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Pharm II > Coag Drugs > Flashcards

Coag Drugs Flashcards

0
Q

Heparin affects which factors (5)

A

Mainly: Xa and Thrombin
Also: IXa, XIa, and XIIa

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1
Q

HMW heparin binds to?

A

Antithrombin III

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2
Q

heparin antidote

A

protamine sulfate

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3
Q

LMW heparin MOA

A

inhibits factor Xa

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4
Q

protamine sulfate & LMW heparin (2)

A

does not completely reverse Enoxaprin

No effect of Fondaparinux

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5
Q

LMW indications (3)

A

subcutaneous injection- not IV
Replacement for warfarin in pregnancy
Lower incidence of heparin-induced thrombocytopenia

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6
Q

direct thrombin inhibitors (3)

A

lepirudin
argatroban
dabigatran

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7
Q

heparin contraindications (3)

A

Renal or hepatic dysfunction
Active bleed, hemophilia, after brain/spinal cord/eye surgery
Hx of heparin-induced thrombocytopenia

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8
Q

Lepirudin MOA

A

highly specific direct inhibitor of thrombin

from leeches

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9
Q

Lepirudin use & cautions

A

Alternative in HIT
IV only
hypersensitivity rxns
Caution in pts w/ poor renal fxn- use argatroban instead

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10
Q

Argatroban MOA

A

direct inhibitor of thrombin

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11
Q

Argatroban use and cautions (4)

A

given as alternative in HIT
cleared by liver
IV
caution w/ poor liver fxn- use lepirudin instead

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12
Q

dabigatran MOA

A

Oral direct thrombin inhibitor

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13
Q

dabigatran use (3)

A

prevention of stroke in A Fib pts
Predictable anticoag effects- not monitored by PTT
Cleared by kidneys

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14
Q

dabigatran black box warning?

A

avoid abrupt discontinuation w/o alternative anticoagulation

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15
Q

oral factor Xa inhibitors (2)

A

Rivaroxaban (Xarelto)

Apixaban (Eliquis)

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16
Q

rivaroxaban (xarelto) use (3)

A

DVT
PE
future clots

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17
Q

xarelto & eliquis contraindications (2)

A

renal failure

liver disease

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18
Q

warfarin MOA

A

Inhibits vitamin K epoxide reductase

19
Q

Warfarin interferes with which clotting factors?

A 
II
VII
IX
X
Protein C & S
20
Q

heparin is monitored by?

A

PTT

21
Q

warfarin is monitored by?

A

INR

22
Q

Warfarin uses (5)

A 
Prevent emboli development
DVT
Thromboembolism
No effect on already-formed thrombi
Given chronically
23
Q

Warfarin antidotes (2)

A

Vitamin K: takes time

FFP: immediate

24
Q

Warfarin adverse effects (3)

A

Hemorrhage
warfarin-induced thrombosis —> cutaneous necrosis & infarction
liver enzyme changes

25
Q

Warfarin contraindications (4)

A

pregnancy- category X
Vit K- antibiotics
OCPS
Aspirin

26
Q

thrombolytic agents (3)

A

Alteplase (t-PA)
Reteplase
Tenecteplase

27
Q

Thrombolytic Agents MOA (2 things)

A

converts plasminogen to plasmin

lyses thrombus from within

28
Q

what does clot selective mean

A

higher activity for fibrin-bound plasminogen vs. plasma plasminogen

29
Q

Alteplase uses (2)

A

lysis of clots to re-establish tissue perfusion

severe PE, DVT, and arterial thromboses

30
Q

treatment of Alteplase-related bleeding?

A

aminocaproic acid and whole blood

31
Q

Alteplase contraindications

A

stroke pts

32
Q

Antifibrolytics (2)

A

Aminocaproic acid

Tranexamic acid

33
Q

Antifibrinolytic MOA (2)

A

inhibits plasminogen activation

inhibits streptokinase activity —> decrease plasmin formation

34
Q

antifibrinolytic uses (3)

A

bleeding disorders
adjunct in hemophilia
reveral of fibrinolytic therapy

35
Q

Aminocaproic acid adverse effects (3)

A

Intravascular thrombosis
Hypotension
Nasal stuffiness

36
Q

Aminocapric acid contraindications (2)

A

DIC

genitourinary bleeding

37
Q

aspirin MOA

A

irreversible inhibition of COX enzyme –> decreased TXA2

38
Q

clopidigrel MOA (2)

A

irreversibly blocks the ADP receptor on platelets

inhibits platelet aggregation

39
Q

clopidigrel uses (3)

A

aspirin allergy
decrease thrombolytic events following MI & stroke
prevent thrombosis in pts undergoing coronary stent placement

40
Q

clopidigrel adverse rxns

A

bleeding

drug interactions via CYP2C19

41
Q

abciximab, eptifibatidine, tirofiban MOA

A

decrease platelet aggregation by inhibiting GPIIb/IIIa receptors from binding fibrinogen

42
Q

hemostasis achieved by (3)

A

Vascular contraction
Platelet adhesion, activation, and aggregation
Fibrin formation & platelet plug

43
Q

arteries, high flow will form

A

white thrombus

44
Q

veins, low flow will form

A

red thrombus- dangerous

Pharm II (14 decks)

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