CV: Anticoagulants and Antiplatelets

Question 1

Antiplatelet Drugs

Answer 1

AspirinDipyradimole - only given with ASA, unknown mechanismThienophyridines - ClopidogrelGPIIa/IIIB Receptor Antagonists - Abciximab, Eptifibatide

Question 2

Clopidogrel

Answer 2

inhibits P2Y12 for lifetime of pltdecreases ADP to decrease plt aggregationCONTRAINDICATED pts w/CYP2C19 metabolism

Question 3

Heparins

Answer 3

Unfractionated HeparinEnoxaparin - LMWHFondaparinux - pentasaccharide

Question 4

Direct Xa Inhibitors

Answer 4

RivaroxabanApixaban

Question 5

Direct Thrombin Inhibitors

Answer 5

DabigatranLepirudinArgatroban

Question 6

Vitamin K Antagonists

Answer 6

Warfarin - Factors 2,7,9,10, C, S Vitamin K reductase** use during breastfeeding, but not pregnancy

Question 7

Fibrinolytics

Answer 7

Streptokinase - complexes to plasminogen to convert to plasminAlteplase - version of tPAReteplase - version of alteplase

Question 8

GPIIa/IIIb Inhibitors

Answer 8

blocks final step in platelet aggregration pathwayinhibits fibrinogen bindingrenal clearanceAbciximab - mural/human monoclonal AbEptiifibatide - reversibly binds, competitive inhibitor

Question 9

Safe for Pregnancy

Answer 9

UFHLMWHFornadparinux (for pts w/ HIT)DypyridamoleThienopyridines (only high risk)ASA - but risk PDA closure, prolonged labor, bleeding