Antithrombotic and Fibrinolytics Flashcards
1
Q
Anti-coagulants drugs
A
- Prevents thrombus formation
2
Q
Anti-platelet drugs
A
Prevents platelet aggregation
3
Q
Fibrinolytics
A
- Clot retraction
4
Q
Warfarin
A
- Vitamin K antagonist
5
Q
Apixaban, Edoxaban and Rivaroxaban
A
- Direct oral anticoagulant and reversible factor Xa
6
Q
Dabigatran
A
- Reversible inhibitor of thrombin
7
Q
Function of Warfarin
A
- Coagulation factor (II, VII, IX, X) undergoes y - carboxylation to get activated
- y-carboxylation requires the reduced vitamin K which is converted into oxidized vit K
- Vitamin K reductase enzyme inhibit by Warfarin restores the reduced vitamin K
8
Q
Warfarin characteristics
A
- Slow onset
- Inhibit vit K-dependent protein C which is natural anti-coagulant causing pro-coagulant before anticoagulant effect
- Excess administration can overcome warfarin binding to reductase enzyme
8
Q
Pharmacokinetics of Warfarin
A
- 99% bound to plasma albumin also metabolized in liver eliminated in urine
9
Q
Drug interaction of Warfarin
A
- Warfarin causes breakdown antibiotics and azoles which and H2 receptor antagonist
- NSAIDs potentiate the effect of warfarin
- Antibiotics kill gut flora and vit K increase effect of warfarin
10
Q
Dabigatran
A
- Reversible inhibitor of free thrombin
- Fibrin-bound thrombin and thrombin induced platelet aggregation
11
Q
Apixaban
A
- Direct and reversible inhibitors of factor Xa
- Inhibition prevent thrombotic process
12
Q
Heparin
A
- Anti-thrombin and heparin complex bind inhibit thrombin mediated platelet activation
13
Q
Externally administered Heparin
A
- Unfractionated heparin larger molecule and low molecular weight heparin both replicate effect of normal heparin
- Inhibitor factors of Xa (compliment anti-coagulant effect)
14
Q
Adverse effects of Heparin : Hemorrhage
A
- Caused when there is low levels of unfractionated or low MW heparin
- Reverse effects by using protamine sulphate reverse low MW
