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Cardio > Antithrombotics > Flashcards

Antithrombotics Flashcards

1
Q
A
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2
Q

Accelerate lysis of thrombus in STEMI (patients with UA and NSTEMI do not benefit)

A

Fibrinolytic therapy

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3
Q

Transform inactive plasminogen to plasmin

A

Alteplase Streptokinase

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4
Q

When does fibrinolytic therapy need to be administered?

A

Within 30 minutes of presentation to the hospital

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5
Q

What are some adverse effects of fibrinolytic therapy?

A

Bleeding Systemic lytic state

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6
Q

In what patients is fibrinolytic therapy contraindicated?

A

Active peptic ulcers Recent stroke Recent surgery

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7
Q

Interfere with coagulation cascade; goal is to inhibit thrombin activation by Xa, directly inhibit thrombin or decrease functional thrombin production

A

Anti-coagulants

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8
Q

What is unique about heparin (UFH)?

A

It can inactivate Xa and inactivate free thrombin

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9
Q

Inactivate Xa

A

Low MW heparin Enoxaparin Dalteparin Fondaparinux

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10
Q

What is a possible severe side effect of UFH?

A

Thrombocytopenia

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11
Q

Why would you use LMWH over UFH?

A

It has a longer 1/2 life and more predictable bioavailability than UFH.

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12
Q

Direct thrombin inhibitor; inhibits independently of antithrombin; acts on circulating and clot-bound thrombin

A

Bivalirudin

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13
Q

Irreversibly acetylates COX-1 in platelets; blocks production of thromboxane. Permanent effect.

A

Aspirin

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14
Q

What patients is aspirin used in?

A

Patients with UA, acute MI, history of MI; chronic stable angina w/o history of MI; minor stroke; Coronary artery bypass surgery

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15
Q

Inhibit ADP-mediated activation of platelets; ADP activates P2Y1 and P2Y12 – drugs inhibit P2Y12

A

Thienopyridines: Clopidigrel, Ticlopidine, Prasugrel, Ticagrelor

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16
Q

Which Thienopyridine is reversible and when is this an advantage?

A

Ticagrelor – prevents perioperative bleeding complications w/o a waiting period (lifespan of platelets is 7-10 days)

17
Q

What are some side effects of Ticagrelor?

A

Severe neutropenia and thrombotic thrombocytopenic purpura

18
Q

Used in patients that cannot tolerate aspirin; relatively ineffective; increase platelet cAMP

A

Dipyridamole

19
Q

Reversible inhibit the final common pathway of platelet aggregation – binding of GPIIa/IIIb to fibrinogen and vWF

A

Abciximab Eptifibatide

20
Q

Chimeric human mouse antibody; blocks access of fibrinogen and vWF to GPIIa/IIIb receptor; non-competitive; IV

A

Abciximab

21
Q

Synthetic peptide; motif that binds GPIIb/IIIa receptors; competitive; IV; renal clearance

A

Eptifibatide

22
Q

New drug, inhibits free and fibrin bound thrombin

A

Dabigatran

23
Q

New drug, direct Xa inhibitor

A

Rivaroxaban

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