Drugs For Coagulation Disorders Flashcards
ADP: Platelet________
Aggregation
TXA2: Platelet _______ and ___________
Activation and vasoconstriction
Serotonin: Platelet __________ and ___________
Aggregation and vasoconstriction
Anticoagulants
Heparin
Warfarin
Direct Thrombin Inhibitors
Thrombolytics
T-PA derivatives
Streptokinase
Antiplatelet drugs
Aspirin
Glycoprotein IIb/IIIa inhibitors
Clopidogrel
PDE/Adenosine uptake inhibitors
Drugs that facilitate clotting
Vit K
Antiplasmin drugs
Replacement factors
Nonselective irreversible cox 1 and 2 inhibitor
Inhibits platelet aggregation
Drug for ARTERIAL THROMBI (increased platelets vs. venous thrombi)
Drug?
Aspirin
LAHAT NG MAY -SAL- at -ATE
Toxic dose and lethal dose of Aspirin
Toxic 150mg/kg
Lethal 500 mg/kg
Drug associated with Reye Syndrome in children
Aspirin
Triad of Aspirin Hypersensitivity?
SAMTER TRIAD
Asthma
Aspirin sensitivity
Nasal polyps
Expected acid base abnormality in salicylate poisoning
Respiratory alkalosis with HAGMA
Presentation of aspirin toxicity in adults vs. children?
Adults: Respiratory Alkalosis + HAGMA
Children: Pure HAGMA
Inhibits platelet aggregation by interfering with GpIIB/IIIA binding
Drug used during PCI, adjunct to thrombolysis, ACS
Prevents vessel restenosis, reinfarction and death
Drug, class?
Abciximab, Antiplatelet
Eprifibatide, Tirofiban
Drug that irreversibly inhibits binding of ADP to platelet receptors reducing platelet aggregation
For prevention and treatment of ARTERIAL thrombosis
SE: bleeding
Additive effects with ASA
Clopidogrel
Ticlopidine, Prasugrel
Inhibits Phosphodiesterase III, inhibits platelet aggregation and causes vasodilation
Drug for intermitent claudication, prevention of thromboembolic complications of cardiac valve replacement, and secondary prevention of ischemic stroke (with aspirin)
Drug, class?
Dipyridamole, Anti-platelet
(Cilostazol)
Dipyridamole has little or no benefit by itself
Cilostazol is contraindicated in HF
Anticoagulants: Indirect Thrombin Inhibitors
heparin, enoxaparin (LMWH), lepirudin
Anticoagulants: Direct Thrombin Inhibitors
Coumarin derivatives (Warfarin)
route of administration:
Heparin:________
Warfarin:________
Heparin: IV
Warfarin: Oral
Can this be given in Pregnancy?
Heparin:________
Warfarin:________
Heparin: Yes
Warfarin: No
Activates Antithrombin III
Drug for DVT, Pulmo Embo, MI
SE: Drug-induced Thrombocytopenia
Monitor PTT (Normal is 1.5-2.5)
Drug, Class
Heparin, Anticoagulant
Antidote for Heparin Toxicity
Protamine Sulfate
Potentiates effect of antithrombin III on Factor Xa (more selective), less effect on Thrombin
Drug for DVT, Pulmo Embo, MI
SE: less risk of thrombocytopenia
Does not require PTT monitoring
Drug, Class
Enoxaparin, Anticoagulant
(Fondaparinux, Tinzaparin, Danaparoid, Dalteparin)
Protamine is only partially effective in reversal of effects
Binds to Thrombin’s active site and inhibits its enzymatic action
Drug for PErcutaneous Coronary Angiography (with ASA), HEparin-Induced Thrombocytopenia
Monitor with PTT
No reversal agents exist, use with caution in pxs with renal insufficiency
Drug, Class
Lepirudin, Anticoagulant
Desirudin, Bivalirudin, Argatroban
Inhibits Vit K epoxide reductase (Factor 2,7,9,10,ProteinC/S)
Drug for chronic anticoagulation, except in pregnancy
SE: bleeding, drug-induced skin necrosis (for pxs with protein c&s deficiencies)
Monitor PT
Drug, Class
Warfarin, Anticoagulant
Dicumarol
Antidote for Warfarin toxicity
Vitamin K (slow) FFP (fast) Discontinue drug
Anticoagulant with narrow therapeutic window
Active ingredient in most rat poisons
Warfarin
Why is an overlap of warfarin and heparin necessary?
Warfarin is initially prothrombotic and requires elimination of preformed clotting factors (8-60h)
Drug that partially reverses effects of LMWHs
Protamine Sulfate
Chemical antagonist of heparin
tPA analog converting plasminogen to plasmin, degrading fibrin and fibrinogen, causing thrombolysis
Drug for acute MI, Ischemic stroke, pulmonary embolism
SE: cerebral hemorrhage
Drug, Class
Alteplase, Thrombolytic
(STREPTOKINASE)
LAHAT NG MAY -PLASE/-KINASE
Speed of Onset:
Heparin:________
Warfarin:________
Heparin: rapid (mins)
Warfarin: slow (days)
Loss of effectiveness on 2nd use and allergic reactions may be observed with this thrombolytic
Drug?
Streptokinase
Completely inhibits plasminogen activation
Drug for prevention of acute bleeding
Contraindicated in DIC and genitourinary bleeding
Antidote for Streptokinase Toxicity
Drug, Class
Aminocaproic Acid, Antiplasmin
Tranexamic Acid
Increases supply of reduced vitK
Drug for VitK deficiency, Warfarin antidote, prevents bleeding in newborns
SE: infusion reaction
Drug, Class
Vit K1 Phytonadione
Vit K2 Menaquinone
Vit K3 Menadione (never use in therapeutics, ineffective)
Endogenous vitamin
Vasopressin V2 agonist
Drug for Hemophilia A, vWD, Central DI
SE: Headaches, flushing, hyponatremia, seizures
Increases factor VIII activity of pxs with mild Hemophilia A or vWD
Drug?
Desmopressin
Potent endothelium derived vasoconstrictor
Endothelin
