Drugs for Blood Disorders

Question 1

Heparin mechanism of action

Answer 1

Catalyzes the binding of Antithrombin 3 (a serine protease inhibitor) resulting in their raped inactivation

Question 2

What do you monitor for Heparin

Answer 2

PTT

Question 3

What do you counteract Heparin in when there is Toxicity?

Answer 3

Protamine sulfate

Question 4

What is Heparin used for

Answer 4

Rapid anticoagulation for thromboses, emboli, unstable angina, DIC

Question 5

Heparin adverse affects

Answer 5

1. Bleeding
2. Osteoporosis
3. HIT
4. HS

Question 6

Warfarin mechanism of action

Answer 6

Decrease hepatic synthesis of Vit K dependent factors (1972)

Question 7

What do you monitor in Warfarn

Answer 7

PT and INR

Question 8

Warfarin adverse affects

Answer 8

1. Bleeding
2. Skin necrosis (low Protein C)
3. Drug interactions
4. Teratogenic (Bone dysmorphogenesis)

Question 9

Enoxaparin is

Answer 9

LMW Heparin that has a longer t-1/2 and less HIT

Question 10

Protein C deficiency

Answer 10

Can be induced with Warfarin, so maintain Heparin until warfarin kicks in

Question 11

Argatroban mechanism of action

Answer 11

Directly inhibit thrombin and do not require antithrombin 3

Question 12

WHen do you use Argatroban

Answer 12

In HIT

Question 13

Dabigatran mechanism of action

Answer 13

Directly inhibits thrombin and do not require antithrombin 3

Question 14

Advantage of Dabigatran

Answer 14

Oral anticoagulant that does not need monitoring

Question 15

Bivalirudin mechanism of action

Answer 15

Directly inhibit thrombin and does not require antithrombin 3

Question 16

Rivaroxaban (-XABAN) mechanism of action

Answer 16

Directly inhibits factor 10a

Question 17

Streptokinase mechanism of action

Answer 17

Acts on both bound and free plasminogen causing a depletion of circulating plasminogen and factor 5 and factor 8

Question 18

Alteplace (tPA) mechanism of action

Answer 18

Clot specific, acting mainly on fibrin-bound plasminogen

Question 19

Factors that activate platelets

Answer 19

1. T_XA₂
2. ADP
3. Collagen
4. 5HT
5. Thrombin

Question 20

Asprin role in antiplatelet

Answer 20

Cox inhibitor in platelets that decrease activation

Question 21

Clopidogrel mechanism of action

Answer 21

Blocks ADP receptors on platelets decreasing activation

Question 22

Prasugrel mechanism of action

Answer 22

Block ADP receptors on platelets

Question 23

Ticagrelor mechanism of action

Answer 23

Block ADP receptors on platelets decreasing activation

Question 24

Ticlopidine mechanism of action

Answer 24

Block ADP receptors on platelets decreasing activation

Question 25

Clopidogrel, Prasugrel, Ticagrelor, and Ticlopidine adverse affects

Answer 25

1. Hemorrhage
2. Leukopenia
3. Thromocytopenic purpura

Question 26

Abciximab mechanism of action

Answer 26

Antagonist that bind to glycoprotein IIb/IIIa receptors and decrease aggregation by preventing cross-linking

Question 27

Eptifibatide mechanism of action

Answer 27

Antagonist that bind to glycoprotein IIb/IIIa receptors and decrease aggreggation by preventing cross-liking

Question 28

Tirofiban mechanism of action

Answer 28

Antagonist that bind to glycoprotein IIb/IIIa receptors and decrease aggregation by preventing cross-linking