Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

pharm II exam 2 > coagulation > Flashcards

coagulation Flashcards

1
Q

hemostasis (arrest of bleeding) is achieved in what three ways

A
  1. vascular contraction (vasospasm)
  2. platelet adhesion, activation, and aggregation
  3. fibrin formation and reinforcement of the platelet plug
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a factor that is produced from endothelial cells and inhibits platelet adhesion

A

PGI2

  • Prostacyclin (also called prostaglandin I2)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What factor in platelets binds to fibronogen in blood stream

A

GPIIb/IIIa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the three functions of thrombin

A
  1. positive feedback on intrinsic pathway
  2. activate platelets
  3. catalyze conversion of fibrinogen to fibrin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What factors are part of the intrinsic pathway

A

8, 9, 11, 12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What factors are part of the extrinsic pathway

A
  • tissue factor
  • VII
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Damage to the blood vessel endothelium causes release of

A

von Willebrand factor (vWF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Binding of platelets to collagen (through glycoprotein 1a (GP 1a)) and vWF (through GP 1b) activates the bound platelets to release

A

ADP, thromboxane A2 (TXA2), and serotonin (5-HT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are three natural inhibitors of coagulation in the body

A
  • Antithrombin III
  • Tissue factor pathway inhibitor (TFPI) – blocks the activity of TF/VIIa
  • Protein C – with its cofactor, protein S, destroys factors Va and VIIIa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

PTT evaluates which pathway

A

intrinsic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

PT and INR evaluate which pathway

A

extrinsic pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

PTT monitors action of which drug

A

Heparin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

INR (PT) monitors action of which drug

A

warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

list the High-molecular weight heparins

A

Heparin sodium (Liquaemin®)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

List the Low molecular weight heparins

A
  • Enoxaparin (Lovenox®)
  • Fondaparinux (Arixtra®): synthetic pentasaccharide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

List the Direct thrombin inhibitors

A
  • Lepirudin (Refludan®)
  • Argatroban (Novastan®)
  • Dabigatran (Pradaxa®)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

List the Direct inhibitors of factor Xa

A
  • Rivaroxaban (Xarelto®)
  • Apixaban (Eliquis®)
  • Edoxaban
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is Heparin

A

a heterogenous mix of sulfated mucopolysaccharies; action from a unique pentasaccharide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

MOA of Heparin

A
  • accelerates Antithrombin III activity
    • mainly affects Xa and thrombin
  • is recycled and stays active after releasing from inactivated clotting factor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When is heparin used

A
  • anticoagulant -> operations and IV catheters
  • prophylaxis against thrombosis (DVT and PE)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

route of administration of heparin

A

IV only, onset of action is immediate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

adverse effects of heparin

A
  • hemorrhage
  • heparin induced thrombocytopenia (HIT)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

treatment of hemorrhage from heparin

A

Protamine sulfate

24
Q

contraindications/precautions to taking heparin

A
  • renal or hepatic dysfunction
25
The low molecular weight heparins, Enoxaparin (Lovenox®) and Fondaparinux (Arixtra®) are similar to HMW heparins except:
* main inhibitory action is on **Factor Xa** * can be injected **subcutaneously** * lower incidence of HIT
26
Does protamine sulfate have an effect on Enoxaparin (Lovenox®) and Fondaparinux (Arixtra®)
* Enoxaparin (Lovenox®): does not completely reverse * Fondaparinux (Arixtra®): no effect
27
When is the direct thrombin inhibitor, Lepirudin (Refludan®) used
* given as **alternative** in patients with h/o **HIT** * use in patients with **poor liver function** * do not use in patients with poor renal function
28
route of administration of Lepirudin and Argatroban
IV
29
when is the direct thrombin inhibitor Argatroban used
* given as an **alternative** in patients with h/o **HIT** * use in patients with **poor renal function** * do not use in poor liver function
30
route of administration of the the direct thrombin inhibitor Dabigatran
oral
31
all new oral anticoagulants have the black box warning
* avoid abrupt discontinuation without adequate alternative anticoagulation * Dabigatran has predictable anticoagulant effects
32
route of administration of direct inhibitors of factor Xa
oral
33
when are direct inhibitors of factor Xa used
* DVT, PE, and prophylaxis * Rivaroxaban -\> any patients * Apixaban (Eliquis®) and Edoxaban: patients with non-valvular AFIB
34
MOA of warfarin
* inhibits vitamin K epoxide reductase * interferes with synthesis of II, VII, IX, X, protein C and S
35
peak effect of warfarin
after 48 hours * takes time to go off of warfarin too
36
when is warfarin used
* prevents development of emboli * no effect on already formed thrombi * uses: * DVT * thromboembolism * **given chronically**
37
route of administration of warfarin
oral
38
how is action of warfarin reversed
1. vitamin K with discontinuation of warfarin -\> takes time 2. fresh frozen plasma -\> immediate
39
why does warfarin have to be coadministered with heparin for the first 5 days
* **warfarin quickly reduced levels of Protein C** (short half life) * increases chance for warfarin-induced thrombosis -\> **cutaneous necrosis and infarction**
40
when is warfarin contraindicated
pregnancy (category X)
41
Warfarin has LOTS of drug interactions. list some
* drugs that affect * vit K * clotting factors : estrogen/pregnancy * platelet aggregation/function - aspirin * inhibit microsomal liver enzymes * induce liver microsomal enzymes
42
list thrombolytic agents
* Alteplase or Tissue plasminogen activator or t-PA * Reteplase (Retevase® ) * Tenecteplase (TNKase®)
43
MOA of thrombolytic agents
* convert plasminogen to plasmin which cleaves fibrin and fibrinogen
44
when are thrombolytic agents given
* lysis of clots -\> re-establish tissue perfusion * severe PE, DVT, and arterial thrombosis
45
What makes Tenecteplase different from other thrombolytic agents
* longer plasma half life * single IV injection * more fibrin specific
46
MOA Urokinase
* directly activates plasminogen * not clot-fibrin specific -\> generalized systemic fibrinolysis
47
list the Antifibrinolytics
* Aminocaproic acid * Tranexamic acid
48
MOA of Aminocaproic acid (Amicar®), Tranexamic acid (Cyklokapron®)
* inhibits plasminogen activation -\> decreases plasmin formation
49
when are antifibrinolytics used
Reversal of fibrinolytic therapy * used for bleeding
50
MOA of Aspirin
* **irreversible** inhibition of COX enzyme -\> decrease TXA2 * lasts the life of the platelet 7-10 days
51
when is ASA used
secondary prevention of cardiovascular events in most patients with established cardiovascular disease
52
MOA of Clopidogrel (Plavix®), Ticlopidine (Ticlid®)
* **irreversibly** block the **ADP receptor on platelets** * inhibits platelet aggregation
53
when are Clopidogrel (Plavix®), Ticlopidine (Ticlid®) used
used in patients who are allergic to ASA
54
DOC to prevent thrombosis in patients undergoing placement of coronary stents
Clopidogrel (Plavix®), Ticlopidine (Ticlid®) * Clopidigrel is frequently preferred over ticlodipine – because of better side effect profile and dosing
55
List the inhibitors of GPIIB/IIIa receptor
* Abciximab (ReoPro®) * Eptifibatide (Integrilin®) * Tirofiban (Aggrastat®)
56
route of administration of GPIIB/IIIa receptor inhibitors
IV

pharm II exam 2 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions