Blood (im so tired of pharm) Flashcards
name adverse effects of heparin
bleeding
hypotension
inc HR
loss of conciousness
headache, confusion, change n vision
thrombocytopenia
how does heparin work
binds to and activates anthrombin 3
how long does warfarin take to treat
3-4 days
how is LMW heparin cleared
by the kidneys
what is warfarin used for
long term prophylaxis of thrombosis
name an adverse effect of thrombolytics
destruction of pre-existing clots -> promote bleeding at sites of recent injury
what is fondaparinux
an indirect specific factor X inhibitor
name an indirect specific factor X inhibitor
fondaparinux
what is the INR
patient prothrombin time divided by the average time
warfarin therapy aims to have an INR of what
2-3.5
what does ADP do
it further promotes platelet activation
apixaban and rivaroxaban are examples of what kind of drugs
direct factor X inhibitors
name an adverse effect for streptokinase
since it has a bacterial origin, pts can have an immune response limiting it’s use to MI
how do thrombolytics work
inc conversion of plasminogen to plasmin
what is the treatment fo heparin toxicity
protamine
what tests do you use to monitor heparin
aPTT
anti-factor Xa
what is factor 2
protrombin (thrombin when activated)
what are the two historically used anticoagulant
heparin
warfarin
what two factors are involved in the extrinsic pathway
3 (tissue) and 7
what are some uses of heparin
prevention/ treatment of blood clots
during extracorporeal circulation
what anticoagulant do we have in our blood vessels
antithrombin 3
what forms a mesh that will stabilize a clot
fibrin
what is hemophilia
factor 8 or 9 deficiency
how does warfarin work
prevents activation of vitamin K (and dec synthesis of vit K dependant factors)
what kind of drug is tranexamic acid
antifibrinolytic
name some uses for thrombolytics/fibrinolytics
MI
PE
ischemic stroke
what is protamine used for
treatment of heparin toxicity
name 2 substances that platelets release to stimulate activation and aggregation of other platelets
thromboxane A2
ADP
name an antifibrinolytic
tranexamic acid
what ADP receptor antagonists must be activated by hepatic enzymes
clopidogrel
prasugrel
name a direct thrombin inhibitor
dabigatran
what is the final result of antiplatelet drugs
reduction of platelet aggregation
prolonged bleeding time
the prothrombin time evaluates what
the extrinsic pathway
name 3 ADP receptor antagonists
clopidogrel
prasugrel
ticagrelor
is ASA slowly or rapidly absorbed
rapidly
name 5 advantages of LMW heparin
longer half life
subQ injection
more predictable response
reduced need for monitoring
fewer haemorrhagic complications
what anticoagulant is still used as a rat poison
warfarin
what factors are involved in the intrinsic pathway
12, 11, 9, 8
what can be caused by long term high use of heparin
osteoporosis
what enzyme produces thromboxane A2
cyclooxygenase
what test is used to monitor levels of warfarin therapy
PT
name two direct factor X inhibitors
apixaban
ribaroxaban
how do antiplatelet drugs act
they suppress platelet aggregation and adhesion
what enzyme must clopidogrel be acitvated by
CYP 2C19
what drug can cause osteoporosis at high doses and long term use
heparin
what factors are vitamin K dependant
2, 7, 9, 10
what is dabigatran
a direct thrombin inhibitor
what is an adverse effect of clopidogrel
agranulocytosis
benefits of dabigatran over warfarin
not sensitive to vit K intake
less drug interaction
more predictable
how is coagulation triggered
an injury that exposes tissue factor or thromboplastim
what factor needs to be paired with calcium to help activate factor 10
5
what are the adverse effects of dabigatran
bleeding
bruising
dyspepsia
name 3 examples of thrombolytics
tissue plasminogen activtor
synthetically modified tPAs
streptokinase
dalteparin and enoxaparin are examples of what kind of drug
LMW heparin
name two examples of LMW heparin
dalteparin
enoxaparin
what does plasmin do
destroys fibrin within blood clots
how do you treat a warfarin overdose
vitamin K
prothrombin complex concentrate
fresh-frozen plasma
what is the most common side effect of acetylsalicylic acid
gastric irritation
what are some adverse effects of factor X inhibitors
excessive bleeding
what are some uses for tranexamic acid
reduce bleeding
menorrhagin
hemophilia
surgery
how much more selective is LMW heparin for factor X vs thrombin
2-4 times
what drug inhibits cyclooxygenase enzymes
acetylsalicylic acid
name 2 adverse effects of antifibrinolytics
thromboembolic events
allergic skin rxns
what is factor 1
fibrinogen (fibrin when activated)
low does of ASA is effective for what
prevention of thrombosis complications
circumstances wehre there is an inc risk of arterial thrombosis
the aPartial thromboplastin time evaluates what
the intrinsic pathway
why is warfarin dangerous in pregnancy
it can cross the placenta and is a known teratogen
how must heparin be administered
parenterally
what is used to treat an overdose of dabigatran
idarucizumab
what’s the difference between natural heparin and low molecular weight heparin
LMW heparin is mostly smaller molecules as opposed to such a wide range in natural heparin
are we gonna pass pharm?
YAS
how is heparin cleared
by the reticuloendothelial system
what side effect is there a risk for with ASA
gastric ulceration
what 3 things help factor 10 to convert prothrombin to thrombin
factor V
calciium
lipids
what does thrombin do
cleaves fibrinogen into fibrin
what is idarucizumab used for
treat dabigatran overdose
what two factors stimulate the activation of factor 10
factor 3 (TF) and factor 7
what has a higher selectivity for factor X vs thrombin? natural or LMW heparin
LMW
what factors is antithrombin 3 responsible for the inactivation of
10, 2, 9, 11, 12
what are ADP receptor antagonists used for
to prevent thrombus formation (eg following angioplasty)
what does clopidogrel do
blocks ADP receptors on platelets
what is the main adverse effects of ADP receptor antagonists
bleeding
what releases substances that stimulate activation and aggregation of platelets to form a plug
platelets
what stimulates the formation of thrombin
activated factor 10
