Coagulation Disorders Drugs Flashcards
MOA of Aspirin
Nonselective COX1 and COX2 inhibitor –> reduces production of TXA2
Potent platelet aggregation
Thrombaxane A2
Aspirin/Salicylate is associated with what blood disorder?
a. Hemophilia
b. Reye’s Syndrome
c. Von Willebrand
d. Polycythemia Vera
B. Reye’s Syndrome
Phosphodiesters inhibitors: Dipyridamole and Cilostazol. Which among the MOA is not true?
a. inhibit platelet activation
b. increase Calcium
c. increase cAMP
d. inhibits cAMP to AMP
B. reduces Calcium influx
The drugs that inhibit platelet aggregation by interfering with GPIIb/IIIa receptor binding to fibrinogen
Abciximab - Eptifibatide - Tirofiban
Cilostazol is C/I in px with:
a. DM
b. HF
c. CKD
d. PAD
B. HF - increases HR and rhythm
MOA of Clopidogrel?
inhibits the binding of ADP (P2Y12) to platelet receptor
This drug directly activates antithrombin?
a. Enoxaparin
b. Argatroban
c. Heparin
d. Vit. K
C. Heparin
Enoxaparin –> binds and potentiates effect of antithrombin III on factor Xa
Antidote to Heparin?
Protamine Sulfate
Anticoagulant responsible for Heparin induced Thrombocytopenia (HIT)?
Lepirudin - Desirudin - Bivaluridin - Argatroban - Dabigatran
Antidote to Thrombolytics?
Aminocaproic Acid/ Tranexamic Acid
Vitamin K dependent clotting factors?
II, VII, IX, X
Drug that is a Tissue plasminogen activator analog, that can be given in px with MI, ischemic stoke, Pulmonary embolism?
a. Tranexamic acid
b. Retiplase
c. Warfarin
d. Prasugrel
B. Retiplase
Warfarin inhibits?
a. ADP to platelet receptor
b. phosphodiesterase
c. tPA
d. Vit. K epoxide reductase
D. Vit. K epoxide reductase
this enzyme converts Reduced Vit K to Oxidized Vit K which is responsible for activation of II, VII, IX, X clotting factors
Mainly Contraindicated in DIC?
a. Antiplasmin
b. Antiplatelet
c. Anticoagulant
d. Fibrinolytics
A. Antiplasmin (TXA and Aminocaprioc Acid)
These inhibits fibrinolysis by inihbiting plasminogen –> exerting antiplasmin activity
They can cause thrombotic complications (MI, renal artery thrombosis)
HIT – IgG binds to Heparin + ____ complexes that activates platelet that causes Hypercoagulable state
a. Fibrinogen
b. Prothrombin
c. Stuart-Prower factor
d. Calcium Ions
d. Calcium Ions - PF4
Enumerate the Clotting Factors
I - Fibrogen
II - Prothrombin
III - Tissue Thromboplastin
IV - Calcium Ions
V - Labile Factor
VII - Stable Factor
VIII - Antihemophilic Factors
IX - Christmas Factor/ Plasma Thromboplastin Component
X - Stuart Prower Factor
XI - Plasma Thromboplastin Antecedent
XII - Hageman Factor
Antidote to Warfarin toxicity?
Vitamin K
Involved in Step 1 of hemostatis
local myogenic spasm a
Endothelin 1
Involved in Adhesion in primary hemostasi
vWF and Gp1b
Involved in Aggregation in primary hemostasis
Fibrinogen and Gp2b-3a
involved in secondary hemostasis
PiTT
Extrinsic pathway - factor III
Intrinsic pathway - factor XII
Fibrin
Involved in the resolution of the Hemostasis
Fibrinolysis/Plasmin
irreversibly inhibits binding of ADP to platelet receptors –> reducing platelet aggregation
Clopidogrel, Ticlopidine, Prasugrel, TicaGrelor
lethal dose for Aspirin toxicity
500mg/kg
toxic dose for Aspirin toxicity
150mg/kg
DOC for anticoagulation during pregnancy
Heparin - Indirect thrombin inhibitors
binds and potentiates effect of antithrombin III on factor Xa
Enoxaparin, Fondaparinux, -PARIN
management for HIT
LMW: Fondaparinux
Direct Thrombin inhibitor: Lepirudin
Direct thrombin inhibitors
Lepirudin, Bivalirudin, Dabigatran, Argatroban
monoclonal antibody used for reversal of Dabigatran toxicity
Idarucizumab
Antidote for Fibrinolytics
Aminocaproic acid
it inhibits tPA –> inhbits plasminogen activation
Tranexamic acid
Uses for Hemophilia A, Von willebrand disease
ADH agonist - Desmopressin, Vasopressin
ADP inhibitor
Clopidogrel, Prasugrel, Triclopidine
GpIIB/IIIA inhibitor
Abciximab, Eptifibatide, Tirofiban
Acid disorder of Aspirin toxicity
Repiratory alkalosis with HAGMA
drug with highest oral Iron prepation
Fe carbonate/Carbonyl Iron
medical management for acute Iron intoxication
Deferoxamine
Management for Chronic Iron Intoxication
Defarasirox
Deferipone
TRIAD of Hemochromatosis
Cirrhosis
DM
skin pigmentation