Coag Drugs Flashcards
Asprin
Irreversibly inhibits COX, preventing thromboxane A2 formation and platelet aggregation. AE: bleeding, tinnitus at high doses.
Clopidogrel
(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.
Ticopidine
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
Prasugrel
irreversible ADP receptor antagonist, preventing platelet activation and fibrin formation. Used before stenting, AE: nausea, diarrhea, bleeding rash. Severe lukopenia(r).
Dipyridamole
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.
Abciximab
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
Eptifibatide
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
Tirofiban
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
Unfractionated heparin
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.
Low molecular Weight heparin
Indirect thrombin inhibitor, also accelerates inactivation of factor Xa. Prevents clotting, no monitoring, AE: bleeding, heparin induced thrombocytopenia, lowered antidote effect
Fondaprinux
Synthetic heparin. accelerates inactivation of factor Xa. Prevents clotting, no monitoring, AE: bleeding, low heparin induced thrombocytopenia risk. best bioavailability, No antidote effect
Leirudin
Direct thrombin inhibitor, Binds directly to thrombin and inhibits the enzyme. Derivative of leech hirudin
Bivalirudin
Direct thrombin inhibitor, Binds directly to thrombin and inhibits the enzyme.
Argatroban
Direct thrombin inhibitor, Binds directly to thrombin and inhibits the enzyme.
Dabigatran etexilate
(oral) Binds directly to thrombin and inhibits the enzyme.
Protamine
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.
Warfarin
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.
Phytonadione
Vitamin K. is antidote for warfarin. Used in clotting factors, II, VII, IX,X and proteins C/S.
Urokinase
Kidney Enzyme that directly converts plasminogen to plasmin
Alteplase
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.
Reteplase
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.
Tenecteplase
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.
