bleeding

Question 1

hemostasis - causes bleeding to stop - keep blood within a damaged vessel
formation of a clot has 3 steps

Answer 1

vessel constriction
platelet adhesion/bind, activation, and aggregation (plug)
cross-linking of fibrin thru coagulation cascade (extrinsic mort important than intrinsic)

Question 2

formation of platelet

upon injury - vascular endothelial cells begin to produce PG F 2alpha and thromboxane A2

Answer 2

vessel constriction

these are potent vasoconstrictors acting on SM - helps limit hemorrhage

Question 3

the response to vascular injury is a complex and tightly controlled process. the body’s goal is to repair the damage without _ formation or presence of a blood clot in a blood vessel.

Answer 3

thrombosis

clot itself is termed thrombus

thromboemobilsm - breaks free and travels in BS

there are proteins that serve to block formation of blood clots

Question 4

proteins that block formation of blood clots

Answer 4

antithrombin - enhanced with Heparin -

protein C

tissue factor pathway inhibitor

Question 5

fibrinolysis is the process that prevents blood clots from growing and becoming problematic

Answer 5

Plasminogin - precursor to plasmin
Plasmin degrades blood clot

Too much plasmin - can’t form clot

TPA- tissue plasminogen activator - cleaves plasminogen - give to heart attack patients to prevent blood clots

Question 6

_ drugs

used to lyse the thrombi/clot - to recanalize the occluded blood vessel (mainly coronary artery)

Answer 6

fibrinolytics - thrombolytics

versions of tPA
tissue plasminogen activator

SURAT

Question 7

_ drugs are agents that prevent the formation of blood clots, by affecting blood coagulation factors.
used to treat thrombotic and thromboembolic diseases such as stroke, MI, deep vein thrmosis, pulmonary embolism

Answer 7

anti-coagulant drugs - to prevent strokes and heart attacks

Question 8

anti-coagulatic

indirect thrombin inhibitors, act on _

fractionated heparin

works immediately

Answer 8

act on antithrombin

heparin binds to AT and increases it activity by 1000fold

low MW fractionated better

Question 9

thrombolytics

direct _ inhibitors
Hirudin - leeches has anticoag property

Bivalirudin - synthetic reversible version

Answer 9

direct thombin inhibitors

fibrin binding site on thrombin

Question 10

Thrombolytics

_ like oral direct thrombin inhibitors

warfarin(Coumadin) - 48-72 hours to work
used to treat deep vein thrombosis, pulmonary embolism, and to prevent emboli in patients with atrial fibrillation and mechanical prosthetic valves
interfer with vitamin K

Answer 10

Coumarin

plant based

Question 11

balancing threat of stroke(block of blood) vs. intracerebral hemorrhage with _

Answer 11

warfarin

vitamin K for OD

Question 12

if OD on _ you give Protamine Sulfate

Answer 12

heparin

Question 13

Newer class of thrombolytic drugs

faster onset/off set, few drug interactions and predictable pharmacokinetics

Answer 13

NOACS
novel oral anti-coagulants

block IIa thrombin directly

or block factor Xa

Question 14

Anticoagulant

Aspirin inhibitions of _ synthsis -

Answer 14

thromboxane A2 -