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Pharmacology 3 > End of Misc Cardiac > Flashcards

End of Misc Cardiac Flashcards

1
Q

what is the father of anti platelets

A

aspirin

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2
Q

name the two first generation anti platelet drugs

A

Ticlopidine

Clopridogrel

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3
Q

adverse effects of ticlopidine

A

neutropenia

thrombocytopenia

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4
Q

what a/e with clopidogrel?

A

potential Proton pump inhibitor interaction, results in reduced efficacy

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5
Q

what are the 2nd generation anti platelet agents?

A

prasurgel

ticagrelor

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6
Q

what is the benefit of prasugrel?

A

no ppi interactions

QD

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7
Q

benefit of ticagrelor

A

BID
faster shorter so quicker reversibility if you have to take the patient to surgery.

SHORT ON SHORT OFF

NO PPI interaction

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8
Q

Unfractioned Heparin
derived from what?
activated what?
administered how?

A

porcine derived
activates antithrombin 3
inhibits 9a 10a 12a
IV or SQ ONLY (no po)

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9
Q

indications for unfractioned heparin?

A

venous thrombosis
pulmonary embolism
bridge to warfarin
other cardiovascular disease states

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10
Q

how do you monitor unfractioned heparin?

A

aPTT

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11
Q

does unfractioned heparin used in pregnant patients?

A

yes does not cross placenta

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12
Q

standard dose of unfractioned heparin

A

80 u /kg load

18 u/kg/he

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13
Q

what are the two indications for anti platelet agents

A

post stent

stroke

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14
Q

What is unfractioned heparin antidote?

A

IV protamine (1 mg for every 80-100 units of heparin)

Beware! salmon semen (allergy risk)

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15
Q

What is the risk with unfractioned heparin?

A

Heparin induced thrombocytopenia (HIT)
decreased platelets when heparin binds to platelet, body immune system destroys it

Under 100K worry, Under 50K bad

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16
Q

How is LMWH administered? Eliminated?

A

SQ

Renal elimination

17
Q

Whats the benefit of LMWH?

A

more predictable

18
Q

Use caution in what patients for LMWH?

A

> 150 kg, standard dose not standard

Pregnant patients- more likely to cross placenta

19
Q

What is LMWH antidote?

A

IV Protamine

*only blocks 60% of anti Xa activity

20
Q

What is Nesiritide used for? Administered how? Caution with what? What is it?

A

IV
Acute decompensated CHF with dyspnea at rest
Peptide so do not shake preparation
B-type natriuretic peptide analogue, so increases concentration of peptides

21
Q

How does dopamine effect the body? 3 things

A 
Renal artery vasodilation (increases urine)
B1 agonist (treat bradycardia, CHF)
A1 agonist (vasoconstricts, treat hypotension)

positive inotrope

22
Q

What are doses for R B A?

A

2-5 mcg/kg/min
5-10 mcg/kg/min
>10 mcg/kg/min

23
Q

What is dobutamine? used for what?

A

B1 agonist

decompensated CHF

24
Q

Glycoprotein IIB & IIIA antagonists are administered how?

A

UV

25
Q

Glycoprotein IIB & IIIA antagonists do what?

A

Block the FINAL common pathway to platelet aggregation

26
Q

Are GP IIB / IIIA antagonissts more or less potent that ASA or clopidogrel?

A

MORE

ASA- cox
Clopidogrel- ADP

these block both

27
Q

Indications for GP IIb/IIIa antagonists?

A

Acute coronary syndrome

Adjuncts in Percutaneous transluminal angioplasty

28
Q

What is risk with GP IIb/IIIa antagonists?

A

bleeding

29
Q

What is the purpose of plasminogen activators?

A

dissolve acute thrombi

30
Q

What is plasmin?

A

potent endogenous fibrinolytic enzyme (dissolves clots)

31
Q

TPAs dissolve what?

A

normal and pathologic thrombi

32
Q

TPAs are an alternative to what?

A

angioplasty

33
Q

How is TPA administered?

A

IV bolus or continuous infusion

Earlier administration is best (within 4h of onset)

34
Q

Contraindications for TPA?

A 
Intercranial hemorrhage
Intercranial trauma
Brain tumors
Major surgeries in last 30 days of thorax/abdomen
major GI bleeding

these patients will bleed out

35
Q

TPA precautions in what patients?

A

pregnancy
recent surgery
HTN (>180 or >100)
Advanced age

36
Q

What do TPAs end in?

A

“-eplase”

except for streptokinase

Pharmacology 3 (10 decks)

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