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Cardiology > Antiplatelet, anticoagulant and thombolytic drugs > Flashcards

Antiplatelet, anticoagulant and thombolytic drugs Flashcards

1
Q

Where would an arterial thrombus (white thrombus) become lodged?

A

Brain (stroke) or other organ

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2
Q

Where would a venous (red thombus) become lodged?

A

Lungs (pulmonary embolus)

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3
Q

In vivo pathway tissue factors

A

VIIa

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4
Q

Contact pathway factors

A

XIIa and IXa

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5
Q

X becomes Xa and what does this to?

A 
Changes prothrombin (II) to thrombin IIa
this then converts fibrinogen to fibrin
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6
Q

Xa inhibitor

A

Rivaroxiban

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7
Q

Thrombin inhibitors

A

Dabigatran etexilate

Bivalirudin

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8
Q

What state must vitamin K be in to act as an essential cofactor?

A

In its reduced form (hydroquinone)

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9
Q

How does warfarin work?

A

Structurally similar to vitamin K, competes with vit. K for binding to vitamin K reductase

(prevents conversion of epoxide to hydroquinone)

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10
Q

Which factors does warfarin inactivate?

A

II, VIII, IX and X

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11
Q

Pregnancy, hypothyroidism and clotting factors?

A 
Pregnancy = increased synthesis of clotting factors
Hypothyroidism = decreased degradation of clotting factors
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12
Q

Treatment for overdose of warfarin?

A

Vitamin K or concentrate of plasma clotting factors

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13
Q

Enoxaparin

Dalteparin

A

LMWH

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14
Q

Name 2 LMWH

A

Enoxaparin

Dalteparin

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15
Q

How is heparin administered?

A

IV or SC

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16
Q

How are LMWH administered?

A

SC

17
Q

How do you determine optimum dosage for heparin?

A

In vitro clotting

18
Q

How are LMWH excreted?

A

Via the kidneys

19
Q

Heparin inhibits which factors?

A

IIa and Xa

20
Q

LMWH inhibits which factor?

A

Xa

21
Q

Adverse effects of heparin and LMWH?

A

Haemorrhage
Osteoporosis
Hypoaldosteronism
Hypersensitivity reactions

22
Q

Direct thrombin inhibitor

A

Dabigatran etexilate

23
Q

Factor Xa inhibitor

A

Rivaroxiban

24
Q

How are platelets cross linked?

A

Fibrinogen

25
Q

What are contained in platelet storage granules?

A

ADP, 5HT and coagulation factors

TXA2 is synthesised on demand by COX

26
Q

Blocks P2Y12 receptor

A

Clopidogrel

27
Q

Blocks IIb/IIa receptor

A

Tirofiban

28
Q

Blocks COX-1

A

Aspirin

blocks COX and so blocks TXA2 synthesis

29
Q

Aspirin side effects

A

GI bleeding and ulceration

30
Q

How is tirofiban administered?

A

IV

-used to prevent MI in high risk patients with unstable angina (with aspirin and heparin)

31
Q

Drugs which activate plasminogen? (plasminogen –> plasmin –> breaks up fibrin)

A

Streptokinase
Alteplase
Duteplase

32
Q

Why are alteplase and duteplase given IV?

A

Short half life

33
Q

Side effect of streptokinase?

A

Cause allergic reaction

34
Q

Reversing haemorrhage caused by fibrinolytics?

A

TRANEXAMC ACID (inhibits plasminogen activation)

Cardiology (22 decks)

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