Coagulation And Dyslipidemia Pharm Flashcards
What is a hypercoagulable state?
Too much blood clots (malignancy or pregnancy)
What is a vascular wall injury?
A lot of clotting factors needed (trauma or surgery)
What is circulatory stasis?
A fib or left ventricular dysfunction
What hates clotting?
Hemophilia (factor 2, 7, 8, 11 deficiency and Von Willebrand)
What loves clotting?
Inherited hypercoagulable states and acquired hypercoagulable states
What do antithrombotic agents do?
Inhibit platelet function and prevent thrombus formation
What do antiplatelet agents do?
Inhibit platelet function
What do anticoagulant agents do?
Alter clotting factors and prevent thrombus formation
What do thrombolytic agents do?
Help breakdown thrombus once formed and restore flow
What are the two pathways in the clotting cascade?
Intrinsic and extrinsic
What turns on the pathways in the clotting cascade?
Damage to a blood vessel
What is the reversal agent for anticoagulants?
Protamine
What is heparin used for?
A fib
ACS
What are side effects of heparin?
Bleeding and thrombocytopenia
What is the most common initial agent used for blood clots?
Heparin (very fast only done through IV)
What are some key things to look for if someone gets heparin induced thrombocytopenia?
It may cause a high rate of thrombus formation which can lead to amputation or death
What is the difference between LMWH compared to UFH?
Longer onset and more predictable response (less monitoring required)
What are the therapeutic uses for anticoagulant warfarin?
Prophylaxis of venous thrombosis
Prevention of systemic embolism
Acute MI
Valvular heart disease
A fib
What is important to monitor when taking warfarin?
INR frequently
What are side effects of warfarin?
Bleeding
What do you want INR to be when taking warfarin?
Between 2 and 3
What is warfarin highly affected by?
Diet and other medications
What is Pradaxa (direct thrombin inhibitor) therapeutic use?
Non-valvular a fib
Treatment and secondary prevention of VTE
What type of medication is pradaxa (direct thrombin inhibitor)?
Anticoagulant (causes bleeding)
What are the therapeutic uses of Xarelto, Eliquis, and Savaysa (oral factor-Xa inhibitor)
Non-valvular a fib
Treatment and secondary prophylaxis of VTE
VTE prophylaxis after hip or knee surgery
What type of medication is Xarelto, Eliquis, and Savaysa (oral factor-Xa inhibitor)?
Anticoagulant
What are the therapeutic uses for aspirin?
Angina
MI
CABG
Stroke
A fib
How long should P2Y12 be used with aspirin post heart surgery?
1 year
What is used as an alternative to be taken with P2Y12 if a patient is unable to take aspirin?
Clopidrogel
What are types of P2Y12 medications?
Plavix
Effient
Brilinta
What is the mechanism of action of anti platelets (glycoprotein IIb/IIIa inhibitors)?
Inhibits platelet formation by preventing fibrinogen from binding to the glycoprotein IIb/IIIa inhibitors
What are glycoprotein IIb/IIIa inhibitors medications?
Reopro
Integrilin
Aggrastat
What are the therapeutic uses of thrombolytics?
Stroke
PE
Catheter clearance
What is the action of HMG-CoA reductase inhibitors?
Decrease cholesterol production in the liver
How does HMG-CoA reductase inhibitors decrease cholesterol production? (Statins)
Up regulate LDL surface receptors which increases LDL breakdown
When do statins work best?
Bedtime
What are fibric acid derivatives mainly used for?
High triglycerides
What are types of fibric acid derivatives?
Lopid and TriCor
What do bile acid sequesterants (questran and zetia) do?
Decrease GI absorption
What are statins effects on LDL and triglycerides?
Decreases both
What are fibric acid derivatives effects on LDL and triglycerides?
Decreases both
What are nicotinic acid effects on LDL and triglycerides?
Decreases both
What are bile acid sequesterants effects on LDL and triglycerides?
Decreases LDL but increases triglycerides
