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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
Q

rivaroxaban uses

A

oral anticoagulant
prevention of DVT in patients w/knee and hip replacement
prevention of stroke and DVT in non-valvular afib

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26
Q

rivaroxaban mechanisms

A

binds directly to and inhibits Xa

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27
Q

monitor testing rivaroxaban

A

none

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28
Q

rivaroxaban side effects

A

bleeding >/= enoxaparin

expensive

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29
Q

apixaban uses

A

oral anticoagulant

prevention of stroke and systemic embolism in non-valvular aFib

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30
Q

aspirin mechanism

A

inhibits TXA2 formation blocking platelet aggregation

31
Q

aspirin indications

A

prophaylaxis and treatment of MI, stroke, PAD

32
Q

Clopidogrel mechanism

A

blocks platelet aggregation by blocking P2Y12 ADPR

33
Q

clopidogrel indications

A

prophylaxis of stroke, MI, PAD, and ACS

34
Q

prasugrel mechanism

A

irreversibly binds P2Y12 ADPR inhbits platelet aggregation

35
Q

prasugrel indications

A

prophylaxis of thrombotic CV events in patients w/ACS being managed w/PCI

36
Q

dipyridamole mechanisms

A

blocks platelet aggregation inhibits adenosine uptake and cAMP phosphodiesterase inhibitor

37
Q

dypyridamole indications

A

prophylaxis of thromboembolism

38
Q

ticlopidine mechanisms

A

blocks platelet aggregation by blocKing P2Y12 ADPR

39
Q

ticlopidine indications

A

prophylaxis of recurrent stroke, thrombosis during stent placement,
adverse die effects limit use

40
Q

cilostazol mechanism

A

blocks platelet aggregation causes vasodilation

41
Q

cilostaxol indications

A

intermittent claudication

PAD

42
Q

pentoxifylline mechanisms

A

hemorheologic agent

improves blood flow

43
Q

pentoxifylline indicatios

A

intermittent claudication of limbs
PAD
efficacy questionable

44
Q

antiplatlet drugs

A 
aspirin
clopidogrel
prasugrel
sipyridamole
ticlopidine
cilostazol
pentoxifylline
45
Q

GPIIb/IIIa inhibitors

A

abciximab
eptifibatide
tirofiban

46
Q

abciximab mechanism

A

monoclonal Ab vs glycoprotein IIb/IIIa complex

47
Q

epitfibatide and tirofiban mechanism

A

block fibrinogen binding to IIb/IIIa complex

48
Q

indications for GPIIb/IIIa inhibitors

A

acute coroary syndromes during percutaneous coronayr intervention (PIC)/angioplasty

49
Q

direct thrombin inhibitors

A

lepirudin
bivalirudin
argatroban

50
Q

lepirudin mechanism

A

direct binding to thrombin

51
Q

lepirudin indications

A

Tx of heparin induced thrombocytopenia (HIT)

52
Q

bivalirudin mechanisms

A

direct binding to thrombin

53
Q

bivalirudin indications

A

percutaneous coronary angioplasty

54
Q

argatroban mechanism

A

direct binding to thrombin

55
Q

argatroban indications

56
Q

thrombolytic drugs summary

A

alteplase
reteplase
tenecteplase
streptokinase

57
Q

alteplase mechanism

A

activator of plasminogen

58
Q

alteplase

A 
AMI
PE
arterial thrombosis
non-hemorrhagic ischemic stroke
DVT
59
Q

reteplase mechanism

A

activator of plasminogen

60
Q

reteplase indications

A

AMI

coronary artery thrombosis

61
Q

tenecteplase mechanism

A

activator of plasminogen

62
Q

tenecteplase indications

63
Q

streptokinase mechanism

A

nonenzymatic activaotr of plasminogen

stimulated dissolution of fibrin clots

64
Q

streptokinase indications

A

AMI
PE
DVT
arterial thrombosis

65
Q

heparin effects on clotting tests

A

prolongs both aPTT and thrombin time

at high plasma concentrations will also prolong PT

66
Q

HIT

A

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
Q

treatment for heparin overdose

A

protamine sulfate

strongly basic protein administered IV binds and inactivated heparin b/c of strong + charge

68
Q

fondaparinux

A

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
Q

warfarin pharmacokinetics

A

onset delayed 36-72 hours
99% bound to albumin
termination delayed due to long half life 40hours

70
Q

contraindication of warfarin

A 
pregnancy
bleeding
unreliable patient
severe HTN
suspected aneurysm
71
Q

ticopodine adverse effects

A 
life-threatening rxns
neutropenia/agranulocytosis
TTP
aplastic anemia
should only be used in patients intolerant or allergic to aspirin or clopidogrel
72
Q

aPTT

A

intrinsic pathway
hemophilias
used to monitor UFH

73
Q

PT

A

should be 12-14 seconds

IRN normalizes result and used to monitor warfarin

74
Q

thrombin itime

A

if long may be due to increased antithrombin

Cardio 2 (17 decks)

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