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Pharm 6 > Coag > Flashcards

Coag Flashcards

1
Q

Thrombus

A

occlusion of bv from clot formed within the vessel

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2
Q

Emboli

A

occlusion of artery from an object that migrates from one part of the body to the bv.
- object can be clot, fat, cholesterol, tumor

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3
Q

Warfarin

A

Vit K Antagonist

aka - coumidin

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4
Q

Warfarin MOA

A

inhibits synthesis of coag factors 2,7,9,10, protein C & S

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5
Q

How do you take Warfarin

A

orally

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6
Q

How soon does Warfarin work

A

3-5 days

use heparin bridge

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7
Q

What to monitor Warfarin

A

PT/INR

- 2-3
- Mechanical heart valve 3-4.5
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8
Q

Indications to use Warfarin

A

DVT
Afib
artificial heart valve
combo with heparin for MI

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9
Q

ADR Warfarin

A

TERATOGEN
bleeding
alopecia

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10
Q

Warfarin drug interactions

A

MANY!

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11
Q

Reversal of Warfarin

A

1- Vit K

2- FFP

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12
Q

Heparin

A

Indirect Thrombin Inhibitor

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13
Q

What factors does Heparin inhibit

A

2 (thrombin) , 9, 10

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14
Q

How is Heparin given

A

IV or SQ

**NOT IM

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15
Q

Monitoring Heparin?

A

PTT

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16
Q

Adequate PTT on Heparin

A

1.5-2

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17
Q

Indications for Heparin

A 
Venous thrombosis
       - prevents clots
       - prevents clots getting bigger
Arterial thrombosis
      **only in combo

Afib

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18
Q

ADR Heparin

A

Bleeding
Alopecia
Osteoporosis
HIT**

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19
Q

Contraindications to Heparin

A

bleeding

allergy to cows or pigs

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20
Q

Do the kidneys clear heparin?

A

NO

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21
Q

Reverse Heparin

A

Protamine Sulfate

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22
Q

LMWH

A

Indirect Thrombin Inhibitor

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23
Q

LMWH MOA

A

Similar to heparin, but more effect on Xa

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24
Q

How to give LMWH

A

SQ 1-2x day

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25
Q

Monitor LMWH

A

not needed

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26
Q

Indications for LMWH

A

Venous thrombus

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27
Q

ADR LMWH

A

less thrombocytopenia

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28
Q

Reversal of LMWH

A

Not reversed well

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29
Q

Enoxaprin

A

LMWH

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30
Q

Dalteparin

A

LMWH

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31
Q

Tinzaparin

A

LMWH

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32
Q

Danaparoid

A

LMWH

33
Q

Endings for LMWH

A
  • aprin
  • parin
  • paroid
34
Q

Fondaparinux

A

Synthetic Indirect Thrombin Inhibitor

35
Q

MOA Fondaparinux (Synthetic Indirect Thrombin Inhibitor)

A

more selective factor X inhibitor

36
Q

Dose for Fondaparinux (Synthetic Indirect Thrombin Inhibitor)

A

1x day SQ

37
Q

Indications Fondaparinux (Synthetic Indirect Thrombin Inhibitor)

A

Acute DVT
Prophylaxis of DVT after joint replacement surgery
PE

38
Q

ADR Fondaparinux (Synthetic Indirect Thrombin Inhibitor)

A

Accumulates in pt with renal impairment

39
Q

Reversal Fondaparinux (Synthetic Indirect Thrombin Inhibitor)

A

Protamine has NO EFFECT

40
Q

MOA Direct Thrombin Inhibitor

A

bind to Thrombin active site, preventing clots

*inhibit clot bound and circulating thrombin

41
Q

Monitor Direct Thrombin Inhibitor

A

PTT

42
Q

Indications for Direct Thrombin Inhibitor

A

HIT with thrombosis
PTCA
***HOSPITAL BASED SPECIALTY DRUGS

43
Q

Dose Direct Thrombin Inhibitor

A

parenteral

*more predictable than heparin

44
Q

Direct Thrombin Inhibitor endings?

