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561 > Coagulation And Hyperlipidemia Drugs > Flashcards

Coagulation And Hyperlipidemia Drugs Flashcards

1
Q

Vitamin K antagonist - anticoagulant/anti-platelet, example and MOA

A

Anticoagulant

Ex. Warfarin (Coumadin)

Inhibits vitamin K dependent clotting factors

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2
Q

Vitamin K antagonist - clinical utility, SE

A

Clinical: a-fib, DVT/PE prevention and tx, valve replacement

SE: bleeding, skin necrosis (rare), teratogenic

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3
Q

Direct thrombin inhibitors - anticoagulant/anti-platelet, example, MOA

A

Anticoagulant

Dabigatran (Pradaxa)

MOA: inhibits thrombin directly

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4
Q

Dabigatran - clinical utility, SE

A

Clinical: a-fib, DVT/PE tx

SE: bleeding, GI symptoms

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5
Q

Apixaban MOA

A

inhibit factor Xa, preventing prothrombin conversion to thrombin

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6
Q

Apixaban SE

A

SE: bleeding, elevated liver enzymes

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7
Q

Heparin MOA

A

Enhance activity of antithrombin, inhibiting thrombin and Factor Xa

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8
Q

Heparin SE

A

Bleeding, heparin-induced thrombocytopenia (HIT)

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9
Q

Aspirin MOA

A

Irreversibly inhibit COX-1, reducing thromboxane A2 production leading to decreased platelet aggregation

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10
Q

Aspirin SE

A

bleeding, gastric ulceration, tinnitus

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11
Q

Clopidogrel MOA

A

Inhibits platelet P2Y12 ADP receptor reducing platelet activation and aggregation

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12
Q

Clopidogrel SE

A

bleeding, dyspnea (ticagrelor)

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13
Q

Alteplase MOA

A

Activate plasminogen to plasmin, which digests fibrin and dissolves clots

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14
Q

Alteplase SE

A

bleeding (including intracranial hemorrhage), allergic reactions (streptokinase)

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15
Q

4 main indications for anticoagulation therapy
Main adverse effect

A

Indications: DVT, PE, atrial fibrillation, MI

AE: bleeding

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16
Q

Statins SE

A

myalgia, increased liver enzymes, rhabdomyolysis (rare)

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17
Q

Statins (HMG-CoA reductase inhibitors) MOA

A

inhibit HMG-CoA reductase enzyme which plays a role in cholesterol production

18
Q

Bile acid sequestrants - examples, MOA

A

Cholestyramine, colestipol, colesevelam

Bind bile acids in the intestines, promoting their excretion and reducing circulating cholesterol

19
Q

Bile acid sequestrants - clinical indications, SE

A

Hypercholesterolemia

SE: constipation, bloating, indigestion

20
Q

Ezetimibe MOA

A

Inhibits cholesterol, absorption in small intestine

21
Q

Ezetimibe SE

A

diarrhea, joint pain, sinusitis, fatigue

22
Q

PCSK9 inhibitors - examples, MOA (not on study guide)

A

Evolocumab, alirocumab

MOA: monoclonal antibodies that inhibit PCSK9, increasing LDL receptor availability and reducing LDL cholesterol

23
Q

PCSK9 inhibitors - clinical indications, SE (not on study guide)

A

HeFH, ASCVD requiring additional LDL-C lowering

SE: nasopharyngitis, injection site reactions

24
Q

Fenofibrate MOA

A

activate PPAR alpha, reducing triglyceride synthesis and enhancing triglyceride clearance

25
Q

Fenofibrate SE

A

dyspepsia, gallstones, myopathy (when combined with statins)

26
Q

Omega-3 fatty acids - examples, MOA (not on study guide)

A

Fish oil, icosapent ethyl

MOA: reduce hepatic triglyceride production and increase triglyceride clearance

27
Q

Omega-3 fatty acids - clinical indications, SE (not on study guide)

A

Hypertriglyceridemia

SE: fishy aftertaste, diarrhea, nausea

28
Q

Niacin - examples, MOA (not on study guide)

A

Nicotinic acid

Reduces free fatty acid release, decreases VLDL and LDL synthesis, raises HDL levels

29
Q

Niacin - clinical indications, SE (not on study guide)

A

Hypercholesterolemia, mixed dyslipidemia

SE: flushing, itching, elevated glucose levels

30
Q

Define blood clotting

A

coagulation; prevents excessive bleeding when vessel is damaged

31
Q

5 stages of blood clotting

A

1 - vasoconstriction
2 - formation of platelet plug (primary hemostasis)
3 - activation of coagulation cascade (2ndary hemostasis)
4 - clot retraction and repair
5 - fibrinolysis

32
Q

PT tx consideration for pt on warfarin

A

gentle w/ MT b/c pts bruise more easily

33
Q

What sign would a PT check for pt on antigcoags? What causes this sign?

A

bleeding; INR may be too high

34
Q

PT consideration for pts on heparin (3)

A

-gentle during MT to avoid bruising
-padding during ex/act w/ fall risks to avoid internal bleeding
-modalities like deep heat –> increase BF –> increase risk of bleeding

35
Q

PT edu for anticoags

A

signs of excessive bleeding (prolonged nose bleeds, bloody urine, lg bruises)

36
Q

What 4 symptoms might suggest internal bleeding

A

unusual pain, swelling, headache, dizziness

37
Q

What 3 tx techniques increase the risk of hematoma formation

A

dry needling, electroacupuncture, deep tissue mob

38
Q

3 signs of DVT

A

unilateral calf pain, swelling, warmth

39
Q

When is the most beneficial time to schedule sessions for anticoag pt?

A

when drug’s effect is moderate, NOT peak or trough

40
Q

What are the 3 statin-associated mus symps (SAMS)

A

mus pain, tenderness, weakness (different from MSK pain d/t ex)

41
Q

Hyperlipidemia meds can affect what vitals

A

BP or HR

42
Q

What 3 symps of hyperlipidemia meds indicate immediate medical attention is needed

A

severe mus pain, tea colored urine, unexplained fatigue

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