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Blood Pharma > Drugs used in Coagulation Disorders > Flashcards

Drugs used in Coagulation Disorders Flashcards

1
Q

Drugs used in clotting disorders

A

Anticlotting (anticoagulant, thrombolytics & antiplatelet)
Drugs that facilitate clotting

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2
Q

Anticoagulant moa

A

Inhibits the formation of fibrin clots

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3
Q

Types of anticoagulant

A

Heparin
Direct thrombin inhibitors
Direct factor Xa inhibitors
Warfarin

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4
Q

Heparin and LMW heparin molecular weight

A

Heparin - 15,000-20,000
LMW heparin - 2000-6000

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5
Q

Heparin route of administration

A

IV or subcutaneously to avoid the risk of hematoma associated with intramuscular injection

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6
Q

LMW heparins

A

Enoxaparin
Dalteparin
Tinzaparin

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7
Q

Heparin mechanism

A

Binds to antithrombin III (ATIII) to inactivate thrombin and factor Xa

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8
Q

Action of heparin is monitored with

A

Activated partial thromboplastin time (aPTT)

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9
Q

Heparin onset of action

A

Rapid (within mins)

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10
Q

Antidote for unfractionated heparin

A

Protamine
(Only partially reverses the effects of LMW heparins and does not effect the action of fondaparinux)

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11
Q

Heparin use in pregnancy

A

Yes

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12
Q

Heparin clinical use

A

When anticoagulation is needed immediately
DVT
Pulmonary embolism
Acute MI

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13
Q

Combination use of heparin

A

Combination with thrombolytics for revascularization
Combination with glycoprotein IIb/IIIa inhibitors during angioplasty and placement of coronary stents

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14
Q

Heparin toxicity

A

Increased bleeding (hemorrhagic stroke)
Thrombocytopenia (HIT)
Osteoporosis (prolonged use of unfractionated heparin)

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15
Q

Direct thrombin inhibitors are based on proteins made by

A

Hirudo medicinalis, the medicinal leech

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16
Q

Direct thrombin inhibitors forms

A

Lepirudin (recombinant)
Desirudin
Bivalirudin
Argatroban
Dabigatran (oral)

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17
Q

Direct thrombin inhibitors mechanism

A

Inhibit both soluble thrombin and the thrombin enmeshed within developing clots

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18
Q

Direct thrombin inhibitors clinical

A

Alternative to heparin
Bivalirudin + asprin for percutaneous coronary angioplasty
Dabigatran for prevention of stroke and systemic embolism in nonvalvular atrial fibrillation

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19
Q

Direct thrombin inhibitors monitoring test

A

aPTT

20
Q

Direct thrombin inhibitors toxicity

A

Bleeding

21
Q

Direct factor Xa inhibitors

A

Rivaroxaban
Apixaban
Edoxaban

22
Q

Direct factor Xa inhibitors monitoring

A

Drugs have fixed oral doses and do not require monitoring

23
Q

Direct factor Xa inhibitors mechanism

A

Directly bind to and inhibit both free factor Xa and factor Xa bound in the clotting complex

24
Q

Direct factor Xa inhibitors clinical

A

Rivaroxaban- prevention and treatment of venous thromboembolism following hip or knee surgery and for prevention of stroke in patients with atrial fibrillation, without valvular heart disease
Apixaban- prevention of embolic stroke in patients with nonvalvular atrial fibrillation

25
Q

Factor Xa inhibitors toxicity

A

Bleeding

26
Q

Warfarin mechanism

A

Inhibits vitamin K epoxide reductase which converts vitamin K epoxide to reduced vitamin K

27
Q

Vitamin K dependent factors

A

Thrombin, factors VII, IX & X

28
Q

Warfarin antidote

A

Vitamin K

29
Q

Effect of warfarin monitored by

A

Prothrombin time PT

30
Q

Warfarin clinical

A

Same as heparin except in preg women

31
Q

Warfarin toxicity

A

Bleeding
Thrombosis early in therapy due to protein C deficiency
Bone defects and haemorrhage in the developing fetus

32
Q

Which drugs reduce warfarin’s anticoagulant effect

A

Cytochrome P450-inducing drugs
(carbamazepine, phenytoin, rifampin, barbiturates)

33
Q

Which drugs increase warfarin’s anticoagulant effect

A

Cytochrome P450-inhibitors
(amiodarone, SSRIs, cimetidine)

34
Q

Thrombolytic agents

A

Tissue plasminogen activator (t-PA)
Streptokinase

35
Q

Plasmin function

A

Degrades clots by splitting fibrin into fragments

36
Q

Thrombolytic agents mechanism

A

Converts plasminogen into plasmin

37
Q

Alteplase clinical

A

Coronary artery thrombosis
Ischemic stroke
Pulmonary embolism

38
Q

Alteplase toxicity

A

Bleeding
Cerebral haemorrhage

39
Q

Platelet aggregation is triggered by

A

Thromboxane
ADP
Thrombin
Fibrin

40
Q

Antiplatelet drugs classification

A

NSAIDs (asprin)
Glycoprotein IIb/IIIa receptor inhibitors (abciximab,tirofiban and eptifibatide)
ADP receptor antagonists (clopidogrel, prasugrel & ticlopidine)
Phosphodiesterase 3 inhibitors (dipyridamole & cilostazol)

41
Q

Drugs used in bleeding disorders

A

Vitamin K
Clotting factors
Antiplasmin agents

42
Q

Vitamin K deficiency treatment

A

Phytonadione (vitamin K1)
Oral or parenteral

43
Q

Hemophilia treatment

A

Fresh plasma
Clotting factors (factor VIII for hemophilia A and factor IX for hemophilia B)

44
Q

Antiplasmin agents clinical

A

Prevention or management of acute bleeding episodes in patients with hemophilia and bleeding disorders

45
Q

Antiplasmin agents

A

Aminocaproic acid
Tranexamic acid

46
Q

Antiplasmin agents toxicity

A

Thrombosis
Hypotension
Myopathy
Diarrhoea

47
Q

Sudden cessation of short acting oral anticoagulant can lead to

A

Stroke

Blood Pharma (3 decks)

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