Coag Drugs

Question 1

Asprin

Answer 1

Irreversibly inhibits COX, preventing thromboxane A2 formation and platelet aggregation. AE: bleeding, tinnitus at high doses.

Question 2

Clopidogrel

Answer 2

(plavix) irreversible ADP receptor antagonist, preventing platelet activation and fibrin formation. Used before stenting, AE: nausea, diarrhea, bleeding rash. Severe lukopenia(r). Requires CYP2C19 , drug drug.

Question 3

Ticopidine

Answer 3

irreversible ADP receptor antagonist, preventing platelet activation and fibrin formation. Used before stenting, AE: nausea, diarrhea, bleeding rash. Severe lukopenia(r). Thrombotic, thrmbocytopenic purpura Most side effects

Question 4

Prasugrel

Answer 4

irreversible ADP receptor antagonist, preventing platelet activation and fibrin formation. Used before stenting, AE: nausea, diarrhea, bleeding rash. Severe lukopenia(r).

Question 5

Dipyridamole

Answer 5

Increases cAMP and inhibits platelet activation. Inhibits platelt uptake of adenosine, thus increases adenosine interaction with Adenosine A2 receptor leading to icreased cAMP. Also vasodilator AE: headaches. given with asprin or warfarin.

Question 6

Abciximab

Answer 6

Humanized Mab against GPIIb/IIIa receptor, inhibitor, prevents binding of adhesive glycoproteins such as fibrinogen and vWF to activated platelets. Given IV w/ aspirin and heparin for acute coronary syndromes. AE: bleeding and thrombocytopenia

Question 7

Eptifibatide

Answer 7

fibrinogen analogue against GPIIb/IIIa receptor, inhibitor, prevents binding of adhesive glycoproteins such as fibrinogen and vWF to activated platelets. Given IV w/ aspirin and heparin for acute coronary syndromes. AE: bleeding and thrombocytopenia

Question 8

Tirofiban

Answer 8

fibrinogen analogue nonpeptide competitive inhibitor against GPIIb/IIIa receptor, inhibitor, prevents binding of adhesive glycoproteins such as fibrinogen and vWF to activated platelets. Given IV w/ aspirin and heparin for acute coronary syndromes. AE: bleeding and thrombocytopenia

Question 9

Unfractionated heparin

Answer 9

Indirect thrombin inhibitor, also accelerates inactivation of factor Xa. (same as high molecular weight heparin. Prevents clotting, no monitoring, AE: bleeding, heparin inducedthrombocytopenia, lowest bioavailability, highest antidote effect.

Question 10

Low molecular Weight heparin

Answer 10

Indirect thrombin inhibitor, also accelerates inactivation of factor Xa. Prevents clotting, no monitoring, AE: bleeding, heparin induced thrombocytopenia, lowered antidote effect

Question 11

Fondaprinux

Answer 11

Synthetic heparin. accelerates inactivation of factor Xa. Prevents clotting, no monitoring, AE: bleeding, low heparin induced thrombocytopenia risk. best bioavailability, No antidote effect

Question 12

Leirudin

Answer 12

Direct thrombin inhibitor, Binds directly to thrombin and inhibits the enzyme. Derivative of leech hirudin

Question 13

Bivalirudin

Answer 13

Direct thrombin inhibitor, Binds directly to thrombin and inhibits the enzyme.

Question 14

Argatroban

Answer 14

Direct thrombin inhibitor, Binds directly to thrombin and inhibits the enzyme.

Question 15

Dabigatran etexilate

Answer 15

(oral) Binds directly to thrombin and inhibits the enzyme.

Question 16

Protamine

Answer 16

Is the antidote for heparins, binds and forms a stable complex with heparin which lacks anticoagulant activity. has less effect on low MW heparin, and no effect on fondaparinux.

Question 17

Warfarin

Answer 17

Blocks synthesis of vitamin K dependant clotting factors II , VII, IX, X, and PROTEIN C/S by inhibiting vitamin K reductase. Vitamin K antidote, and must bridge with heparin because Protein C/S have very short half lives and increased clotting results. Interacts with P450 enzymes.

Question 18

Phytonadione

Answer 18

Vitamin K. is antidote for warfarin. Used in clotting factors, II, VII, IX,X and proteins C/S.

Question 19

Urokinase

Answer 19

Kidney Enzyme that directly converts plasminogen to plasmin

Question 20

Alteplase

Answer 20

Fibrinolytic drug. Preferentially activate plasminogen that is bound to fibrin which confines it to the thrombus rather than systemic activation. Dissolves existing life threatening thrombi, activates plasminogen, IV, narrow spectrum. Used for stroke.

Question 21

Reteplase

Answer 21

Fibrinolytic drug. Preferentially activate plasminogen that is bound to fibrin which confines it to the thrombus rather than systemic activation. Dissolves existing life threatening thrombi, activates plasminogen, IV, narrow spectrum. Used for stroke.

Question 22

Tenecteplase

Answer 22

Fibrinolytic drug. Preferentially activate plasminogen that is bound to fibrin which confines it to the thrombus rather than systemic activation. Dissolves existing life threatening thrombi, activates plasminogen, IV, narrow spectrum. Used for stroke.