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Intro to Pharmacology > Blood > Flashcards

Blood Flashcards

1
Q

“Hemo” is defined as related to _______ ( Hematology, hemoglobin, hemophilia, hemocytometer)

A

BLOOD

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2
Q

Hemostasis is a process to ____ and stop _____ (hemorrhage)

A

prevent, bleeding

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3
Q

Thrombosis is the formation or presence of a _______ ______ in a blood vessel
▪ Vein thrombosis (_____ thrombi: ___ embedded in fibrin) —> __________
▪ Coronary (artery) thrombosis (______ thrombi: ______ embedded in fibrin) –> ________

A

blood clot, red, RBC, Anticoagulants, white, platelets, Antiplatelets

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4
Q

Drugs Affect Hemostasis and Thrombosis
by acting at:

❖Blood ________ ( ______ formation)
❖ ________ function
❖ ________ removal (_________)

A

coagulation, fibrin, Platelet, Fibrin, fibrinolysis

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5
Q

Red Blood Cells (__________) transport _______.

A

Erythrocytes, oxygen

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6
Q

White Blood Cells (_________) fight _____ and __________ by attacking infected cells

A

Leukocytes, germs, infections

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7
Q

Platelets (___________) help to ____ bleeding by forming a blood ____

A

Thrombocytes, stop, clot

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8
Q

Red Blood Cells (RBCs) or Erythrocytes
Structure:
▪_______-shaped
▪ _______ surface area
▪ Has no _______
▪ Contains _______ which picks oxygen
Function:
▪ Transport _______ from the lungs to the body and __________ _______ from the body back to the lungs

A

Disk, Large, nucleus, hemoglobin, oxygen, carbon dioxide

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9
Q
A
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10
Q

Platelets (Thrombocytes)
Structure:
▪ __________, _____-shaped
▪ ______ surface area (2 μm in diameter)
▪ Has no _______
▪ Fragments of cytoplasm from cells of the ?

A

Colorless, lens, Small, nucleus, bone marrow

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11
Q

Platelets
Found:
▪ Platelets are found in ______
▪ In birds and amphibians they are presented as?

A

mammals, intact mononuclear cells

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12
Q

Platelets - Function:
▪ Prevent excessive ______ or _______ bleeding after an injury by forming a ?

A

internal, external, blood clot

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13
Q

What can be seen here?

A

Platelets

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14
Q

Types of White Blood Cells

A
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15
Q

Function of WBC

A

Function: each type has a specific function, and they work together to fight illness or disease
▪ Infections
▪ Inflammation
▪ Allergic reactions
▪ Stress
▪ Use if certain medications

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16
Q

The Phases of Hemostasis

A

The basic process of Hemostasis:
▪ Vascular
▪ Platelet
▪ Coagulation
▪ Fibrinolysis

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17
Q

Coagulation (clotting) is the process by which blood changes from a ______ to a ___,
forming a blood clot. It is mediated by ?

A

liquid, gel, cellular components and coagulation factors.

Activation
Adhesion
Aggregation of platelets
Deposition
and maturation of fibrin

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18
Q

Describe the phases of hemostasis

A
  1. Vascular spasm
    - Damaged blood vessel. Body releases clotting factors.
    - Prothrombin becomes thrombin IIa.
  2. Plug formation
    - Thrombin IIa is important for activation of fibrinogen which becomes fibrin. Collagen plays a role here.
  3. Fibrin then polymerizes and forms clot during Coagulation.
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19
Q

Describe the platelet pathway

A

Procoagulation and anticogulation: which phase go first depends on what is activated first.
ADP, NO, and PG1 tissue factor, collagen all participate in aggregation of platelets.

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20
Q

Describe the clotting cascade

A

Tissue factor is important for factor 7A.
zymogens - once activated, coagulation factors numbered I-13, Xa = activated,
Factor 5A is necessary for stopping the cascade.

