Drugs for PAD and DVT Flashcards
1
Q
cilostazol
A
- PDE-III inhibitor
- prolongs life of cAMP
- inhibits platelet aggregation and vasodilates
- used for intermittent claudication
- DO NOT use in pts w/ HF
2
Q
heparin (unfractionated)
A
- pentasaccharide that activates antithrombin III to inhibit Factor Xa and Thrombin
- prevents formation of RED CLOTS
- must be given parenterally due to negative charge
- monitor levels via aPTT
- risk of HIT, and contraindicated in thrombocytopenia, or surgery involving eye, brain, or spinal cord
3
Q
enoxaparin (low MW heparin)
A
- shortened heparin
- can only inhibit Factor Xa
- prevents formation of RED CLOTS
- used in prevention of DVT after abdominal surgery or hip/knee surgery, and for prevention of ischemic complications of MI
- risk if HIT
4
Q
fondaparinux
A
- synthetic pentasaccharide
- selectively inhibits Factor Xa
- blocks coagulation by preventing conversion of prothrombin to thrombin
- used in preventing DVT, treatment of PE w/ warfarin,
- very long t1/2
- risk of IRREVERSIBLE bleeding
5
Q
bivalirudin
A
- synthetic 20 aa peptide, similar to hirudin
- REVERSIBLY inhibits thrombin
- can be given w/ aspirin for pts undergoing coronary angioplasty
- must be given IV
6
Q
argatroban
A
- thrombin inhibitor
- directly binds to catalytic site of thrombin
- used in treatment and prophylaxis of thrombosis in pts with HIT, and pts undergoing PCI who are at risk for HIT
- treatment monitored by aPTT
7
Q
warfarin
A
- vitamin K antagonist
- inhibits VKORC1
- decreases production of Ca+ depentdent clotting factors: Factor II, VII, IX, X and proteins c and s
- used for prophylaxis of thrombosis in aFib and mech heart valves
- orally active, and eliminated by liver in bile
- monitored with INR
- risk of bleeding
- many drug interactions, and varying metabolism in different races
- effects are slow on and slow off
8
Q
rivaroxaban, apixaban, edoxaban
A
- direct inhibitor of activated factor X
- used in prevention of DVT and PE after or hip/knee surgery, and prevention of stroke in pts with aFib
- administered orally
- major risk of bleeding, should be avoided in pts with renal/hepatic impairment
- interacts with CYP3A4
9
Q
dabigatran
A
- reversible direct thrombin inhibitor
- used in prevention of stroke in pts with aFib
- risk of bleeding
- competes at P-glycoprotein so metabolism may vary
10
Q
protamine sulfate
A
-antidote for unfractionated and LMW heparins
11
Q
vitamin K
prothrombin complex concentrate
A
-antidotes for warfarin
12
Q
andexanet alfa
A
-antidote for factor Xa inhibitors
rivaroxaban, apixaban, endoxaban
13
Q
idarucizumab
A
-antidote for dabigatran (direct thrombin inhibitors)
