Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Cardiology: Anti-platelets, anti-coagulants and anti-thrombolytic drugs > Flashcards

Cardiology: Anti-platelets, anti-coagulants and anti-thrombolytic drugs Flashcards

1
Q

What forms a white thrombus?

A

Platelets with a fibrin mesh

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What forms a red thrombus?

A

Mainly fibrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where do white thrombus tend to cause embolisms?

A

Cerebral- stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where do red thrombus tend to cause embolisms?

A

Pulmonary - PE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the inactive clotting factor of thrombin?

A

Prothrombon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What do activated clotting factors act as?

A

Serine proteases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Name the process which modifies the precursors in order for them to become activated.

A

Gamma- carboxylation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is required in order for gamma carboxylation to take place?

A

Vitamin K in the REDUCED form is a cofactor for the enzyme which catalyses gamma carboxylation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does warfarin do?

A

Decreased the concentration of reduced vitamin K- less activation of clotting factors=anticoagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When would you use an anti-coagulant?

A

To treat a venous thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Give examples of specific incidences in which you would wish to use an anti-coagulant to treat.

A

DVT and PE
Post operative thrombosis
Prosthetic hear valves
AF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does warfarin prevent the reduction of reduced vitamin K?

A

Competes with vitamin K for binding to vitamin K reductase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

At what point does warfarin block coagulation?

A

In vivo

NOT vitro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is warfarin administered?

A

Orally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why does warfarin have a slow onset?

A

Takes time for inactive factors to replace active ones that are cleared slowly from the plasma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which anticoagulant can be added to have a more rapid anticoagulant effect

A

Heparin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the disadvantages of Warfarin?

A

Risk of haemorrage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How can the effect of warfarin be monitored?

A

By monitoring INR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What can increase your risk of haemorrage on warfarin?

A

Liver disease
Higher metabolic rate
Drug interactions- be careful with aspirin and NSAIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What factors lessen the action of warfarin?

A

Pregnancy
Vitamin K in diet
Drug interacton

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How can you treat an overdose of warfarin?

A

Vitamin K or plasma clotting factors administration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What does antithrombin III do?

A

Binds to the active site of activated clotting factors and ‘de-activates’ them- inhibits coagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What does heparin do?

A

Binds to antothrombin III increasing its affinity for the active clotting factors= ANTICOAGULATION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What must heparin do to inhibit IIa?

A

Bind to both AT III and IIa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What must heparin do to inhibit Xa?

A

It only needs to binds to AT III

26
Q

When is LMWH not preferred?

A

In renal failure

27
Q

Name two LMWH?

A

Enoxaparin

Dalteparin

28
Q

What is the difference between LMWH and heparin

A

LMWH only inhibits Xa not thrombin IIa

29
Q

How is heparin administered?

A

IV or subcutaneously( LMWH)

30
Q

How is LMWH eliminated from the body?

A

Renal excretion

31
Q

What order kinetics does HMWH show?

A

First

32
Q

What order kinetics does heparin show?

A

Zero

33
Q

How is optimum dosage determined for heparin? (NOT LMWH)

A

In vitro clotting test

34
Q

Give the adverse affects of heparin.

A

Haemorrage
Osteoporosis
Hypoaldosternism
Hypersensitivity reactions

35
Q

Name an orally administered drug that directly inhibits thrombin

A

Dabigatran etexilate

36
Q

Name an orally administered drug that directly inhobots factor Xa

A

Rivaroxaban

37
Q

When are dabigatran and rivaroxaban used?

A

Prophylactically in hip and knee replacements

38
Q

What initially stimulates platelet aggregation?

A

Endothelial damage or plaque rupture

39
Q

How do platelets adhere to the endothelium?

A

GPlB receptors and VWF

40
Q

Name substances that increase the expression of GPIIB/IIIA receptors and this cause aggeegtion.

A

ADP
5-HT
and TXA2

41
Q

What enzyme synthesises thromboxane A2?

A

COX- cyclooxygenase

42
Q

What does acidic phospholipids on platelet surface cause?

A

Promotion of thrombon formation

43
Q

When are anti-platelet drugs used?

A

To treat arterial thrombosis

44
Q

Name three anti platelet drugs.

A

Aspirin
Clopidogrel
Tirofibrin

45
Q

How does aspirin work?

A

Irrevesible COX inhibitor- prevents TXA2 synthesis and production of prostaglandin.

46
Q

What is the advese affect of aspirin?

A

GI ulceration and bleeding

47
Q

How does clopidogrel work?

A

Irrevesibly blocks the P2Y12 receptors- decreased in ADP

48
Q

When is clopidogrel used?

A

Synergistically with aspirin

When intolerant of aspirin

49
Q

How does tirofiban worK?

A

Prevents convertion of fibringogen to fibrin

50
Q

When is tirofiban used?

A

Given IV in short term to prevent MI in patients with unstable angina

51
Q

What do fibrinolytic drugs do?

A

Break down fibrin and thus dissolve thrombi

52
Q

What breaks down the fibrin?

A

Plasmin

53
Q

How do fibrinolytic drugs work?

A

Activate plasmin from the inactive plasminogen

54
Q

When are fibrinolytic drugs used?

A

Actue MI or stroke if PCI not available

55
Q

Name three fibrinolytic drugs

A

Streptokinase
Altepase
Duteplase

56
Q

What is streptokinase.

A

Protein from streptococci.

Antibodies form against it after four days

57
Q

What is the risk of streptokinase?

A

Allergic reaction

58
Q

How do alteplases and duteplase work?

A

They are recomboninent tissue plasminogen activators

59
Q

How are fibrinolytic drugs administered?

A

IV- short half life

60
Q

What is the adverse affects of alteplase and duteplase?

A

Haemorrhage

61
Q

How can haemorrage in fibrinolytics be controlled?

A

Tranexamic acid- inhibits plasminogen activation.

Pharmacology (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions