Antithombotic

Question 0

Dyridamole

Cilostazol

Answer 0

Vasodilator, anti platelet

Inhibit adenosine reuptake by rbc and endothelial cells -^ cAMP in platelets
Inhibits Phosphodiesterase -^ camp and cgmp in platelet

Increase PGI-2
-used with aspirin to prevent thromboembolism in prosthetic valves and stroke

Question 1

Aspirin

Answer 1

Irreversible blocks cOX -no TXA2 decreases platlet aggregation

Low dose prevents MI(spares PGI-2 synthesis)

Disadvantage -gastric bleeding

Question 2

Clopidrogrel
Prausigrel
Ticoplidine

Answer 2

ADP receptor antagonist

• high oral bioavailability
• less GI bleeding

A.e. Neutropenia, thrombocytopenia, ticlopidibe

Question 3

Abciximab-monoclonal ab

Tirifiban

Answer 3

Inhibit GP11b/111a-inhibit cross linking aggregation

Use in : acute coronary syndrome** coronary angioplasty

Can be given with heparin /and aspirin

Question 4

Heparins
Vitamin k antagonist
Direct thrombin inhibitors

Answer 4

Anticoagulants

Question 5

Heparin

Answer 5

Water soluble -short half life-not orally,controlled by PTT
Heterogenous polysaccharide
^ activity of endogenous anticoagulant anti thrombin III
- inhibits factors Xa, IXa, XIa
-Does not cross placenta
A.e. Bleeding, thrombocytopenia , osteoporosis , alopecia

Question 6

Enoxaparin
Dalteparin
Tinzapatin

Answer 6

Low molecular weight heparin
Selectivity inhibit factor Xa
Longer half life
Lower risk A.e. Of osteoporosis or thrombocytopenia

Question 7

Heparin antagonist-for heparin bleeding

Answer 7

Protamine sulfate

Given IV -1mg for 100 units if heparin

Works better in regular heparin

Question 8

Protamine sulfate

Answer 8

Heparin antagonist

Question 9

Fondaparinux

Answer 9

Direct factor Xa inhibitor
Synthetic pentasaccharide

Low risk-thrombocytopenia

Question 10

Lepirudin
Argatroban
Bivalirudin

Answer 10

Direct thrombin inhibitors

For patients with heparin induced thrombocytopenia

Question 11

Warfarin

Answer 11

Vitamin k antagonist -inhibits 2,7,9,10, (works in liver)
Inhibits protein c
Long half life-given orally
Controlled by PT INR

A.e. Alopecia, bleeding, skin necrosis, purple toes,fetal warfarin syndrome

Question 12

Warfarin overdose

Answer 12

Vitamin k
Frozen plasma
Plasma concentrates 2,7,9,10

Question 13

Streptokinase

Answer 13

Antigenic
Non fibrin specific
Half life specific-
A.e. Hypersensitivity

Binds circulating plasminogen changes it to plasmin

Question 14

Aprotinin

Answer 14

Inhibition of fibrinolysis

Inhibits plasmin and Kalikrein

Question 15

Aminocaproic acid

Tranexamic acid

Answer 15

Acts by binding plasminogen and inhibits it’s activation to plasmin

Question 16

Tpa

Answer 16

Binds to fibrin bound plasminogen
Localized action
Fibrinolytic

Question 17

Ateplace

Reteplace

Answer 17

DNA recombinant T-pa
Non antigenic
Fibrin specific
Half life-10 minutes

Fibrinolytic drug

Question 18

Side effect of heparin

Answer 18

Alopecia hairless
Bleeding
thrombocytopenia
Osteoporosis