Drug mechanisms

Question 1

Warfarin

Answer 1

Blocks vitamin K from making factor 2,7,9,10 (remember the year 1972) and protein C

Question 2

Aspirin

Answer 2

Blocks COX; prostaglandins can’t be made, thromboxane A2 can’t be made so platelets can’t aggregate

Question 3

Clopidogrel

Answer 3

ADP receptor antagonist - P2Y12 receptor, inactivates platelets

Question 4

Coagulation cascade intrinsic

Answer 4

12 to 11 to 9 to 8

Question 5

Coagulation cascade extrinsic

Answer 5

10 to 5 to 2, add 13 to stabilise

Question 6

Rivaroxaban

Answer 6

inhibits factor Xa

Question 7

Dabigatran

Answer 7

inhibits thrombin factor 11a

Question 8

Statins

Answer 8

block HMG CoA reductase; more LDL receptors produced so more LDL cleared

Question 9

Ezetimibe

Answer 9

Inhibits cholesterol absorption

Question 10

Amiodarone

Answer 10

Class 3, potassium channel blocker, makes AP longer (works on RHYTHM)

Question 11

LMWHeparin

Answer 11

Inhibits antithrombin III on factor Xa

Question 12

Normal heparin

Answer 12

Inhibits thrombin, factors Xa, IXa, XIa and XIIa - binds to AT3 and increasing affinity for clotting factors; allowing inactivation

Question 13

What makes LMWH better

Answer 13

longer acting, lower risk of osteoporosis