Drugs Used In Coagulation Disorders Flashcards
Antiaggregants
PGI-2
cAMP
Adenosine
Causes vasoconstriction (hemostasis)
TXA2
Endothelin
Clotting factors involved in intrinsic pathway
5 8 9 10 11 12 Prothrombin Fibrinogen
Clotting factors involved in extrinsic pathway
5 7 10 Prothrombin Fibrinogen
Used for the treatment of venous thromboses
Heparin
Warfarin
Used for the treatment of arterial thromboses
Antiplatelets
MOA of aspirin
Nonselective, irreversible COX inhibitor
Prophylaxis of choice for the prevention of arterial thrombosis
Aspirin
Toxic dose of aspirin
150mg/kg
Lethal dose of aspirin
500mg/kg
Triad of aspirin hypersensitivity
SAMTER TRIAD
Asthma
Aspirin sensitivity
Nasal polyps
Expected acid-base abnormality in salicylate poisoning
Respiratory alkalosis with HAGMA
Glycoprotein IIb/IIIa inhibitors
Abciximab
Eptifibatide
Tirofiban
ADP inhibitors
Clopidogrel
Ticlopidine
Prasugel
PDE III inhibitors
Dipyridamole
Cilostazole
Anticoagulants
Heparin
Direct thrombin inhibitor
Warfarin
Function of antithrombin III
Inactivates thrombin and factor Xa
Used during PCI to prevent thrombosis
GP IIb/IIIa inhibitors (inhibits platelet aggregation
Used for the prevention of restenosis after PCI
ADP inhibitors (reduces platelet aggregation)
Causes TTP
Ticlopidine
Used for the prevention of thromboembolic complications of cardiac valve replacement
PDE III inhibitors
Used for the management of intermittent claudication
Cilostazol
Cilostazol is contraindicated in patients with?
Heart failure
2 major types of anticoagulants
Indirect thrombin inhibitors
Direct thrombin inhibitors
Indirect thrombin inhibitors
Heparin
Enoxaparin (LMWH)
Lepirudin
Direct thrombin inhibitors
Coumarin derivatives (warfarin)
Anticoagulant of choice in pregnancy
Heparin
MOA of heparin
Activates antithrombin III
Antidote for heparin toxicity
Protamine sulfate
LMWHs
Enoxaparin Dalteparin Tinzaparin Danaparoid Fondaparinux
MOA of LMWH
Binds and potentiates effect of antithrombin III on factor Xa (more selective); less effect on thrombin
Does not require aPTT monitoring
LMWH
MOA of lepirudin
Binds to thrombin’s active site and inhibits its enzymatic action
Anticoagulant of choice in patients with HIT
Lepirudin
Desirudin
Bivalirudin
Argatroban
MOA of warfarin
Inhibits vitamin K epoxide reductase
Used for chronic anticoagulation (DVT, afib, valve replacement) except in pregnancy
Warfarin
Antidote for warfarin toxicity
Vitamin K (slow) FFP (fast)
Effect of CP450 inducers on warfarin
Reduce anticoagulant effect
Effect of CP450 inhibitors on warfarin
Increase anticoagulant effect
Fibrinolytic drugs are used mainly for the treatment of?
Acute MI
Ischemic stroke
Massive pulmo embo
tPA analogs (covert plasminogen to plasmin)
Alteplase Anistreplase Reteplase Streptokinase Tenecteplase Urokinase
Antidote for tPA analog toxicity
Aminocaproic acid
MOA of aminocaproic acid and tranexamic acid
Competitively inhibits plasminogen activation
Aminocaproic acid and tranexamic acid are contraindicated in?
DIC
GU bleeding
Used for hemophilia A, vWF disease, and Central DI
Demopressin
Proaggregants
TXA2
5-HT
ADP