A

-irudin
+
Argatroban

45
Q

Dabigatran

A

Direct Thrombin Inhibitor - ORAL!!

46
Q

Monitor Dabigatran

A

none

47
Q

Indications Dabigatran

A

Reduce risk of stroke and embolism in pt with nonvalvular Afib

48
Q

ADR Dabigatran

A

bleeding

*lower risk than warfarin

49
Q

Dosing Dabigatran

A

BID oral

**adjust in pts with renal disfunction

50
Q

Apixaban

A

Active Factor Xa inhib

51
Q

Indications Apixaban

A

Stroke prevention in Afib

52
Q

Dose Apixaban

A

5mg 2x day

53
Q

Rivaroxaban

A

Direct Xa inhibitor

54
Q

Indications Rivaroxaban

A

Prevent DVT, clots, PE AFTER SURGERY

stroke prevention in Afib

55
Q

Dose Rivaroxaban

A

Adjust dose for renal failure

56
Q

ASA type

A

Antiplatelet

57
Q

MOA ASA

A

inhibit thromboxane perm

thromboxane initiates granule release from platelets to help aggragation
**no granules = no aggregation

lasts life of platelet

58
Q

Indication ASA

A

prevention of MI (pre or post MI)

After TIA or stroke

59
Q

Dose ASA

A

QD 81-325

60
Q

ADRs/contraindications ASA

A

bleeding
allergic reaction
epigastric pain
heartburn

NO ASTHMA

61
Q

MOA Clopidogrel & Ticlopidine

A

irreversibly blocks ADP receptor (needed for platelet agg)
inhibits expression of GP IIb/IIa
inhibit platelet func

lasts life of platelet

62
Q

ADR Clopidogrel & Ticlopidine

A

Both:
- TTP (coag w/ low platelet)

Ticlopidine:

  • N/V/D
  • neutropenia

Clopidogrel:
- BBW ** - CYP2C19 - genetic non metabolizer
& avoid proton pump inhibitors

63
Q

MOA Dipyridamole

A

inhibits platelet uptake of adenosine and blocks ADP induced aggregation

inhibits platelet adhesion to vessel wall

64
Q

Indications Dipyridamole

A

combo with aspirin and warfarin

65
Q

ADRs Dipyridamole

A

N/D
tummy pain
HA
rash

66
Q

MOA GPIIb/IIIa receptor antagonist

A

prevent platelet agg by competing with fibrinogen and VWF for receptors

67
Q

Indications GPIIb/IIIa receptor antagonist

A

ACS
PCI

**short periods via IV

68
Q

ADRs GPIIb/IIIa receptor antagonist

A

acute thrombocytopenia

69
Q

Abciximab

A

GPIIb/IIIa receptor antagonist

70
Q

Eptifibatide

A

GPIIb/IIIa receptor antagonist

71
Q

Tirofiban

A

GPIIb/IIIa receptor antagonist

72
Q

GPIIb/IIIa receptor antagonist remember*

A

ATE mab-fan-tide

73
Q

HIT

A

type II hypersensitivity reaction
decreased platelet w/ clots in veins and arteries or skin necrosis

**discontinue heparin and start direct thrombin inhibitor

74
Q

When and how to give antiplatelet drug

A

Start:

-ASA 81-325 QD

(can’t take ASA)

  • Clopidogrel - UA, stroke, TIA, stent
    ~if can’t take C or ASA –> Ticlid
75
Q

MOA Fibrinolytics

A

converts plasminogen to plasmin –> plasmon degrades fibrin to fibrinogen = DISSOLVES CLOT

76
Q

Reversal Fibrinolytic agents

A

Aminocaproic acid - stops bleeding caused by fibrinolytics

77
Q

Indication Fibrinolytics

A 
PE w/ hemdynamic instability
severe DVT
acute MI - w/o access to PCI!!
stroke within 3 hrs --> alteplase!!
arterial embolism
78
Q

Endings Fibrinolytics

A
  • kinase

- plase

Pharm 6 (5 decks)

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