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RB Y1 Cardiology > clotting cascade and drugs > Flashcards

clotting cascade and drugs Flashcards

1
Q

arterial thrombus

A

white thrombus: platelets in fibrin mesh

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2
Q

arterial thrombus treatment

A

antiplatelet

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3
Q

venous thrombus

A

red thrombus

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4
Q

venous thrombus Treatment

A

anticoagulants

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5
Q

what does the extrinsic pathway start with

A

TF

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6
Q

what does the intrinsic pathway start with

A

XII

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7
Q

what converts prothrombin to thrombin

A

Xa

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8
Q

what converts fibrinogen to fibrin

A

thrombin

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9
Q

what converts plasminogen to plasmin

A

tPA

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10
Q

what is warfarin structure similar to

A

vitamin K

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11
Q

warfarin action

A

blocks vit K dependent gamma carboxylation of glutamate residues
results in the production modified factors VII, IX, X and prothrombin (factor II)

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12
Q

what is used to monitor warfarin dosage

A

prothrombin time

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13
Q

how long does warfarins full effect take

A

4-5 days

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14
Q

what must you do with warfarin if you require an immediate effect

A

use heparin

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15
Q

warfarin therapeutic index

A

low

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16
Q

factors that potentiate warfarin (inc risk of haemorrhage)

A

liver disease

high metabolic rate

17
Q

factors that lessen warfarin action (risk of thrombosis inc)

A

pregnancy or hypothyroidism

vitamin K consumption

18
Q

warfarin overdose

A

stop drug and give vitamin K (oral phytomenadione)

19
Q

heparin action

A

activates antithrombin III

20
Q

what does antithrombin III do

A

inhibit thrombin, factor Xa and IXa/tenase

21
Q

LMWH action

A

inhibits Xa

22
Q

LMWH example

A

dalteparin

23
Q

LMWH half life in comparison to heparin

A

longer

24
Q

LMWH dosage

A

daily dose by SC injection

25
Q

eliminate of heparin order

A

0

26
Q

eliminate of LMWH order

A

1

27
Q

why is heparin preferred in renal failure to LMWH

A

LMWH is excreted via the renal system

28
Q

what inactivates heparin e.g. in event of haemorrgae

A

sulphate IV

29
Q

rare adverse effect of heparin

A

osteoporosis

30
Q

dabigataran etexilate action

A

inhibit thrombin

31
Q

rivaroxaban action

A

inhibit Xa

32
Q

clopidogrel action

A

blocks P2Y receptors

33
Q

tirofiban action

A

interfere with fibrongen binding to GPIIb/IIIa receptors on activated platelets.

34
Q

what effect does the fibrinolytic cascade have on the coagulation cascade

A

opposes it

35
Q

streptokinase action

A

cleaves plasminogen molecules to produce plasmin

36
Q

what is streptokinase

A

streptococcus bacterial protein

37
Q

who shouldn’t streptokinase be given to

A

patients with recent streptococcal infections

38
Q

alteplase and dulteplase action

A

inc action of tPA

39
Q

how is haemorrhage with fibrinolytic controlled

A

tranexamic acid

RB Y1 Cardiology (34 decks)

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