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5TH YR- CMS2 > Anticoagulants, drugs affecting blood clotting > Flashcards

Anticoagulants, drugs affecting blood clotting Flashcards

1
Q

What do anticoagulants do

A

They interfere with or block soem aspect of blood coagulation

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2
Q

How can anticoagulants be classified

A

As oral or injectable

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3
Q

Give examples of anticoagulants

A
  1. Heparin
  2. Warfarin
  3. Phenindione
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4
Q

What is the principle mode of action of heparin

A

Action on antithrombin III
This inhibits thrombin and inactivates prothrombin
Anti thrombin III neutralises several of the activated clotting factors
Heparin activates antithrombin and accelerates its rate of action

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5
Q

How is heparin given

A

Either intravenously or subcutaneously

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6
Q

Where is heparin metabolised

A

Liver and excreted via kidneys

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7
Q

When does an intravenous injection of heparin begin to work

A

Immediately

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8
Q

When does a subcutaneous injection of heparin begin to work

A

50-60 mins after dosing

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9
Q

List some unwanted side effects associated with heparin

A

Haemorrhage most commonly from the gastrointestinal or genitourinary tract

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10
Q

What should we do if a patent on heparin suffers form haemorrhage

A

Stop administrating heparin and give the patietn protamine sulphate 1mg for every 100 units of heparin

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11
Q

How does warfarin work

A

It acts as an antagonist to the vitamin K dependent clotting factors (eg II, VII, IX, X)

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12
Q

When is low molecular weight heparin used clinically

A

When there is an immediate need for anticoagulation eg DVT and pulmonary embolism

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13
Q

When is warfarin given to patients

A

Used in the prophylaxis of embolisation in rheumatic heart disease, heart valve replacement and atrial fibrillation
also used in the management of DVT and pulmonary emboloism where 3-6 month course is given after initial heparin treatment

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14
Q

What do Antiplatelet drugs do

A

They decrease platelet aggregation and may also inhibit thrombus formation in the arterial circulation where anticoagulants have little or no effect

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15
Q

Give examples of Antiplatelet drugs

A
  1. Aspirin
  2. Clopidogrel
  3. Dipyridamole
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16
Q

What does aspirin do

A

Increase bleeding time by reducing platelet aggregation

17
Q

How does aspirin work

A

It inhibits the synthesis of thromboxane A2 in the platelet by blocking cyclo-oxygenase

18
Q

What is thromboxane A2

A

A prostaglandin that promotes platelet aggregation

19
Q

How long can the effect of a single dose of aspirin last

A

7-10 days

20
Q

When is aspirin given

A
  1. 150-300 mg is given soon as possible after an ischaemic even
  2. 75mg is used for long term maintenance or prophylaxis of established cardiovascular disease
21
Q

What does clopidogrel do

A

Inhibits ADP induced platelet aggregation and is often used in combination with aspirin in the prevention of atherosclerotic events

22
Q

What is dipyridamole

A

is a phosphodiesterase inhibitor with an antithrombotic effect based upon its ability to modify various aspects of platelet function such as adhesion, aggregation and survival.

23
Q

What is the main use of Dipyridamole

A

Used as an adjunct to oral anticoagulants for the prophylaxis of thromboembolism associated with prosthetic heart valves and as an adjunct to aspirin following a stroke or transient ischaemic attack

24
Q

What do fibrinolytic drugs do

A

Promotes the breakdown of thrombi by activating plasminogen to form plasmin

25
Q

Give examples of fibrinolytic drugs

A
  1. alteplase
  2. streptokinase,
  3. reteplase
  4. tenacteplase.
26
Q

When are fibrinolytic drugs indicated

A

Acute mI and other life threatening thromboembolic disorders

27
Q

What is alteplase

A

A tissue plasminogen activator which acrivats bound plasminogens

28
Q

When is alteplase used

A

Managements of acute MI and pulmonary embolism

29
Q

What is the main unwanted effect of alteplase

A

haemorrhage

30
Q

what is Streptokinase

A

it is a protein derived from β-haemolytic streptococci, which interacts with the proactivator of plasminogen to catalyse the conversion of plasminogen to plasmin

31
Q

What do Antifibrinolytic drugs do

A

Encourage the stabilisation of fibrin by inhibiting plasminogen activation

32
Q

Name the most commonly used Antifibrinolytic drug in dentistry

A

tranexamic acid,

33
Q

When is tranexamic acid given to patients

A

Used as a mouthwash in controlling persistent haemorrhage after tooth extraction.

5TH YR- CMS2 (7 decks)

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