Dislipidaemia + thrombosis

Question 1

Two types of antiplatelet drugs + their classes

Answer 1

Aspirin - COX inhibitor
Clopidogrel - ADP inhibitor

Question 2

Aspirin MOA/adverse effects

Answer 2

• irreversibly inhibits COX I + II enzymes therefore stops platelet activation/aggregation by stopping chain that causes it
• prolonged bleeding, bruising

Question 3

Clopidogrel MOA/adverse effects

Answer 3

• irreversibly blocks ADP receptor to inhibit platelet activation/aggregation to decrease risk of clot formation
• prolonged bleeding, bruising

Question 4

Why is only 100mg of aspirin taken per day?

Answer 4

any more will have worse effects in other areas of the body

Question 5

Warfarin MOA/adverse effects

Answer 5

• inhibits enzyme that reduces vitamin K which decreases production of clotting factors therefore decreasing coagulation
• increased clotting or increased bleeding if outside range
• bleeding + bruising

Question 6

Heparin MOA/adverse effects

Answer 6

• inactivates clotting factors by binding to antithrombin III (enhances it’s effects)
• bleeding
• heparin-induced thrombocytopenia

Question 7

Rivaroxaban/apixaban MOA/adverse effects

Answer 7

• inhibit factor Xa which blocks thrombin production therefore preventing fibrin from being formed thus stopping thrombus development
• excessive bleeding/bruising

Question 8

Dabigatran MOA/adverse effects

Answer 8

• inhibits thrombin thus prevents fibrin + coagulation occurring
• excessive bleeding/bruising

Question 9

HMG-CoA reductase inhibitor for dyslipidaemia

Answer 9

Atorvastatin

Question 10

Atorvastatin MOA/adverse effects

Answer 10

• inhibits HMG-CoA reductase to prevent it’s conversion to melavonate
• reduces cholesterol production in liver -> more LDL taken up
• myopathies eg. myalgia

Question 11

Cholesterol absorption inhibitor for dyslipidaemia

Answer 11

Ezetamibe

Question 12

Ezetamibe MOA/adverse effects

Answer 12

• inhibits cholesterol uptake + absorption through the intestine by binding to NPC1L1 transporter -> increases LDL transport to liver
• diarrhoea + abdominal pain

Question 13

Fibrate for dyslipidaemia - particularly high TG

Answer 13

Fenofibrate

Question 14

Fenofibrate MOA/adverse effects

Answer 14

• increases PPAR-a activation to increase oxidation of fatty acids in muscle cells + liver to reduce TG, LDL + VLDL
• GIT disturbances

Question 15

PCSK9 inhibitor for dyslipidaemia

Answer 15

Evolocumab

Question 16

Evocolumab MOA/adverse effects

Answer 16

• stops PCSK9 from binding to its receptors which prevents LDL receptors from being flagged for degradation in hepatocytes
• therefore more LDL receptors available to take up LDL
• injection site reactions

Question 17

Bile acid binding resin for dyslipidaemia

Answer 17

Colestyramine

Question 18

Colesterymine MOA/adverse effects

Answer 18

• binds to bile acids in intestine to prevent reabsorption therefore liver needs more LDL so upregulates receptors to decrease LDL in blood by 15-25%
• GIT irritation