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PharmSci > Fibrinolytics > Flashcards

Fibrinolytics Flashcards

0
Q

What are the adverse effects of Thrombolytic agents?

A

bleeding complications (systemic fibrinolysis, lysis of normal clots, bleeding often at catheter sites, GI & cerebral hemorrhages may occur)

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1
Q

What do Thrombolytic (Fibrinolytic) Agents treat?

A 
Acute MI
Cerebrovascular thrombotic stroke (stroke caused by clot in brain blood vessel)
Peripheral artery occlusion
deep venous thrombosis 
(DVT) 
pulmonary embolism (PE)
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2
Q 
Which of the following adverse effects is associated with ticlopidine as compared to other antiplatelet agents?
A. Bleeding
B. Gastric Irritation
C. N/V or diarrhea
D. Neutropenia
A

D

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3
Q 
Overdose of heparin is treated with. . . 
A. Vitamin K1
B. Protamine Sulfate
C. Aminocaproic acid
D. Aprotinin

What is the answer’s mechanism of action?

A

B. Protamine Sulfate
Heparin is (-) charged and protamine sulfate is very (+) charged and binds heparin to inhibit it from working
(it also used to make the insulin slow acting formulation)

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4
Q

Which P2Y12 inhibiting drug is NOT a prodrug?

A

Brilinta

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5
Q

Factor IIa

A

Thrombin

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7
Q 
The following agents are administered orally except. . . 
A. warfarin
B. ticagrelor
C. fondaparinux
D. eptifibatide 
E. tenecteplase
F. aspirin
A

C, D, E

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8
Q

How do thrombolytic agents work?

A

Activate plasminogen → plasmin (plasmin degrades fibrin)

they degrade ALL clots (nonspecific)

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9
Q

Because thrombolytic agents are non-specific, what can occur?

A

hemorrhaging

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10
Q

Which fibrinolytic agent is derived from ß-hemolytic streptokinase?

A

streptokinase

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11
Q

Which fibrinolytic agents are derived from recombinant t-Pa?

A

Alteplase (Activase)
Reteplase (Retavase)
Tenecteplase (TNKase)

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12
Q 
What is the half life of Streptokinase?
A. 5 min
B. 10 min
C. 20 min
D. 30 min
A

D. 30 min when given as IV infusion

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13
Q 
What is the half life of Alteplase?
A. 5 min
B. 10 min
C. 20 min
D. 30 min
A

A. 5 min (when given as IV bolus + infusion)

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14
Q 
What is the half life of Reteplase?
A. 5 min
B. 10 min
C. 15 min
D. 20 min
A

C. 15 min when given as 2 IV bolus doses

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15
Q 
What is the half life of Tenecteplase?
A. 5 min
B. 10 min
C. 15 min
D. 20 min
A

D. 20 min when given as an IV bolus dose

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16
Q

Which thrombolytic agent can cause hypotension during infusion?

A

streptokinase

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17
Q

Why is streptokinase rarely used as a thrombolytic agent?

A

Allergic rxns & Bleeding

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18
Q 
[SATA] Which thrombolytic agents are clot specific?
A. Streptokinase
B. Alteplase
C. Reteplase
D. Tenecteplase
A

B, C, D

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19
Q 
Which thrombolytic agent is resistant to PAI?
A. Streptokinase
B. Alteplase
C. Reteplase
D. Tenecteplase
A

D

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20
Q

What is PAI?

A

Plasminogen activator inhibitor

21
Q

How does aminocaproic acid work as a reversal agent?

A

aminocaproic acid works by binding to lysine in the active site on fibrinogen activators and keeps the drug from binding there

22
Q

What are contraindications of thrombolytic agents?

A

trauma injury

history of cerebral hemorrhagic stroke

23
Q 
Tenecteplase (TNKase) causes the \_\_\_\_\_\_\_\_ of blood clots by activating \_\_\_\_\_\_\_\_\_\_. 
A. degradation, protein C
B. degradation, plasminogen
C. formation, fibrinogen
D. formation, thrombin
A

B. degradation, plasminogen

24
Q 
Which of the following adverse effects is associated with ticlopidine use compared to other antiplatelet agents?
	A. bleeding
	B. N/V/D
	C. Gastric irritation
	D. neutropenia
A

D

25
Q

An antiplatelet drug is a member of a class of pharmaceutical agents that ________________.

A

block activation and aggregation of platelets

26
Q 
Overdose of heparin is treated with:
	A. vitamin K1
	B. Protamine sulfate
	C. Aminocaproic acid
	D. aprotinin
A

B

27
Q

How does protamine sulfate work?

A

It is very positively charged and it binds to the negatively charged heparin to keep it from working

28
Q

Which of the following statements regarding the use of ibuprofen by a patient taking low-dose aspirin to prevent a second heart attack is/are true?
A. ibuprofen reduces the antiplatelet effect of aspirin
B. both agents irreversibly inhibit the formation of thromboxane A2 (TXA2)
C. Aspirin should be taken 2 hours before ibuprofen
D. A and C
E. A, B and C

A

D. A & C

29
Q
  1. The syndrome where pts develop antibodies to a hapten created when heparin molecules bind to platelets causing platelet depletion is known as ______________.
A

HIT (heparin-induced thrombocytopenia)

30
Q

What is a hapten?

A

a small molecule that can elicit an immune response only when attached to a large carrier such as a protein; the carrier may be one that also does not elicit an immune response by itself.

31
Q
  1. [SATA] Which of the following agents are used for continued coagulation therapy in a patient that develops HIT?
    A. argatroban
    B. enoxaparin
    C. lepirudin
A

A, C

32
Q 
Which of the following drug::pharmacological target is/are incorrectly paired?
A. argatroban :: thrombin
B. enoxaparin :: antithrombin
C. dabigatran :: factor X
D. warfarin :: vitamin K Reductase 
E. dipyridamole :: P2Y12
F. aspirin :: COX
G. abciximab :: GPIIb/IIIa receptor
A

C, E

33
Q

Name one agent that DIRECTLY targets GPIIb/IIIa receptor.

A

Abciximab

34
Q

Name one agent that targets P2Y12.

A

plavix

35
Q

Name an agent that targets Factor X, IX, and II.

A

Warfarin

36
Q

Name an agent that DIRECTLY targets Factor IIa.

A

. . .

37
Q

Name one agent that INDIRECETLY targets Factor IIa.

A

. . .

38
Q

Name an agent that DIRECTLY targets factor Xa.

A

xarelto (rivaroxiban), eliquis (apixaban), pradaxa (dabigatran)

39
Q

Name an agent that INDIRECTLY targets factor Xa.

A

heparin
LMWH
Fondaparinux

40
Q

Name an agent that activates tPA.

A

streptokinase

41
Q 
The following agents are administered orally except: 
	A. warfarin
	B. ticagrelor
	C. eptifibatide
	D. tenecteplase
	E. aspirin
A

C, D

42
Q

What does tPA do?

A

Catalyzes the conversion of plasminogen to plasmin

43
Q

What does plasmin do?

A
  • Degrades fibrin clots
  • Degrades fibrinogen, Factor V & Factor VIII in the blood
  • Does not discriminate between pathologic & normal clots
44
Q

tPA is most effective when bound to _____ ______

A

fibrin mesh

45
Q

t-PA is inhibited by ___________.

A

Plasminogen Activator Inhibitor (PAI)

46
Q

What increase the release of plasminogen activator inhibitor (PAI)?

A

Thrombin and inflammatory cytokines increase the release of PAI

47
Q

What inactivates circulating plasmin?

A

Alpha-2-antiplasmin

48
Q

How does Vorapaxar work?

A

blocks PAR-1 and keeps thrombin from activating platelets

PharmSci (12 decks)

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