Drugs Flashcards
Intrisic pathway factors ccan be affected by what?
Activated partial thrombolplastin time (KCCT).
Unfractionated heparni
What are factors in the extrinsice coag pathway dependdent on? How are they measured?
VItamin K
INR
What does fibrinogen?
Crooss links platelets
How does clopidogrel act?
P2Y12 inhibitor
How doe dypryridamole act?
Blocks cAMP in platelelet??
How does tirofiban act?
On IIb/IIIa receptor
How do thrombi in venous system differ from arterial thombi?
Colour, content and treatent
Red vs white
Fibrin rich vs platelet rich
Heparin/warfarin vs antiplatelet agentsmain use of antiplatelet agens?
Main use of antiplatelets?
CV events
Primary (not recommended) and secondary prevention (well established)
Acute treatment (established)
What is rate of GI haem/ulcer perforation when apsirin iis used
0.1-0.5% per annum (?check?)
SSide effects of asthma? (2, not bleeding)
Asthma
Hyperuricaeemia
Which antiplatelet drug is a PRO drug? Why is this signif?
Clopidogrel. You should not give omeprazole because stops C proteins form metabolising clopidogrel and activating, give H2 antag instead
What is most widely used anti-coag drug?
Warfarin
how does warfarin work?
Inhibits vit K dep caraboxylation of factors II, VII, IX, X
What is the hlaf life of wararin?
Long
Wheen is warfarin used?
Venous thrombo event.
1st VT event, how long on warfarin? 2nd? INR targets?
6 months
Lifelong
2.5 for both
What do you do wwith warfarin after DVt on warfarin?
Incr INR (sometiimes) to 3.5
How long do you take warfarin for when you are preparing for aF peri-cardioversion? Why?
6w before and after. Atria may not starrt to pump propery for a few weeks so there is still clot risk.
WHat is INR target for lifelong warfarin for lifelong AF?
2.5
Mechanical valcve warfarin, what is INR target?
2.75 (?)
What are the absolute CIs for warfarin? (5)
Active bleeding Bleeding disorder 1st trimester of pregnancy Space occupying lesion of CNS Recent surgeery
What are teh imoortnat interactions (pharm) of warfarin
drugs
Compare unfractionated vs LMW hepararin Clinical use Admin Dose Dose monitoring Monitoring metthod Reversal Adverse effects .....
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Clinical uses of heparins
Pregnancy
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Bridging anti-coag - mech valve patients undergoing non-cardiac surgery
