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Systemic Pharm Final > Blood Thinners > Flashcards

Blood Thinners Flashcards

1
Q

When is Coumadin [Warfarin®] indicated?

A

Vitamin K antagonist

Anticoagulation

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2
Q

When is Enoxaparin (Lovenox) indicated?

A

Coagulation factor Antagonist
Post-op Deep Vein Thrombosis prophylaxis (commonly given with ASA)
Unstable Angina

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3
Q

When is Rivaroxaban indicated?

A

Coagulation factor antagonist

DVT & Stroke Prophylaxis (can be administered orally VS Enoxaparin)

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4
Q

When is Clopidogrel (PLAVIX) indicated?

A

Adenosine Receptor Blocker
Platelet inhibitor
Acute Coronary Syndrome, Thrombotic Event Prophylaxis

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5
Q

When is Abciximab indicated?

A

Glycoprotein IIb/IIIa Receptor Antagonists
Platelet inhibitor
An adjunct to percutaneous coronary intervention (PCI) for the prevention of cardiac ischemic complications
Unstable angina

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6
Q

Drug interactions with Coumadin?

A

Azole antifungals, Macrolides, Fluoroquinolones, Tetracyclines (Impair Coumadin metabolism)
NSAIDs, Omega-3 & Omega-6 fatty acids (Additive blood thinning effects)

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7
Q

Drug interactions with Enoxaparin?

A

NSAIDs, Omega-3 & Omega-6 fatty acids (Additive)

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8
Q

Drug interactions with Rivaroxaban?

A

Macrolides, Fluoroquinolones , Cyclosporine, Azoles (increased Rivaroxaban levels)
NSAIDs (additive hemorrhage)
Ophthalmic NSAIDs, Omega fatty acids (additive hemorrhage)

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9
Q

Drug interactions with Clopidogrel?

A

Evening Primrose Oil, Flaxseed, Omega-3 FA, NSAIDs (Additive)
Ketoconazole (Reduced metabolism/activation)

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10
Q

Drug interactions with Abciximab?

A 
Omega-3 & Omega-6 fatty acids, NSAIDs (Additive)
Ophthalmic NSAIDs (Additive)
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11
Q

Contraindications of Abciximab?

A

Recent surgery or trauma

Uncontrolled hypertension

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12
Q

Contraindications of Clopidogrel?

A

Caution:

Ocular disease

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13
Q

Contraindications of Rivaroxiban?

A

Caution:

Active major bleeding

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14
Q

Contraindications of Enxaparin?

A 
Caution:
Recent ocular surgery
Diabetic retinopathy
Hypertension
Diabetes
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15
Q

Contraindications of Coumadin?

A

Recent ocular surgery
Hypertension
Diabetes

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16
Q

What are the side effects of Coumadin?

A

ADVERSE EFFECTS
Common: Bleeding/bruising, headache, dizziness, pruritus, edema, dermatitis, fever, paresthesias, alopecia
SERIOUS ADVERSE EFFECTS
CV: syncope, vasculitis, hemorrhage, cholesterol embolism
Hematology: anemia
Antidote: Vitamin K or prothrombin complex concentrate

17
Q

What are the side effects of Enoxaparin?

A 
ADVERSE EFFECTS
Common: hemorrhage, fever
SERIOUS ADVERSE EFFECTS
Hematology: Anemia
Antidote: Heparin or protamine sulfate
18
Q

What are the side effects of Rivaroxiban?

A 
ADVERSE EFFECTS
Common: hemorrhage, pruritus
SERIOUS ADVERSE EFFECTS
Severe hemorrhage
Hypersensitivity: SJS
No antidote!
19
Q

What are the side effects of Clopidogrel?

A

ADVERSE EFFECTS
Common: hemorrhage, pruritus, cough, bronchitis, dizziness, headache
SERIOUS ADVERSE EFFECTS
Hypersensitivity: Angioedema, SJS, Toxic epidermal necrolysis (TEN)
Hematology: thrombotic thrombocytopenic purpura (TTP)

20
Q

What are the side effects of Abciximab?

A

ADVERSE EFFECTS

Common: hemorrhage, hypotension, dizziness, headache

21
Q

What is the mechanism of action of Clopidogrel?

A

Platelet Inhibitor
Prodrug: metabolized to active metabolite by the CYP450 enzyme CYP2C19*
Irreversible inhibition of platelet ADP receptors which normally trigger platelet activation and aggregation via downstream activation of the GPIIb/IIIa complex

22
Q

What is the mechanism of action of Rivaroxiban?

A

Coagulation factor antagonist
Factor-Xa inhibitor
Selectively blocks the active site of Factor-Xa, inhibiting blood coagulation

23
Q

What is the mechanism of action of Enoxaparin?

A

Coagulation factor antagonist
Fractionated, heterogeneous low molecular weight heparin (LMWH) extracted from porcine intestinal mucosa
Binds to the circulating anticoagulant antithrombin and accelerates its irreversible inactivation of clotting Factor-Xa much more so than Factor-IIa (thrombin)

24
Q

What is the mechanism of action of Coumadin?

A

Vitamin K antagonist

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

25
Q

What is the mechanism of action of Abciximab?

A

Platelet inhibitor
Fab fragment: a chimeric human-murine mAB
Binds to the GP IIb/IIIa receptor of human platelets and inhibits platelet aggregation
Binds to the vitronectin (αvβ3) receptor on platelets and vessel wall endothelial and smooth muscle cells

Systemic Pharm Final (12 decks)

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