Drugs for Coagulation Disorders

Question 1

Antiplatelet, Anti inflammatory, COX Inhibitor
Non selective COX 1 & 2 Inhibitor
Used to prevent thrombosis and inflammation
SE: HAGMA, Gatrointestinal Toxicity

Answer 1

Aspirin

Question 2

Uncoupler of oxidative phosphorylation
Associated with Reye syndrome in children
NOT used in Gout

Answer 2

Aspirin

Question 3

SAMTER Triad

Answer 3

Asthma
Aspirin Sensitivity
Nasal Polyps

SAM the ASTHMATIC is SENSITIVE to NASAL POLYPS

Question 4

Acid Base abnormality for Salicylate poisoning

Answer 4

Respiratory Alkalosis with HAGMA

Question 5

Difference bet presentation of Aspirin intoxication in Adults and Children

Answer 5

Adults = Mixed acid base disorder (Respiratory alkalosis with HAGMA)
Kids = Pure acid base disorder (HAGMA only)

Question 6

GPIIa/IIIa inhibitor
Used in PCI to prevent thrombosis
Prevents restenosis, reinfarction and death

Answer 6

ABCiximab

Question 7

Antiplatelet (Theinopyridine), ADP inhibitor
Irreversibly inhibits binding of ADP platelet receptors reducing platelet aggregation

Has additive effect with Aspirin

Answer 7

Clopidogrel

Ticlopidine - Most side effects

Question 8

GI and Hemorrhagic SE are common

Answer 8

Ticlopidine

Question 9

Thienopyridine that inhibits ADPsubtype P2Y -> Allosteric Antagonist

Answer 9

Ticagrelor

Question 10

Antiplatelet, PDE inhibitor
Inhibits Phosphodiesterase III and increase cAMP

Used in prevention of Thromboembolic complications of cardiac valve replacement

Never used alone always with Aspirin

Answer 10

Dipyridamole

Question 11

Intermittent Claudication

Contraindicated in HF

Answer 11

Cilostazol

Question 12

Indirect thrombin inhibitors

Answer 12

Heparin
Enoxaparin
Coumarin derivatives (Warfarin)

Indirect war in ox’s hip

Question 13

Direct thrombin inhibitors

Answer 13

Lepirudin

Question 14

Large acidic
Parenteral ->Acts on Blood
Rapid Onset -> Acute
Activates Antithrombin III
Monitored by PTT
Can be used in Pregnancy

Answer 14

Heparin

Malaki at maugat ang hip ng auntie ni brad pitt kaya pwede mabuntis

Question 15

Antidote for Heparin Overdose

Answer 15

Protamine

Question 16

Small Lipid Soluble
Oral -> Acts on Liver
Slow -> Chronic
Impairs Vit K dependent 9,10,7,2
Monitored by PT
Cannot be used by Pregnant

Answer 16

Warfarin

Palaaway, Maliit, mabagal, mataba at kain ng kain ang pet ko na si K kaya bawal mabuntis

Question 17

Antidote for Warfarin

Answer 17

Vitamin K (Slow), FFP (Fast)

Question 18

DOC for Anticoagulation during pregnancy

Answer 18

Heparin

Question 19

SE Heparin

Answer 19

Osteoporosis

Question 20

Potentiates effect of antithrombin III on Factor Xa
Less risk of Thrombocytopenia
DOES NOT require aPTT monitoring
Protamine Sulfate only partially effective in reversing

Answer 20

EnoXAparin

Question 21

Binds to Thrombin’s active site
Anticoagulation in patients with Heparin induced Thrombocytopenia, Percutaneous coronary angioplasty (with Aspirin)
Monitored with aPTT
SE: Effect prolonging antibodies

Answer 21

Lepirudin/ Dabigatran

Question 22

Oral Direct Factor for Xa inhibitor
Prevention of Stroke Patients with Atrial Fib
Does not require monitoring, No antidotes
Used esp after hip or knee surgery

Answer 22

Rivaroxaban/ Apixaban

Question 23

Anticoagulant overlap

Answer 23

to bypass initial prothrombotic effect of warfarin

Question 24

CY P450 Inducers

Answer 24

Ethel Booba Takes Phen Phen and Refuses Greasy Carb Shakes

Ethanol
Barbiturates
Phenytoin
Rifampicin
Griseofulvin
Carbamazepine
St. John's Wort/ Smoking

Question 25

CY P450 Inducers

Answer 25

Ethel Booba Takes Phen Phen and Refuses Greasy Carb Shakes ``` Ethanol Barbiturates Phenytoin Rifampicin Griseofulvin Carbamazepine St. John's Wort/ Smoking ```

Question 26

CY P450 Inhibitors

Answer 26

Inhibitors stop Cyber Kids from Eating the Queen's GRApefruit ``` Isoniazid Sulfonamides Cimetidine Ketoconazole Erythromycin Quinidine Grapefruit Ritonavir Amiodarone ```

Question 27

Chemical Antagonist of Heparin | Used for Heparin Overdose

Answer 27

Protamine Sulfate

Question 28

Thrombolytic Tissue plasminogen activator analog, coverts plasminogen to plasmin For Acute Myocardial infarction LOSS of effectiveness on 2nd use

Answer 28

Alteplase/ Streptokinase/ Urokinase

Question 29

Antidote for Thrombolytics (Alteplase, Streptokinase)

Answer 29

Aminocaproic Acid

Question 30

Forms complex with endogenous plasminogen catalyzing conversion of plasminogen to plasmin

Answer 30

Streptokinase

Question 31

Contraindication for Thrombolysis

Answer 31

``` CVD Bleed anytime CVD Infract within past year HPN >180/110 Aortic Dissection Active Internal Bleeding ```

Question 32

Aminocaproic Acid, Antiplasmin Drug Competitively inhibits plasminogen activation by inhibiting tPA Prevention and treatment of ACUTE BLEEDING Episodes

Answer 32

Tranexamic Acid

Question 33

Contraindicated in DIC

Answer 33

Tranexamic Acid

Question 34

Endogenous Vitamin Antidote to Warfarin Prevention of hemorrhagic diathesis in NB

Answer 34

Vit K Vit K2 - Menaquinone Vit K3- Menadione -> Never used in Therapeautics Phytomenadione

Question 35

ADH Agonist Vasopressin V2 Receptor AGONIST Increases Factor 8 activity in Haemophilia A and vWF disease

Answer 35

Desmopressin/ Vasopressin