Blood drugs

Question 1

ASA (blood)

Answer 1

NSAID
-inhibits COX and TXA2 generation preventing fibrinogen cross link
—-
-anti platelet
—-
-stomach ulcers
-bleeding
-GFR reduction
-reyes syndrome

Question 2

Ticlopidine

Answer 2

Thienopyridine
-irreversible P2Y antagonist
-prevent ADP binding
—
anti platelet
—-
neutropenia

Question 3

Clopidogrel

Answer 3

Thienopyridine
-irreversible P2Y antagonist
-prevent ADP binding
—
anti platelet
used for ASA intolerant people
—-
-dyspepsia
-rash
-diarrhea
-can have poor metabolizers

Question 4

Prasugrel

Answer 4

Thienopyridine
-irreversible P2Y antagonist
-prevent ADP binding
—
anti platelet
fast metabolism to active drug
—-
-more potent therefore more bleeding

Question 5

Ticagrelor

Answer 5

non thienopyridine P2Y antagonist
-reversible allosteric P2Y antagonist
—-
-anti platelet
—-
dyspnea
-dradyarrhythmia

Question 6

Dipyridamole

Answer 6

-PDE inhibitor (cGMP and cAMP have aggregation inhibiting effects)
-adenosine uptake inhibitor
—
anti platelet
used with ASA to prevent TIA/stroke

Question 7

Abciximab

Answer 7

GP2b/3a antagonists
-prevent fibrin crosslinks to platelets
—
anti-platelet
IV admin
—-
bleeding
thrombocytopenia

Question 8

Eptifibatide

Answer 8

synthetic cyclic peptide
GP2b/3a antagonists
-prevent fibrin crosslinks to platelets
—
anti-platelet
IV admin
—-
bleeding
thrombocytopenia

Question 9

tirofiban

Answer 9

synthetic non peptide
GP2b/3a antagonists
-prevent fibrin crosslinks to platelets
—
anti-platelet
IV admin
—-
bleeding
thrombocytopenia

Question 10

Vorapaxar

Answer 10

PAR 1 antagonist
protease activated receptor
-prevents active thrombin generation therefore activation of platelets
—-
anti platelet
not used by stoke/TIA patients
—
Bleeding risk

Question 11

Warfarin

Answer 11

VitK reductase inhibitor
-prevents carboxylation of glutamic acid preventing binding via Ca+
—-
anti-coagulant
takes a 48h to have effect
monitor with INR
–
bleeding
liver damage
necrosis

Question 12

UF heparin

Answer 12

factor 2a inhibitor
-binds AT3 then 2a to inactivate it
—
anti coagulant
IV admin from negative charge (rapid onset)
—-
Bleeding
osteoporosis
HIT

Question 13

LMW heparin

Answer 13

factor Xa inhibitor
-binds AT3 then Xa to inactivate it
—
anti coagulant
IV admin from negative charge (rapid onset)
longer half-life
—-
Bleeding
osteoporosis
HIT

Question 14

Rivaroxaban

Answer 14

Xa inhibitor
-reversible inhibitor
-very selective for Xa
—
anti coagulant
—-
Bleeding
don’t use of kidneys are bad

Question 15

apixiban

Answer 15

Xa inhibitor
-reversible inhibitor
-very selective for Xa
—
anti coagulant
—-
Bleeding
don’t use of kidneys are bad

Question 16

edoxaban

Answer 16

Xa inhibitor
-reversible inhibitor
-very selective for Xa
—
anti coagulant
—-
Bleeding
don’t use of kidneys are bad

Question 17

Daigatran etexilate

Answer 17

/
reversible inhibitor of factor 2a (thrombin)
—
anticoagulant
—-
bleeding
don’t use if kidneys are bad

Question 18

Hirudin

Answer 18

defines the class
-specific thrombin inhibitor
—
anticoagulant

Question 19

lepirudin

Answer 19

hirudin type
-specific thrombin inhibitor
—
anticoagulant

Question 20

Bivalirudin

Answer 20

hirudin type
-specific thrombin inhibitor
—
anticoagulant

Question 21

alteplase

Answer 21

r-tPA
-coverts plasminogen to plasmin to break down clots
—
fibrinolytic
—

Question 22

Duteplase

Answer 22

r-tPA
-coverts plasminogen to plasmin to break down clots
—
fibrinolytic
—

Question 23

Reteplase

Answer 23

r-tPA
-coverts plasminogen to plasmin to break down clots
—
fibrinolytic
—

Question 24

Streptokinase

Answer 24

/
Forms complex with plasminogen to give it fibrinolytic enzyme action without proteolysis
—
fibrinolytic
—
-inactivated by antibodies