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Year 1: Drug Revision > Cardio: Anti-platelets + Anti-coagulants > Flashcards

Cardio: Anti-platelets + Anti-coagulants Flashcards

1
Q

What is the aim of anti-platelets + anti-coagulants?

A

To prevent new thrombosis

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2
Q

Give examples of anti-platelet drugs

A

Aspirin
Clopidogrel
Tirofiban

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3
Q

What is the mode of action of aspirin?

A

Irreversibly inhibits COX enzyme which stops formation of thromboxane A2 (TXA2) - a mediator for platelet aggregation + clot formation

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4
Q

What is the mode of action of clopidogrel?

A

Blocks P2Y12 receptors to prevent ADP (a mediator for platelet aggregation) binding

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5
Q

What is the mode of action of tirofiban?

A

Prevents conversion of fibrinogen to fibrin

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6
Q

What is the main side effect of aspirin?

A

Peptic ulcers

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7
Q

What is the clinical use of tirofiban?

A

Prevention of MI in patients with unstable angina

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8
Q

What is the main clinical use of aspirin?

A

Prophylaxis of MI in high risk patients

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9
Q

Give examples of anti-coagulants

A

Warfarin
Heparin
Riveroxiban

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10
Q

What is the role of vitamin K reductase in coagulation?

A

Converts vitamin K from its oxidised to reduced form

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11
Q

What is reduced vitamin K required for?

A

Gamma carboxylation of precursors 2,7,9,10 into serine proteases

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12
Q

What is the mode of action of warfarin?

A

Inhibits vitamin K reductase enzyme

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13
Q

How can a high dose of warfarin be counteracted?

A

Vitamin K

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14
Q

What are the clinical uses of warfarin?

A

DVT
Prevention of thrombosis in AF
Prevention of thrombosis in patients with prosthetic heart valves

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15
Q

What drug can be added to the dose of warfarin to rapidly produce anti-coagulant effect?

A

Heparin

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16
Q

What are the potential side effects of warfarin?

A

Haemorrhage

Dizziness

17
Q

What is the mode of action of heparin?

A

Binds to antithrombin III to increase rate of inactivation of clotting factors IIa and Xa

18
Q

To which molecules must heparin bind in order to inactivate factor IIa (thrombin)?

A

Antithrombin III + thrombin

19
Q

To which molecules must heparin bind in order to inactivate factor Xa?

A

Antithrombin III only

20
Q

What do low molecular weight heparins inhibit?

A

Factor Xa

21
Q

How are low molecular weight heparins excreted?

A

Via kidneys - NOT used in renal failure

22
Q

What does riveroxiban directly inhibit?

A

Factor Xa

23
Q

What are the clinical uses of riveroxiban?

A

Used after hip/knee surgeries to prevent venous clot

24
Q

What are some of the side effects of anti-coagulants?

A

Haemorrhage
Osteoporosis
Hypoaldosteronism

25
Q

What is the mode of action of thrombolytic drugs?

A

Activate plasminogen to plasmin (opposes coagulation cascade)

26
Q

Give examples of thrombolytic drugs

A

Streptokinase

Duteplase

27
Q

When are thrombolytic drugs used?

A

In an acute MI not treated with PCI within 90 mins

In massive PE’s

28
Q

How can haemorrhage caused by thrombolytic drugs be countered?

A

Tranexamic acid

Year 1: Drug Revision (15 decks)

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