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Blood and Lymphatics > Anticoagulants - Dr. Issar > Flashcards

Anticoagulants - Dr. Issar Flashcards

1
Q

After platelet activation, mediators like what are released, which further activate other platelets?

A
  1. ADP

2. 5-HT (serotonin)

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2
Q

Platelet activation expressed which receptors on the platelet surfaces?

A

GP IIB/ IIIA

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3
Q

GP IIB / IIIA binds to what?

A

Circulating fibrinogen

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4
Q

Tissue factor is a co-factor for which clotting factor?

A

Factor VII

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5
Q

Unfractioned heparin binds to antithrombin III and inactivates what 3 clotting factors?

A
  1. Thrombin
  2. X a
  3. IX a
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6
Q

What part of the unfractioned heparin binds to the antithrombin III?

A

pentasaccharide sequence

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7
Q

Fondaparinux selectively inhibits what?

A

Factor Xa

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8
Q

Why would LMWH/ Fondaparinux NOT inactivate thrombin?

A

The chain is too short to bridge AT III to thrombin

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9
Q

All heparins are metabolized in the liver by what enzyme?

A

Heparinase

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10
Q

LMWH & Fondaparinux are given as prophylactic therapy for what?

A

DVTs

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11
Q

What are the advantages of LMWH?

A
  1. Less bleeding
  2. A longer half-life
  3. no lab monitoring required
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12
Q

What is the black box warning for LMWH?

A

Can cause spinal/ epidural hematomas

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13
Q

What is the common side effect of heparins?

A

Hemorrhage

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14
Q

What could be an antidote to excess heparin?

A

Promatine

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15
Q

How does Promatine work?

A

It neutralizes the negative charge of heparin

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16
Q

Protamine has NO effect on what indirect thrombin inhibitor?

A

Fondapurnix

17
Q

What is the rare and fatal side effect of heparins?

A

Immune mediated HIT

18
Q

In immune mediated HIT, the body produces IgG antibodies against what?

A

heparin- platelet factor 4 complexes

19
Q

The direct thrombin inhibitors, Lepirudin, Desirudin, and Bivalirudin, bind to which sites on thrombin?

A
  1. Enzymatic active site

2. Exosite

20
Q

What makes Lepirudin highly effective?

A
  1. it inhibits both free & fibrin bound thrombin

2. irreversibly binds to thrombin

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