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Pharm > chapter 52: Anticoagulant, Antiplatelet, and thrombolytic Drugs > Flashcards

chapter 52: Anticoagulant, Antiplatelet, and thrombolytic Drugs Flashcards

1
Q

What are the 2 mechanisms of hemostasis?

A

Platelet plug
coagulation

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2
Q

What are the 3 major groups of drugs that are used for thromboembolic disorder?

A
  1. anticoagulants
  2. antiplatlet
  3. thrombolytics
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3
Q

What suppresses the productioin of fibrin?

A

Anticoagulants

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4
Q

What inhibits platelet aggregation?

A

Antiplatelet

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5
Q

What promotes lysis of fibrin?

A

Thrombolytic

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6
Q

True or false?
Most thrombolytic agents are non-specific and can dissolve any clot found in the body

A

True

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7
Q

True or false?
Warfarin is considered a Vitamin K agonist.

A

False, it is considered a Vitamin K antagonist

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8
Q

What is usually given in combination with warfarin until warfarin reaches therapeutic levels and why?

A

Heparin, warfarins effects do not occur for 3-5 days after it is begun

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9
Q

What drug does not activate antithrombin?

A

Warfarin

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10
Q

warfarin inhibits the synthesis of what?

A

Vitamin-k dependent clotting factors

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11
Q

What are the 4 vitamin-K clotting factors?

A

-Vll
-lX
-X
-ll (prothrombin)

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12
Q

Warfarin does not have an effect on what?

A

already circulating clotting factors

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13
Q

What does heparin enhance the activity of?

A

antithrombin

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14
Q

what are the 2 major clotting factors does antithrombin inhibit?

A
  • thrombin
    -factor xa
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15
Q

What does the enhancing of antithrombin lead to?

A

The production of fibrin to be reduced

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16
Q

What must heparin bind to to inactivate thrombin?

A

-antithrombin
-thrombin

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17
Q

What must heparin bind with to inactivate factor Xa?

A

-antithrombin

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18
Q

Which drug has a more rapid onset of action and shorter half-life.
warfarin or heparin?

A

Heparin

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19
Q

What is the antidote for heparin overdose?

A

protamine sulfate

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20
Q

What pathway does heparin use?

A

intrinsic pathway

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21
Q

What pathway warfarin use?

A

extrinsic pathway of the coagulation cascade

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22
Q

What routes can heparin be administered?

A

-IV
-SQ

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23
Q

What is the preferred anticoagulant in pregnant women and why?

A

Heparin; it does not cross the placenta

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24
Q

What happens when heparin is given oral or IM?

A

It is rapidly inactivated

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25
Bleeding is the principle complication in what type of treatment?
Anticoagulant
26
What can a patient develop from heparin use?
thrombocytopenia (DISCONTINUE IF THIS OCCURS)
27
A pt was given 100 units of heparin, how much protamine will inactive this dose of heparin?
1 mg
28
How long should aPTT levels be measured?
every 4-6 hours until therapeutic levels have been sustained
29
Normal value for aPTT?
40 seconds
30
Therapeutic levels of heparin should increase the aPTT by a factor of 1.5-2.0, what would this make the aPTT?
60-80 seconds
31
When should aPTT not be monitered?
When giving low-dose SQ heparin
32
What drug is determined by the persons weight?
Enoxaparin
33
What does enoxaprin have a greater inhibitor effect on?
Factor Xa> thrombin
34
Which class has a longer duration of action and a more predictable plasma level?
LMW Heparins
35
How is fondaparinux administered?
SQ
36
What drug binds selectively to factor Xa?
fondaparinux
37
What is the suffix for the LMW Heparins?
"parin"
38
What effect does fondaprinux have on thrombin?
Reduces the production (not activity) of thrombin
39
What is an example of a direct thrombin inhibitor?
Dabigatran
40
What type of thombin does dabigatran act on?
-clot-bound -circulating thrombin
41
Why is dabigatran administered PO?
prevent the conversion of fibrinogen to fibrin
42
Warfarin inhibits the enzyme needed to to convert what?
Vitamin K to its' active form
43
What type of food should remain consistent when taking warfarin?
Vitamin K foods (green, leafy vegetables)
44
What receptors are the most effective antiplatelet drugs available.
GP llb/llla receptor antagonist
45
What drugs are also called "super aspirins"?
GP llb/llla receptor antagonist
46
How is the dose of warfarin determined?
INR (less variability than the Prothrombin time (PT)
47
Target INR for warfarin?
2.0-3.0
48
What is the antidote for warfarin?
Vitamin K1
49
Vitamin K1 is administered how?
-PO -IV
50
What are the 3 main categories of drug interactions that occur with warfarin?
-Drugs that increase effects of warfarin -drugs that promote bleeding -drugs that decrease effects of warfarin
51
What are the 3 main categories of antiplatelet drugs?
-aspirin (ASA) -ADP receptor blockers -GP llb/llla receptor antagonist
52
Aspirin blocks COX-1 which leads to the blockage of what?
thromboxane A2
53
The blockage of thromboxane A2 causes what two actions to occur that promote hemostasis?
1. platelet activation 2. vasoconstriction
54
Aspirin is the only NSAID that provides protection from what?
-MI -CVA
55
Clopidogrel irreverisbly inhibits platelet aggregation by doing what?
preventing P2Y12 ADP-induced binding between platelets and fibrinogen
56
What is another name for thrombolytics that dissolve/destroy thromi that have already fotmed?
fibronlytics
57
Most serious concern r/t bleeding is...
Intracranial hemorrhage
58
The GP llb/llla receptor antagonists cause revirsable blockade of platelet Gp llb/llla receptors.When activated, these receptors change change their structure so they can bind to__________.
Fibrinogen
59
Alteplase first binds to plasminogen forming a drug complex. This complex does what?
-Catalyzes the conversion of plasminogen molecules into plasmin.
60
Plasmin does what?
-digests the fibrin meshwork of clots -degrades fibrinogen and other clotting factors
61
Why is bleeding the major complication of thrombolytics?
Ty can destroy preexisting clots of recently healed injuries and can disrupt coagulation by interfering with new clot formation
62
How soon should you begin therapy after onset of symptoms from an acute MI
6 hours
63
How long should you being therapy relating to a thrombotic stroke?
3 hours

Pharm (11 decks)

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