Brainscape's Knowledge GenomeTM

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


See full index

Pharm 2 > Class 8 Deck 2 > Flashcards

Class 8 Deck 2 Flashcards

1
Q

During bridging therapy, there is an increased risk of what when Novel anticoags are abruptly stopped?

A

-Stroke

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

Hemodialysis can remove what Novel anticoag?

A

-dabigatran / pradaxa

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

What drug can reverse rivaroxaban and apixaban?

A

-4 factor prothrombin complex concentrate (Kcentra®)

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

4 factor prothrombin complex concentrate (Kcentra®) contains what 5 things?

A
  • Factors II, VII, IX, X (inactivated)

- Heparin

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

Activated 4 factor Prothrombin Complex Concentrate

(FEIBA) contains what? and what does it reverse?

A
  • Factors II, IX, X, activated VII

- Dabigatran

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

What is the potential problem of Activated 4 factor Prothrombin Complex Concentrate (FEIBA)?

A

-Thrombotic effects of activated factor VII

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

What does Factor IX Complex (Profilnine SD) do? and what does it contain?

A
  • Reversal for rivaroxaban or apixaban when combined w/ rFactor VIIa
  • Contains II, IX, X (no heparin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What drug reverse all Novel anticoags?

A

-Recombinant Factor VIIa (NovoSeven®)

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

What kind of drug is used to keep clots from breaking down?

A

-Hemostatics like Amicar / Tranexamic acid / DDAVP

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

How does Epsilon Aminocaproic Acid (Amicar®): work?

A
  • Inhibits plasminogen which inhibits fibrinolysis

- Indirect inhibitor of plasmin’s anti platelet effect

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

When is Epsilon Aminocaproic Acid (Amicar®): used?

A
  • Treatment of excessive bleeding
  • reduces bleeding after CPB
  • Stops oozing in patient w/ cirrhosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why should rapid infusion of Epsilon Aminocaproic Acid (Amicar®) be avoided?

A
  • Hypotension
  • Brady
  • Arrhythmias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Tranexamic Acid inhibits what?

A

plasminogen binding sites

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

when is Tranexamic Acid used?

A
  • Bleeding prophylaxis in Post Bypass, Trauma, Joint replacment
  • Massive transfusion protocol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is desmopressin (DDAVP) and how does it effect hemostasis?

A
  • Synthetic ADH
  • Causes endothelial cells to release: VIII (VWB), plasminogen activator and prostaglandins
  • Increase platelet adhesions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When is DDAVP used as a hemostatic?

A
  • Uremia
  • Liver disease
  • Hemophilia A
  • Minimize blood loss during cardiac/spine surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the side effects of DDAVP?

A
  • Hypo/Hypertension
  • Hyponatremia
  • Nausea
18
Q

Name the 5 thrombolytic agents?

A
  • Altepase
  • Reteplase
  • Tenecteplase
  • Streptokinase
  • Urokinase
19
Q

How do the t-PA agents work?

A

Converts plasminogen to plasmin

20
Q

How is streptokinase different from the other thrombolytic agents?

A
  • No intrinsic enzymatic activity
  • Forms a 1:1 complex with plasminogen and cleaves free plasminogen to plasmin
  • Requires loading dose
21
Q

How is urokinase different from the other thrombolytic agents?

A
  • 2 chain serine protease from human kidneys
  • Converts plasminogen to plasmin
  • Very expensive
22
Q

When are thrombolytic agents used?

A
  • Lysing thrombi during MI
  • Treat PE
  • Venous thrombi
  • to open occluded catheters
23
Q

What are the advantages of uro/streptokinase?

A
  • Lack fibrin specificity

- Induce systemic lysis state

24
Q

What are the toxicity concerns for thrombolytic agents?

A
  • Hemorrhage (lysis of fibrin)
  • Intracranial hemorrhage
  • fibrinolytic activity can last 7-24hrs after last dose
25
Q

How does aspirin inhibit platelet aggregration?

A

Cyclo-oxygenases inhibitor, which decreases Thromboxane -A2

-Last the life of the platelet

26
Q

How do NSAIDs inhibit platelet aggregration?

A

-Temporary depression of thrombaxane-A2

27
Q

Name the platelet aggregation inhibitors that are Thienopyridine P2Y12 receptor agonists.

A
  • Clopidogrel (Plavix®) p.o.
  • Ticlopidyne (Ticlid®) p.o.
  • Prasugrel (Effient®) p.o.
  • Ticagrelor (Brilinta®) p.o.
28
Q

How is Ticagrelor (Brilinta®) different from the other Thienopyridine P2Y12 receptor agonists.

A
  • It is reversible

- Stop 5 days prior to surgery

29
Q

Name the platelet aggregation inhibitors that are Platelet Glycoprotein (GP IIb/IIIa) Receptor Inhibitors

A

Abciximab (ReoPro®) I.V.
Eptifibatide (Integrilin ®) I.V.
Tirofiban (Aggrastat ®) I.V.

30
Q

When are Thienopyridine P2Y12 receptor agonists used?

A
  • Prevention of thrombosis in cerebral, vascular and coronary disease.
  • For patients who cannot tolerate aspirin
31
Q

Much like aspirin, platelets exposed to P2Y12 Receptor Antagonists (except ticagrelor) remain affected for how long?

A

-Lifespan of the platelet

32
Q

Clopidogrel (Plavix) should be stopped how long prior to surgery?

A

5 days

33
Q

Ticlid should be stopped how long prior to surgery? and what is the reversal?

A
  • 10-14 days

- Methylprednisolone and platelet transfusions

34
Q

Which P2Y12 Receptor Antagonists are pro-drugs?

A

-Plavix and effient

35
Q

Thienopyridine P2Y12 receptor Antagonists adverse effects?

A
  • Bleeding
  • Diarrhea and Rash
  • TTP
  • Neutropenia
36
Q

How do Platelet Glycoprotein (GP IIb/IIIa) Receptor Inhibitors work?

A

-Inhibit fibrinogen binding to platelets (Inhibit platelet aggregation)

37
Q

When are Platelet Glycoprotein (GP IIb/IIIa) Receptor Inhibitors used?

A
  • Ischemic complications of PCI

- Unstable angina and MI

38
Q

Adverse effects of Platelet Glycoprotein (GP IIb/IIIa) Receptor Inhibitors.

A
  • Bleeding
  • Thrombocytopenia
  • N/V
  • Hypotension
  • Anaphlyxis
39
Q

What should be monitored when on low dose coumadin, and when can a catheter be removed?

A
  • PT/INR

- INR<1.5

40
Q

Use of what drugs represents a significant risk for hematoma during neuraxial block?

A
  • Factor Xa inhibitors

- LMWH and Fondaparinux

41
Q

What is Dextran 40? and When is it used?

A
  • Low molecular weight dextran
  • Expanding intravascular volume
  • Decreases blood viscosity
42
Q

What are the side-effects Dextran 40?

A
  • Allergic reactions
  • Increased bleeding time
  • Rouleaux formation

Pharm 2 (23 decks)

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