Drugs for Blood disorders

Question 1

protein C and protein S do what

?

Answer 1

cause proteolysis of factors V and 8\

they are endogenous antcoagulants

Question 2

plasmin

Answer 2

degrades fibrin clot

Question 3

Heparin

Answer 3

large, water soluble
given parenterally
turns OFF activated factors (2a, 9a, and 10a, 11a, 12a) by catalyzing antithrombin III binding(a serine protease inhibitor)
increases clotting time

Question 4

warfarin (Coumadin)

Answer 4

small, lipid soluble derivative of vit K
-given orally
LONG halflife
decreases hepatic synthesis of vit K dependent clotting factor production (2, 7, 9, and 10) 
no effect on factors already present

Question 5

argatraban

Answer 5

blocks 2a (thrombin)

Question 6

streptokinase

Answer 6

fibrinolytic (break thrombi) – activates plasmin from plasminogen

acts on both bound and free plasminogen

for short term emergency - DVT, pulmonary emboli, etc

Question 7

heparin pathway and time to monitor

?

Answer 7

— intrinsic pathway! (aPTT monitors it) —-

Question 8

monitoring warfarin/Coumadin?

Answer 8

PT time; extrinsic pathway

Question 9

heparin use? toxicity?

Answer 9

rapid anticoagulation for DIC, thromoses, angina, open heart surgery

thrombocytopenia, bleeding, osteoporosis

Question 10

warfarin/Coumadin use? toxicity?

Answer 10

longer term anticoagulation for post MI, vlaves, arrhythmias, etc

bleeding, skin necrosis, teratogenic (bone dysmorphiogenesis)
NOT FOR PREGNANCY

Question 11

antagonist of heparin

Answer 11

protamine sulfate

Question 12

antagonist of warfarin/coumadin

Answer 12

vitamin K`

Question 13

pregnant woman?

Answer 13

use heparin

Question 14

protein C turns off

Answer 14

5a and 8a

Question 15

tPA

Answer 15

altoplase/tissue plasminogen activator

natural thrombolytic

Question 16

antiplatelet drugs

Answer 16

aspirin - inhibits COX –> decreased activation
ticlopidine/clopidrogel - block ADP receptors on platelets –> decreased activation
abciximab - antagonist that binds 2b/3a receptors – preventing crosslinking reaction