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BMRD > Antiplatelets, Anticoagulants & Fibrinolytic Agents > Flashcards

Antiplatelets, Anticoagulants & Fibrinolytic Agents Flashcards

1
Q

A is an antiplatelet which works by B inhibiting C in platelets which is needed for production of Thromboxane A2.

A

A: Aspirin
B: irreversibly
C: COX-1

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2
Q

A & B are antiplatelets which work by increasing levels of cAMP.

A

A: Dipyridamole
B: Clopidogrel

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3
Q

Describe the mechanism of action of clopidogrel.

A
  1. Clopidogrel is a non-competitive inhibitor of P2Y12 Gi-protein-coupled receptor
  2. It increases conversion of ATP to cAMP via action of adenylate cyclase
  3. This decreases levels of Ca2+
  4. Activation & aggregation of platelets are inhibited
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4
Q

Describe the mechanism of action of dipyridamole

A
  1. Dipyridamole increases levels of cAMP by inhibiting phosphodiesterase which converts cAMP to adenosine monophosphate
  2. Increase in cAMP decreases Ca2+
  3. Activation & aggregation of platelets are inhibited
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5
Q

___ is an antiplatelet which works by inhibiting glycoproteins IIb & IIIa. Fibrinogen link activated platelets together via glycoproteins IIb & IIIa.

A

Abciximab

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6
Q

___ is an antiplatelet which works by inhibiting glycoproteins IIb & IIIa. Fibrinogen aggregate activated platelets via glycoproteins IIb & IIIa.

A

Abciximab

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7
Q

Why is Abciximab administered intravenously?

A

It’s a protein. Hence, oral administration will result in digestion.

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8
Q

Activates plasminogen (apart from tPA) indirectly

A

Streptokinase

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9
Q

Apart from indirectly activating plasminogen, streptokinase also inhibits A, B & C.

A

A: fibrinogen
B: factor V
C: factor VII

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10
Q

Converts clot-specific plasminogen into plasmin

A

Altepase

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11
Q

Anticoagulants

A

Heparin

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12
Q

What do intact endothelium, protein C, antithrombin & prostacyclin have in common?

A

They inhibit coagulation cascade/are anticoagulants.

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13
Q

LMWHeparin

A

Enoxaparin

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14
Q

Which factor do enoxaparin & fondaparinux inhibit?

A

Xa

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15
Q

Heparin inhibits A & B.

A

A: factor Xa
B: thrombin

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16
Q

When (LMW)heparin attaches itself to antithrombin, antithrombin undergoes a change in ___.

A

shape

17
Q

Synthetic pentasaccharide

A

Fondaparinux

18
Q

Refer to slide 28 for additional info on UFH, LMWH & Fondaparinux

A

Slide 28

19
Q

Advantages of prescribing LMWH/enoxaparin & fondaparinux over heparin

A
  1. Can be prescribed on an outpatient basis
  2. Don’t require monitoring of activated partial thromboplastin time (aPTT)
  3. Less bleeding tendencies
  4. Half-lives aren’t dose-dependent
20
Q

Antidote for heparin

A

Protamine sulphate

21
Q

Pathophysiology of heparin-induced thrombocytopenia (low platelet count)

A

Heparin & platelet factor 4 (PF4) form a complex –> production of IgG antibodies against heparin-PF4 complex –> IgG antibody-heparin-PF4 immunocomplex binds on platelet surface –> platelet activation & aggregation –> consumption of platelets (thrombocytopnenia) & thrombosis

22
Q

Irreversible direct thrombin inhibitor

A

Lepuridin

23
Q

Warfarin inhibits hepatic A, thereby blocking synthesis (recycling) of active, B form of vitamin K. Without reduced vitamin K, C of D residues can’t occur, which reduces production of active coagulation factors E, F, G & H, as well as I proteins C & S.

A 
A: epoxide reductase
B: reduced
C: y-carboxylation 
D: glutamate
E: II (2)
F: VII (7) 
G: IX (9)
H: X (10)
I: anticoagulatory
24
Q

Used to treat heparin-induced thrombocytopenia

A

Lepuridin

25
Q

Non-vitamin K oral anticoagulants (NOAC)

A

Reversible direct thrombin inhibitor: dabigatran

Reversible direct factor “Xa” inhibitor: rivaro”Xa”ban

26
Q

Lepuridin is administered intravenously. T/F?

A

True

27
Q

aPTT of patients taking lepuridin don’t need to be monitored. T/F?

A

False

28
Q

Heparin is administered ___.

A

intravenously

29
Q

LMWH & fondaparinux are administered ___.

A

subcutaneously

30
Q

Treatment with warfarin is monitored by measuring ___.

A

Prothrombin time

31
Q

Antidote for warfarin

A

Vitamin K

32
Q

Warfarin should NOT be prescribed to ___.

A

pregnant women

33
Q

How do rifampicin & phenytoin affect warfarin?

A

Rifampicin & phenytoin induces breakdown of warfarin via induction of cytochrome P450

34
Q

How do sulfonamides affect warfarin?

A

Sulfonamides competitively displace warfarin from plasma protein binding sites

35
Q

How do erythromycin, grapefruit juice & ketoconazole affect warfarin?

A

Erythromycin, grapefruit juice & ketoconazole increase levels of warfarin by inhibiting cytochrome P450

36
Q

Anticoagulant of choice during pregnancy

A

Heparin

BMRD (18 decks)

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