B / 1 : Blood Coagulation 1

Question 1

Which properties of the uninjured endothelium inhibit platelet binding?

Answer 1

PGI2 (prostacyclin) and NO

Question 2

Acetylsalicylic acid (aspirin)
- MOA
- Effect
- Indication
- Side effects

Answer 2

• Inhibition of platelet aggregation
• Irreversible inhibition of COX enzyme in platelets
• Fever, pain, inflammation, thromboembolic diseases, thrombosis
• Bleeding, peptic ulcer, hypersensitivity

Question 3

What are the ADP receptor inhibitors?

Answer 3

• Clopidogrel
• Ticagrelor
• Prasugrel

Question 4

Clopidogrel, Prasugrel
- MOA
- Effect
- Indication
- SE
- ROA

Answer 4

• Irreversible inhibition of platelets ADP receptor
• Inhibits activation and aggregation
• For circulatory problems, prophylaxis in atrial arrythmia, coronary syndrome
• GI problems, bleeding, leukopenia (rare)
• Oral

Question 5

Ticagrelor
- MOA
- Effect
- Indication
- ROA

Answer 5

• Reversible inhibition of platelets ADP receptor
• Inhibit platelet activation and aggregation
• Prevention of arterial thromboembolic disorders, prophylaxis in atrial arrythmia, coronary syndrome
• Oral

Question 6

Abciximab
- MOA
- Effect
- Indication
- SE
- ROA

Answer 6

• GP-IIb/III receptor inhibitor
• Prevents cross-linking of platelets
• Acute coronary syndrome
• Bleeding, hypotension, thrombocytopenia
• IV

Question 7

Fibrinolytic / thrombolytic agents (lyse existing thrombi)

Answer 7

• Alteplase
• Reteplase

Question 8

Alteplase, reteplase
- MOA
- Effect
- Indication
- Contraindication
- SE
- Extra
- ROA

Answer 8

• Tissue plasminogen activator
• Direct conversion of plasminogen to plasmin (degrade fibrin mesh)
• For DVT, AMI, ischemic stroke
• GI bleeding, trauma
• Bleeding, cerebral hemorrhage
• Inactivated by PAI
• IV

(-plase : plasminogen)

Question 9

Drugs used in bleeding disorders (4)

Answer 9

• Vitamin K
• Epsilon-amino-caproic acid
• Epinephrine
• Fibrin foam

Question 10

Vitamin K
- MOA
- Effect
- Indication
- ROA

Answer 10

• Post ribosomal modification of factors 2, 7, 9, 10
• Produces coagulation factors
• Warfarin overdose (anticoagulant), premature newborns, vitamin K deficiency (old ppl)
• IV (slowly), oral

Question 11

Epsilon-amino-caproic acid
- MOA
- Effect
- Indication
- SE
- ROA

Answer 11

• Antiplasmin drug
• Inhibition of plasminogen activation : prevents fibrinolysis
• For post-surgical bleeding, to reverse activity of fibrinolytic drugs
• Intravascular thrombosis
• Oral or parenteral

Question 12

Epinephrine
- Effect
- Indication

Answer 12

• Local vasoconstriction (alpha 1 stimulation)
• Local anesthetics with lidocaine to decrease local blood flow

Question 13

Fibrin foam
- Effect
- Indication

Answer 13

• Prevents bleeding
• In surgical wounds

Question 14

Antiplatelet agents (5)

Answer 14

1. Aspirin
2. Clopidogrel
3. Prasugrel
4. Ticagrelor
5. Abciximab

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