angioplasty
54
argatroban mechanism
direct binding to thrombin
55
argatroban indications
HIT
56
thrombolytic drugs summary
alteplase reteplase tenecteplase streptokinase
57
alteplase mechanism
activator of plasminogen
58
alteplase
``` AMI PE arterial thrombosis non-hemorrhagic ischemic stroke DVT ```
59
reteplase mechanism
activator of plasminogen
60
reteplase indications
AMI | coronary artery thrombosis
61
tenecteplase mechanism
activator of plasminogen
62
tenecteplase indications
AMI
63
streptokinase mechanism
nonenzymatic activaotr of plasminogen | stimulated dissolution of fibrin clots
64
streptokinase indications
AMI PE DVT arterial thrombosis
65
heparin effects on clotting tests
prolongs both aPTT and thrombin time | at high plasma concentrations will also prolong PT
66
HIT
heparin induced thrombocytopenia up to 25% of patients due to formation of Abs directed against heparin -> Ab-Ag complexes -> paradoxical thrombosis-> treated w/direct thrombin inhibitors
67
treatment for heparin overdose
protamine sulfate | strongly basic protein administered IV binds and inactivated heparin b/c of strong + charge
68
fondaparinux
synthetic analog of heparin factor X inactivation does not cause HIT does not affect PT, aPTT, bleeding time, or platelet fnx indicated in DCT after fracture or surgery
69
warfarin pharmacokinetics
onset delayed 36-72 hours 99% bound to albumin termination delayed due to long half life 40hours
70
contraindication of warfarin
``` pregnancy bleeding unreliable patient severe HTN suspected aneurysm ```
71
ticopodine adverse effects
``` life-threatening rxns neutropenia/agranulocytosis TTP aplastic anemia should only be used in patients intolerant or allergic to aspirin or clopidogrel ```
72
aPTT
intrinsic pathway hemophilias used to monitor UFH
73
PT
should be 12-14 seconds | IRN normalizes result and used to monitor warfarin
74
thrombin itime
if long may be due to increased antithrombin

Cardio 2 (17 decks)

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