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Kol- Pharm 323 Spring > Antiplatelet/ Thrombolytic > Flashcards

Antiplatelet/ Thrombolytic Flashcards

1
Q

3 types of drugs effecting coagulation

A

Anticoagulants
Antiplatelet
Thrombolytic Therapy

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2
Q

prevents the formation of clots- VENOUS (DVT)

A

Anticoagulantsz

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3
Q

inhibits platelet aggregation (arterial - MI/Stroke)

A

Antiplatelet Agents

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4
Q

dissolves life threatening clots

A

Thrombolytic

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5
Q

4 types of antiplatelet agents?

A
  1. Aspirin
  2. Adenosine Diphosphate Receptor (ADP) Antagonists
  3. PAR-1 Antagonists
  4. Glycoprotein Ilb/llla Receptor Antagonists
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6
Q

how does apirin fxn?

A
  • antiplatelet
  • interfere with platelet aggregation or “stickiness”
  • Used to prevent clot formation in arteries
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7
Q

how long is single dose of aspirin good for antiplatelet effects?

A

up to 1 week!

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8
Q

how does 1 week dose of aspirin fxn? what is the dose?

A
  • –>Irreversible inhibition of cyclooxygenase (COX)

- –>Used to prevent heart attack, TIA & stroke with 81mg

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9
Q

side effects of aspirin? what we gonna do about it?

A

GI Bleed

-GI Bleed not reduced with enteric coated but is helped with proton pump inhibitor

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10
Q

If we put someone on bigger dose of aspirin will it make their shit less sticky and their heart more good?

A

No!

-if increase dose - increase side effects and no CV benefits

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11
Q

Prototype for Adenosine Diphosphate Receptor (ADP) Antagonists

A

clopidogrel (Plavix)

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12
Q

How does clopidogrel (Plavix) fxn?

A
  • Irreversible blockade of ADP receptors on platelet surfaces
  • Used to prevent clots –> high risk MI, CVA patients
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13
Q

What is clopidogrel (Plavix) used for? which patient populations?

A

prevent clots –> high risk MI, CVA patients

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14
Q

Side effects of clopidogrel (Plavix)? what we gonna do about it?

A

Adenosine Diphosphate Receptor (ADP) Antagonists

GI bleed
-Might just let them bleed if risk of thrombotic event (MI/Stroke) is high

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15
Q

Always check with provider before stopping

A

Adenosine Diphosphate Receptor (ADP) Antagonists

clopidogrel (Plavix)

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16
Q

What is dual platelet therapy? when ya gonna do it?

A

give Aspirin + ADP Antagonist

-give this ACS (acute coronary Syndrome)

17
Q

Stop clopidogrel (Plavix) ___ _____ before surgery

A

5 days

18
Q

CYP2C19 genetic variant testing with which drug? what we gonna do about it?

A

Adenosine Diphosphate Receptor (ADP) Antagonists
Prototype: clopidogrel (Plavix)

–poor metabolizers should use another ADP

19
Q

drug interaction with clopidogrel (Plavix)? what we gonna do about it?

A

PPI - but still give it

20
Q

Prototype for PAR-1 Antagonists

A

vorapaxar (Zontivity)

21
Q

how does vorapaxar (Zontivity) fxn?

A

REVERSIBLY blocks the PAR-1 expressed on platelets

22
Q

Route for vorapaxar (Zontivity)?

A

PAR-1 Antagonists

-oral

23
Q

_____ lasts 7-10 days after last dose

A

PAR-1 Antagonists

Prototype: vorapaxar (Zontivity)

24
Q

What do we give vorapaxar (Zontivity) with to prevent CV events? which patient populations?

A

clopidogrel and/or ASA

high risk patients history of MI, PAD disease

25
Q

Prototype for Glycoprotein Ilb/llla Receptor Antagonists

A

abciximab (ReoPro)

26
Q

abciximab (ReoPro) fxn?

A

Reversible inhibition of all factors in platelet aggregation

Glycoprotein Ilb/llla Receptor Antagonists

27
Q

This antiplatelet is IV only

A

Glycoprotein Ilb/llla Receptor Antagonists

Prototype: abciximab (ReoPro)

28
Q

When do we give abciximab (ReoPro)

A

Glycoprotein Ilb/llla Receptor Antagonists

  • Short term use for ongoing instability
  • –>during cardiac catheterization/ balloon angioplasty/stents
  • –>ACS
29
Q

Why does abciximab (ReoPro) suck?

A

costs 1200$!

-major risk of bleeding

30
Q

What other drugs do we give abciximab (ReoPro) with?

A

ASA or Heparin

31
Q

prototype for thrombolytic?

A

alteplase (tPa)

32
Q

fxn of alteplase (tPa)?

A

Break down clots (lysis)

Thrombolytic

33
Q

When do we want to administer alteplase (tPa) for MI?

A

within 6 hours of onset

-3o min ideal!

34
Q

When do we want to administer alteplase (tPa) for CVA?

A

within 3 hours

35
Q

Half life of alteplase (tPa) ?

A

5 Minutes

36
Q

does alteplase (tPa) have narrow or wife margin of safety?

A

narrow

37
Q

What do we do if their are signs of bleeding with alteplase (tPa)?

A

STOP!

38
Q

Contraindication considerations for alteplase (tPa)?

A 
Has someone had recent preg?
Already on anticoag?
Internal bleeding?
Severe HTN?
Peptic ulcer disease?

Kol- Pharm 323 Spring (41 decks)

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