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21
Q

Name the common name and drug inhibitor of Coagulation Factor I

A

Fibrinogen

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22
Q

Name the common name and dug inhibitor of Coagulation Factor II

A

Prothrombin, Heparin

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23
Q

Name the common name and dug inhibitor of Coagulation Factor III

A

Tissue thromboplastin

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24
Q

Name the common name and dug inhibitor of Coagulation Factor IV

A

Calcium (Ca++), Calcium chelators

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25
Q

Name the common name and dug inhibitor of Coagulation Factor V

A

Proaccelerin

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26
Q

Name the common name and dug inhibitor of Coagulation Factor VI

A

Activated accelerin (Va)

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27
Q

Name the common name and dug inhibitor of Coagulation Factor VII

A

Proconvertin: serum prothrombin conversion accelerator

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28
Q

Name the common name and dug inhibitor of Coagulation Factor VIII

A

Antihemophillic factor, none

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29
Q

Name the common name and dug inhibitor of Coagulation Factor IX

A

Plasma thromboplastin component: christmas factor, Warfarin

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30
Q

Name the common name and dug inhibitor of Coagulation Factor X

A

Stuart-prower factor, Heparin Rivaroxaban

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31
Q

Name the common name and dug inhibitor of Coagulation Factor XI

A

Plasma: thromboplastin antecedent

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32
Q

Name the common name and dug inhibitor of Coagulation Factor XII

A

Hageman factor

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33
Q

Name the common name and dug inhibitor of Coagulation Factor XIII

A

Fibrin stabilizing factor, none

34
Q

Clotting takes place in three major steps:
1. Activation of _________ activators
2. Conversion of ________ into ________
3. Conversion of __________ into _____ fibers

A

prothrombin, prothrombin, thrombin, fibrinogen, fibrin

35
Q

Factors: zymogens (inactive) proteolytic enzymes
Become active “a”. Ca++ is important for activation process
12 Factors work together

A
36
Q

Pro-coagulants promote coagulation: ?

A

XIIa; XIa; Xa, IXa and thrombin (IIa)

37
Q

Anti-coagulants inhibit coagulation:

A

antithrombin III (AT); fibrinolysis

38
Q
A
39
Q

Heparin - potentiates _________ inhibition

A

antithrombin; it helps antithrombin to do its job

40
Q

Conditions that Require Anticoagulants and Antiplatelets
Cardiovascular disorders:
1. Thrombosis in both ______ and ______
(may be due to high ________, _____ disease, ________, _________)
2. Stroke (dogs with high rate of _____
disease, _____, _____ ____ in horses)
3. ________ thrombosis (a venous
thrombosis)
4. ______ heart disease
5. Acute _________ syndrome
6. Thromboembolic disease in ?
7. _______ fibrillation
8. ____________ prophylaxis

A

arteries, veins, cholesterol, kidney, diabetes, pancreatic, heart, cats, heat, stroke, Pulmonary, Ischemic, coronary, immune-mediated hemolytic anemia, Arterial, Antithrombotic

41
Q

Coagulation Bleeding need what types of drug?

A

❑ Anticoagulants - blood thinner
❑ Antiplatelet drugs - blood thinner
❑ Fibrinolytic drugs
❑ Drugs for treatment of bleeding
(Antifibrinolytic drugs)

42
Q

Hematopoietic system
❑ Drugs for treatment of anemia
❑ Hematopoietic growth agents

A
43
Q

Blood volume

A

❑ Drugs for treatment of Hypovolemia

44
Q

Anticoagulants are drugs are used to modify the cascade either when there is a _____
in coagulation or when there is ________ coagulation

A

defect, unwanted

45
Q

❑ Heparin and Low-molecular weight heparin (LMWH)
1. List two examples of LMWHs.

❑ Warfarin and Coumarin Derivatives
2. List three examples of Coumarin derivatives.
3. List a form of synthetic vitamin K

❑ Thrombin Inhibitors
❑ Factor Xa Inhibitors

A
  1. ❖ Dalteparin , ❖ Enoxaparin
  2. Dicumarol, Acenocoumarol, Warfarin
  3. Menadione
46
Q
A
47
Q

Anti-coagulants inhibit coagulation: Fibrinolysis, antithrombin III (AT)

AT III, is an _________ anticoagulant (______ co-factor). Upon binding to, it inactivates factors: ?

Heparin potentiates ________ action ~ 1000 times.

