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Apex Review > Coagulation 6 > Flashcards

Coagulation 6 Flashcards

1
Q

Match each medication with its MOA.
Clopidogrel, warfarin, abciximab, enoxaparin
antithrombin cofactor, ADP receptor antagonist, vitamin K antagonist, GpIIB/IIIa receptor antagonist

A

clopidogrel- ADP receptor antagonist
warfarin- vitamin K antagonist
enoxaparin- antithrombin cofactor
Abciximab- GpIIb/IIIa receptor antagonist

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2
Q

Drugs that increase bleeding can be broken down into

A

antiplatelet drugs
anticoagulant drugs
fibrinolytics

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3
Q

Fibrinolytic drugs include

A

plasminogen activators

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4
Q

Plasminogen activators are

A

tPA
streptokinase

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5
Q

Anticoagulant drugs include

A

heparins
thrombin inhibitors
factor 10 inhibitors
vitamin K antaognists

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6
Q

tPA should be stopped _____ before procedures

A

1 hour

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7
Q

Streptokinase should be stopped ________ before procedures

A

3 hours

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8
Q

Heparin should be stopped

A

6 hours before procedures

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9
Q

LMWH should be stopped __________ before procedures

A

1-2 days

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10
Q

Warfarin should be stopped

A

2-4 days before procedures

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11
Q

Factor 10 inhibitors include

A

Fondaparinux

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12
Q

Fondaparinux should be stopped __________ before procedures

A

4 days

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13
Q

Thrombin inhibitors include

A

argatroban
bivalirudin

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14
Q

Arogatroban should be stopped

A

4-6 hours before

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15
Q

Bivalirudin should be stopped

A

2-3 hours before

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16
Q

Antiplatelet drugs include

A

ADP receptor inhibitors
GPIIb/IIIa receptor antagonists
Cox inhibitors (non-specific)
Cox 2 inhibitors

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17
Q

Examples of ADP receptor inhibitors include

A

clopidogrel
ticlopidine
prasugrel
ticagrelor

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18
Q

Ticagrelor & clopidogrel should be stopped

A

5-7 days before procedures

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19
Q

Ticlopidine should be stopped

A

14 days beforee

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20
Q

Prasugrel should be stopped

21
Q

GpIIb/IIIa receptor antagonists include

A

abciximab
eptifabtide
tirofiban

22
Q

Tirofiban & eptifabitide should be stopped

A

1 day before surgery

23
Q

Abciximab should be stopped

A

3 days before surgery

24
Q

Aspirin should be stopped

A

7 days before surgery

25
Q

NSAIDs should be stopped

A

1-2 days before surgery

26
Q

Celebrex should be stopped

A

doesn’t need to be!

27
Q

Non-specific cox inhibitors work by

A

blocking COX-1 which stops the conversion of arachidonic acid to prostaglandins and ultimately thromboxane A2

28
Q

COX 2 inhibitors affect on platelet function

A

they do not affect platelt function

29
Q

Plasminogen activation inhibitors include

A

aminocaproic acid & tranexamic acid

30
Q

Desmopressin stimulates

A

factor 8 and vWF factor release

31
Q

Aprotinin inhibits

A

plasmin, thrombin, protein C, and kallikrein

32
Q

TXA works on the

A

lysine binding sites on plasminogen

33
Q

A patient scheduled for coronary revascularization is diagnosed with type 3 von Willebrand disease. What is the BEST treatment for this patient?
a. DDAVP
b. platelets
c. cryoprecipitate
d. vWF/factor 8 concentrate

A

d. vWF/factor 8 concentrate

34
Q

The most common inherited disorder of platelet function is

A

Von Willebrand disease

35
Q

Von Willebrand disease is a __________ platelet disorder

A

qualitative; platelet count is normal, but the platelets do not function properly

36
Q

Lab abnormalities of Von Willebrand disease include

A

increased PTT and bleeding time

37
Q

Von willebrand factor (MOA

A

anchors the platelet to the vessel wall at the site of vascular injury & carries inactivated factor 8 in the plasma

38
Q

_______ & __________________ contain factors 8 and vFW and can be used for all 3 types of vFW disease

A

Cryo & FFP

39
Q

The first-line agent for the patient with type 3 vWF disease is

A

Purified 8-vWF concentrate

40
Q

Purified 8-vWF concentrate reduces the risk of

A

transfusion-related infection

41
Q

Patients with type 1 vWF disease respond best to

A

desmopressin

42
Q

Desmopressin stimulates the

A

release of endogenous vWF and increases factor 8 activity

43
Q

Patients with type 3 vWF disease do not

A

respond to desmopressin b/c they don’t produce vWF

44
Q

The desmopressin dose is

A

0.3 mcg/k IV

45
Q

Von Willebrand factor is synthesized by

A

vascular endothelium and megakaryocytes

46
Q

What are the three classifications of von Willebran disease?

A

type 1: mild-moderate reduction in the amount of vWF-produced
type 2: the vWF that is produced doesn’t work well
type 3: severe reduction in the amount of vWF produced

47
Q

After using desmopressin, bleeding time is improved for

A

12-24 hours

48
Q

Side effects of desmopressin include

A

vasodilation–> hypotension with rapid administration
hyponatremia d/t free water retention

49
Q

What coagulating factors are in cryo?

A

fibrinogen
8 & 13
vWF

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