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Pharmacology (ikketenkpådetbror) > Chapter 16 xD > Flashcards

Chapter 16 xD Flashcards

1
Q

Warfarin- MoA

A

Blocks reduction of oxidized vitamin K and prevents the post translational carboxylation of coagulation factors 2,7,9 and 10

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2
Q

Warfarin- Clinical use

A

Longterm treatment of thromboembolic disorders:

  • DVT
  • Thrombosis in pt with atrial fibrillation and artificial valve
  • Treatment of MI
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3
Q

Warfarin- Adverse effects

A
  • Bleedings

- Fetal warfarin syndrome

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4
Q

Warfarin- interactions

A
  • Salicylates potentiate anticoagulant effect
  • Rifampin and barbiturates induce CYP enzymes and decrease anticoagulant effect
  • Cholestyramine decrease absorption
  • GIMS FACE inhibit metabolism and increase risk of bleeding
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5
Q

Warfarin- Contraindication

A

Pregnancy

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6
Q

Heparin and related drugs- MoA

A

Heparin->Potentiate activity of endogenous antithrombin 3, an inhibitor of factor 2 and active factor 10
LMWHs and Fondaparinux->Inactivate factor 10

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7
Q

Heparin- Clinical use

A
  • Acute thromboembolic disorders (Pulmonary or peripheral embolism, DIC, and DVT)
  • Prevention of clotting (in arterial and heart surgery, blood transfusions, renal dialysis and during blood sample collection)
  • Prevention of stroke due to emboli from acute atrial fibrillation
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8
Q

LMWHs- Clinical use

A
  • Prevention of venous thromboembolism (associated with abdominal surgery or knee-or-hip replacement surgery)
  • Prevent ischemic complication of unstable angina or NSTEMI
  • Used in acute coronary syndrome and angioplasty
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9
Q

Fondaparinux- Clinical use

A

-Prevention of DVT in pt with hip-fracture, or hip-or knee replacement surgery

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10
Q

Heparin and related drugs- Adverse effects

A

Heparin->Bleeding, thrombocytopenia, and hyperkalemia
LMWHs->Bleeding, and thrombocytopenia
Fondaparinux-> Bleeding

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11
Q

Bivalirudin, Argatroban and Dabigatran- MoA

A

Inhibit thrombin

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12
Q

Bivalirudin- Clinical use

A

Prevent thrombosis in pt with UA or acute MI (including those undergoing coronary angioplasty and stent insertion)

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13
Q

Argatroban- Clinical use

A

Treatment of thrombosis in Pt with HIT or undergoing PCIs for MI

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14
Q

Dabigatran- Clinical use

A
  • Reduce risk of stroke and PE in pt with nonvalvular atrial fibrillation
  • Prevention of DVT in pt undergoing hip-replacement surgery
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15
Q

Dabigatran- Adverse effect

A
  • Increased risk of bleeding

- Dyspepsia and gastritis

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16
Q

Apixaban, Edoxaban and rivaroxaban- MoA

A

Inhibit active factor 10

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17
Q

Apixaban, Edoxaban and rivaroxaban- Clinical use

A
  • Reduce risk of stroke and systemic embolization in pt with nonvalvular atrial fibrillation
  • Prevention of DVT and PE in pt undergoing knee-or hip replacement surgery
18
Q

Apixaban, Edoxaban and rivaroxaban- Adverse effects

A

Bleeding

19
Q

Aspirin- MoA

A

Irreversible inhibition of COX and the synthesis of prostaglandins from arachidonic acid

20
Q

Aspirin- Clinical use

A

-Prevention of thromboembolic diseases (MI, stroke,

chronic limb ischemia etc.)

21
Q

Aspirin- adverse effects

A

GI bleeding and peptic ulcers, renal and hepatic dysfunction, lithium toxicity, hyperkalemia, platelet inhibition, premature closure of ductus arteriosus and Reye syndrome

22
Q

Aspirin- interactions

A
  • Increases hypoglycemic effect of sulfonylureas
  • Increases risk of GI bleeding and ulcers associated with methotrexate and valproate
  • Inhibits uricosuric effect of probenecid
23
Q

Dipyridamole- MoA

A

It leads to coronary vasodilation and inhibition of platelet aggregation by blocking platelet uptake of adenosine

24
Q

Dipyridamole- Clinical use

A
  • Used with aspirin in stroke prevention

- Produce vasodilation in myocardial perfusion imaging in pt with CAD

25
Q

Dipyridamole- Adverse effects

A

GI distress, headache and rash

26
Q

Cilostazol- MoA

A

Vasodilation and platelet inhibition by inhibition of type 3 PDE and thus inhibition of cAMP breakdown

27
Q

Cilostazol- Clinical use

A

-Treatment of intermittent claudication (pain and weakness in limbs due to arterial occlusion)

28
Q

Cilostazol- Adverse effects

A

Headache

29
Q

Clopidogrel, prasugrel, ticagrelor and cbangrelor- MoA

A

Inhibit platelet ADP receptors which inhibit activation of GP-2b/3a receptors and prevents ADP-induced platelet aggregation

30
Q

Clopidogrel, prasugrel, ticagrelor and cbangrelor- Clinical use

A
  • Prevention of MI and stroke

- Prevention of thrombosis in sickle cell anemia, PCI and claudication

31
Q

Clopidogrel, prasugrel, ticagrelor and cbangrelor- Adverse effects

A

Bleeding, GI distress, hypercholesterolemia and neutropenia

32
Q

Clopidogrel- interactions

A

-PPIs (Omeprazole) inhibit clopidogrel activation by CYP

33
Q

Abciximab, Tirofiban and Eptifibatide- MoA

A

Inhibitors of platelet GP-2b/3a receptors and platelet aggregation

34
Q

Abciximab, Tirofiban and Eptifibatide- Clinical use

A

Prevent thrombosis in pt undergoing angioplasty and stent replacement

35
Q

Abciximab, Tirofiban and Eptifibatide- Adverse effects

A

Bleeding

36
Q

Vorapaxar- MoA

A

Occupies PAR-1 receptors, and inhibits thrombin access to its target receptor and thus prevents thrombin-mediated platelet aggregation

37
Q

Vorapaxar-Clinical use

A

Reduce thrombotic cardiovascular events

38
Q

Vorapaxar-Adverse effects

A

Bleeding

39
Q

Thrombolytic agents- names and MoA

A

Reteplase, alteplase, streptokinase, tenecteplase and anistreplase
-They are recombinant forms of human t-PA which convert plasminogen to plasmin. Plasmin lead to clot dissolution

40
Q

Thrombolytic agents- Clinical use and adverse effects

A
  • Used to treat thromboembolic diseases

- Adverse effect is bleeding

41
Q

Stop bleedings caused by:

-Warfarin, Heparins, Dabigatran and Fibrinolysis

A

Warfarin->Phytonadione
Heparins->Protamine sulfate
Dabigatran->Idarucizumab
Fibrinolysis->Aminocaproic acid

42
Q

Contraindications to thrombolytics

A

Hemorrhage, hemophilia, hypertension, hypersensitivity, pregnancy, and Trauma/surgery (HHHHPT)

Pharmacology (ikketenkpådetbror) (29 decks)

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