A

endogenous, Heparin, IXa Xa, XIa, XIIa, Thrombin (IIa), antithrombin

48
Q

MOA: Heparin binds to ____ and causes ________ changes, which significantly enhances its ______ effects on various
activated ______ factors (~ _____-fold)

A

AT, conformational, inhibitory, coagulation, 1,000

49
Q

Which factors does Heparin inactivate?

A

IIa
IXa
Xa
XIa
XIIa

50
Q

▪ Heparin is a _______ occurring ______ _______ found in _____ cells

A

naturally, anticoagulant, proteoglycan, mast

51
Q

▪ Heparin is prepared from _____ ____ tissue or _____ ____ mucosa
▪ White _____, soluble in ____
▪ The dose is in ____ units rather than m

A

bovine, lung, porcine, intestinal, powder, water, USP

52
Q

Heparin Uses:
Used for: _______ clotting or increase risk of ___ formation (applicable to which species? )

List example diseases in which heparin is used.

A

excessive, clot, cats, dogs, horses

BLEPTTVD
❖ Thromboembolic disease
❖ Thromboembolic problems following vascular surgery
❖ Venous thrombosis
❖ Disseminated intravascular coagulopathy (DIC)
❖ Pulmonary thromboembolism
❖ Laminitis (horses)
❖ Endotoxic shock
❖ Burns

USP: united stats pharmacopenia units?

53
Q

Heparin Routes of administration: ?
IM may cause ________
Not absorbed when given ____

A

SC, IV, hematoma, orally

54
Q

❖ Unfractionated heparin (UFH): inactivates which coagulation factors?

A

Thrombin (Factor IIa) and Factor Xa

UFH = standard heparin

55
Q

❖ Low-molecular weight heparin (LMWH) inactivates which coagulation Factor?

A

Xa

56
Q

Heparin MOA: bind to and activate _________ (?) which in turns _______ factors

A

antithrombin (AT), inactivates

57
Q

Heparin is NOT a drug for which ONE DOSE FITS ALL
▪ Patients with ____ AT may not respond as well as those with ______ AT levels
▪ Variable ___ among animals and protein binding
▪ Dose adjustments should be tailored to individual patients by monitoring ______ ___
▪ The _________ _________ __________ time (aPTT) test is available to veterinarians
▪ The ideal range for ____-__ activity in dogs, cats, and horses is not established

A

low, adequate, PK, clotting, times, anti-Xa

58
Q

Heparin - Adverse Effects:
1. ________ problems
2. Heparin-induced _________ (in _____, not in animals)

A
  1. Bleeding
  2. thrombocytopenia, people
59
Q

Heparin Overdose causes excessive __________ and _______

A

anticoagulation, bleeding

60
Q

Heparin
Reversal for overdose: __________ _________ administration
* This is found in the _____ of certain fish
* Strongly ____ and combines with _____ heparin to form _____, ____ salt that ______ further anticoagulant activity of heparin

A

Protamine Sulfate, sperm, basic, acidic, stable inactive, prevents

61
Q
  1. Name two examples of Low-Molecular Weight Heparins ( LMWHs)
  2. LMWH advantages vs UFH:
    ▪ Greater _____ and ____ profile
    ▪ Favorable and predictable ___
  3. Activity: anti-factor ___ / anti-factor ____ratio ( for UFH ratio is __:__)
    ✓ More complete and predictable _____
    ✓ ______ duration
    ✓ ____ frequent administration
    ✓ Reduced risk of ______
    ✓ More ______ anticoagulant response
A
  1. ❖ Dalteparin (Fragmin ), ❖ Enoxaparin (Lovenox )
  2. activity, safety, PK
  3. Xa, IIa , 1:1, absorption, Longer, Less, bleeding, predictable
62
Q

Dalteparin is a ______, MW ~ _____ (compare to UFH, ~______)
- _____ is different than for UFH

A

LMWH, 5000, 15,000, PK

63
Q

Dalteparin MOA: binding to ____ and _________ antithrombin- mediated inhibition of synthesis and activity of coagulation factor ___

A

AT, increasing, Xa

64
Q

Dalteparin
Activity ratio: ___ : ___

Half-life: In dogs: __ hr
In cats: ____ hr
In horses: ____ is similar do humans

A

2.7, 1, 2, 1.5, PK

65
Q

Dalteparin
Adverse effects:?

  • ________
  • If IM administration – _________
  • If renal disease – the elimination will be __________
  • ____-_____ interaction
A
  • Bleeding
  • If IM administration – hematoma
  • If renal disease – the elimination will be prolonged
  • Drug-drug interaction
66
Q

Enoxaparin is a _______, MW ~ ____(compare to ____, ~15,000) ___ is different than UFH

A

LMWH, 5000 , UFH, PK

67
Q

Enoxaparin

MOA: binding to ___ and ______ antithrombin- mediated inhibition of
synthesis and activity of coagulation factor ___

A

AT, increasing, Xa

68
Q

Enoxaparin

Activity ratio: ___ : ___ and ___ : ___

Half-life: In dogs: __ hr
In cats: ___ hr
In horses: PK is similar to _____ (24 hr)

A

3.3, 1, 5.3, 1, 5, 1.9, humans

69
Q

Enoxaparin
Adverse effects:
* ________
* If IM administration – ____________
* If renal disease – the elimination will be _________
* Drug-drug _________

A

Bleeding, hematoma, prolonged, interaction

70
Q

❑ Warfarin and Coumarin Derivatives
❖ Dicumarol
❖ Acenocoumarol

A
71
Q

Vitamin K

Vitamin K is a ____-soluble vitamin essential for the _______ synthesis of the _______ group of coagulation factors (factors ?)

Vitamin K:
K1 — from _______
K2 produced by bacteria in the ___
K3 is ___________: ____ soluble and ____ soluble

A

fat, hepatic, prothrombin, II, VII, IX, and X, plants, gut, synthetic, lipid, water

72
Q

Clover contains __-____ ___________ –> responsible for hemorrhagic disease in cattle. If consume _____ clover —> disease

A

4-OH-coumarin, excess

73
Q

Coumarin Synthetic Derivatives: Vitamin K-antagonists
MOA: reduce the _______/________ of Vit K-dependent factors that promote
clotting (factors ?) by inhibiting the regeneration of vitamin K
(_________ _______) resulting in its depletion.

A

production, activation, II, VII, IX, and X, epoxide reductase

74
Q

Some cinnamon have _________. Cinnamon with ________ causes uncontrolled bleeding.

A

coumarin, warfarin

75
Q

Coumarin Synthetic Derivatives: Vitamin K-antagonists
Uses:
▪ To decrease the tendency for _______ (thromboprophylaxis in ____)
▪ To treat or prevent blood ____ in veins or arteries
▪ To reduce the risk of _____ or ________ _______

A

thrombosis, dogs, clots, stroke, heart attack

76
Q

Coumarin Synthetic Derivatives: Vitamin K-antagonists
Reversal: ?

Adverse effects:
▪ ____-____ interaction (______, _______, and others)

A

Vitamin K, Drug-drug, aspirin, clopidogrel

77
Q

❖ Warfarin
❖ Dicumarol
❖ Acenocoumarol

These are all examples of? They are _______ soluble, _____ sensitive ____

A

Coumarin synthetic derivatives and Vitamin K antagonists

Water, Light, tablets

78
Q

Coumarin Synthetic Derivatives: Vitamin K-antagonists - Synthetic coumarin derivatives, anticoagulants :
reduce the formation of ?

A

blood clots

79
Q

Vitamin K deficiency
Vitamin K deficiency causes _______ bleeding due to failure of normal ____ clot formation
❖ Accidental poisoning by warfarin in dogs and cats:
▪ Over-the-counter anticoagulant _______
▪ Clinical signs: ________ at 2-3 days after consumption. Toxic dose in both dogs and cats: __-___ mg/kg
Cumulative toxic doses: 1-5 mg/kg for 5-15 days in dogs
1 mg/kg for 7 days in cats
❖ Intestinal ___________
❖ Medication containing ______
__________ (synthetic Vitamin K)

A

excessive, fibrin, rodenticide, hemorrhage, 5-50, malabsorption, warfarin, Menadione

80
Q
A

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Intro to Pharmacology (31 decks)

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