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Systemic Pharm > Blood Thinners > Flashcards

Blood Thinners Flashcards

1
Q

Arterial thrombosis usually consist of what type of clot?

A

Platelet-rich

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2
Q

Venous thrombosis is commonly triggered by what?

A

Blood stasis

Inappropriate activation of the coagulation cascade

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3
Q

What are the 2 types of anti-hemostatics?

A

Anticoagulants

Platelet inhibitors

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4
Q

Drugs that act within the extrinsic pathway affect what?

A

Synthesis of vitamin K dependent coagulation factors

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5
Q

What do drugs that act within the intrinsic pathway inhibit?

A

Activity of coagulation factors

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6
Q

What are the 2 anticogulent drug classes?

A

Vitamin K antagonists

Coagulation factor antagonists

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7
Q

What type of drug is Coumadin?

A

Vitamin K antagonist

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8
Q

What is the MOA of Coumadin?

A

Inhibits vitamin K dependent coagulation factor synthetis (II, VII, IX, X, proteins C and S)

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9
Q

What are the 9 common adverse effects of Coumadin?

A 
Bleeding/bruising
Headache
Dizziness
Puritis
Edema
Dermatitis
Fever
Paresthesias
Alopecia
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10
Q

What are the 5 serious side effects of Coumadin?

A 
Syncope
Vasculitis
Hemorrhage
Cholesterol embolism
Anemia
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11
Q

What is the antidote for Coumadin?

A

Vitamin K or prothrombin complex concentrate

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12
Q

What may occur if Coumadin interacts with Azoles, Macrolides, Fluoroquinolones, or Tetracyclines?

A

Impaired Coumadin metabolism

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13
Q

What may occur if Coumadin interacts wieh NSAIDs, Omega-3s/6s?

A

Additive blood thinning

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14
Q

Which 4 drug types can interact with Coumadin to impair metabolism?

A

Azoles
Macrolides
Fluoroquinolones
Tetracyclines

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15
Q

Which 2 drug types may interact with Coumadin to increase blood thinning effects?

A

NSAIDs

Omega3/6

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16
Q

What is the vitamin K antagonist?

A

Coumadin

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17
Q

What are the 3 indications for Enoxaparin?

A

Post-op DVT

Unstable angina

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18
Q

What is the delivery route for Enoxaparin?

A

IV

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19
Q

What are the two drugs that are delivered by IV?

A

Enoxaparin

Abciximab

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20
Q

What is the MOA of Enoxaparin?

A

Low MW heparin

Binds to circulating antithrombin and accelerates the irreversible inactivation of factor Xa

21
Q

What are the 2 side effects of Enoxaparin?

A

Hemorrhage

Fever

22
Q

What is the 1 serious side effect of Enoxaparin?

A

Anemia

23
Q

What are the 2 antidotes for Enoxaparin?

A

Heparin

Protamine sulfate

24
Q

What drug types interact with Enoxaparin to cause additional blood thinning?

A

NSAIDs or Omega 3/6s

25
Q

When does caution need to be had with Enoxaparin?

A

Recent ocular surgery
Diabetic retinopathy
HTN
Diabetes

26
Q

What kind of drug is Rivaroxaban?

A

Vitamin K inhibitor - blood thinner

27
Q

What are the indications of Rivaroxaban?

A

DVT and stroke prophy

28
Q

What is the MOA of Rivaroxaban?

A

Factor Xa inhibitor

Selectively blocks the active site of factor Xa, inhibiting blood coagulation

29
Q

What are the 2 common side effects of Rivaroxaban?

A

Hemorrhage

Pruritis

30
Q

What is the possible hypersensitivity to Rivaroxaban?

A

Steven’s-Johnson syndrome

31
Q

What is the antidote for Rivaroxaban?

A

None!

32
Q

What happens when Macrolides, Fluoroquinolones, Cyclosporine, or Azoles interact with Rovaroxaban?

A

Decreased metabolism

33
Q

What happens when NSAIDs interact with Rivaroxaban?

A

Hemorrhage

34
Q

What are the 2 types of platelet inhibiting blood thinners?

A

Adenosine Receptor Blockers

Glycoprotein IIb/IIa Receptor Antagonists

35
Q

What type of drug is Clopidrogrel?

A

Adenosine Receptor Blocker - blood thinner

36
Q

What are the indications for Clopidrogrel?

A

Acute coronary syndrome

Thrombotic even prohpylaxis

37
Q

What is the MOA of Clopidrogrel?

A

Prodrug, metabolised by CYP450 enzyme CYP2C19

Irreversible inhibition of platelet ADP receptors - stops the activation of GPIIb/IIIa complex

38
Q

What are the 6 common side effects of Clopidrogrel?

A 
Hemorrhage
Pruritis
Cough
Bronchitis
Dizziness
Headache
39
Q

What are the 3 possible hypersensitivity reactions to Clopidrogrel?

A

Angioedema
SJS
TEN

40
Q

What things interact with Clopidrogrel to cause active bleeding?

A

Evening primrose oil
Flaxseed
Omega-3
NSAIDs

41
Q

What happens when Clopidrogrel interacts with Detoconozole?

A

Reduced metabolism

42
Q

What kind of drug is Abciximab?

A

Glycoprotein IIb/IIa receptor antagonist - blood thinner

43
Q

What are the 2 indications for Abciximab?

A

Prevention of cardiac ischemic complications

Unstable angina

44
Q

How is Abciximab administered?

A

IV

45
Q

What is the MOA of Abciximab?

A

Fragment - a chimeric humaneomurine mAB
Binds to GP IIb/IIa receptor of platelet - inhibits platelet aggregation
Binds to vitronectin receptor on platelets, vessel wall, and endothelial smooth muscle

46
Q

What are the 4 common side effects of Abciximab?

A

Hemorrhage
Hypotension
Dizziness
Headache

47
Q

What drugs interact with Abciximab to cause additive bleeding?

A

Omega-3/6, NSAIDs

48
Q

What are the 2 contraindications for Abciximab?

A

Recent surgery/trauma

Uncontrolled HTN

Systemic Pharm (15 decks)

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