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PH 113 - Pharmacology 1 > FINAL 01 - Drugs for Coagulation Disorders > Flashcards

FINAL 01 - Drugs for Coagulation Disorders Flashcards

1
Q

Refers to the prevention of blood loss

A

Hemostasis

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2
Q

3 stages of platelet plug formation (AAA)

A

Adhesion, Activation, Aggregation

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3
Q

When the endothelium is injured, platelets adhere to collagen in the tissues and to a protein called ___________ that leaks into the traumatized tissue from the plasma (Platelet adhesion phase - platelet plug formation)

A

von Willebrand factor (vWF)

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4
Q

Involves morphologic changes in platelets; release of platelet granules adenosine diphosphate (ADP), TXA2, serotonin, platelet-activation factor (PAF), and thrombin (Platelet plug formation phase)

A

Platelet activation

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5
Q

___________, a soluble plasma GP, simultaneously binds to GP IIb/IIIa receptors on two separate platelets, resulting in platelet cross-linking and platelet aggregation (Platelet aggregation - platelet plug formation phase)

A

Fibrinogen

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6
Q

The clot begins to develop in __________ to __________ seconds if the trauma to the vascular wall has been severe (Formation of blood clot)

A

15-20

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7
Q

The clot begins to develop in __________ to __________ minutes if the trauma has been minor (Formation of blood clot)

A

1-2

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8
Q

Within __________ to __________ minutes after rupture of a vessel, if the vessel opening is not too large, the entire opening or broken end of the vessel is filled with clot (Formation of blood clot)

A

3-6

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9
Q

After __________ minutes to an hour, the clot retracts and this closes the vessel still further (Formation of blood clot)

A

20

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10
Q

Substances that promote coagulation

A

Procoagulants

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11
Q

Substances that inhibit coagulation

A

Anticoagulants

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12
Q

Clotting factor I to XIII are __________

A

Procoagulants

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13
Q

Protein C and S are __________

A

Anticoagulants

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14
Q

Plasminogen is a __________

A

Fibrinolytic

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15
Q

Begins with a traumatized vascular wall or traumatized extravascular tissues that come in contact with the blood (Coagulation cascade pathways)

A

Extrinsic pathway

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16
Q

Begins with trauma to the blood itself or exposure of the blood to collagen from a traumatized blood vessel wall (Coagulation cascade pathways)

A

Intrinsic pathway

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17
Q

Activated by damage to the inside of blood vessels (Coagulation cascade pathways)

A

Intrinsic pathway

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18
Q

Have fewer steps; occurs rapidly (in seconds) (Coagulation cascade pathways)

A

Extrinsic pathway

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19
Q

Activated by damage to the outside of blood vessels (Coagulation cascade pathways)

A

Extrinsic pathway

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20
Q

The final pathway where both the intrinsic and extrinsic pathways converge (Coagulation cascade pathways)

A

Common pathway

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21
Q

Extrinsic pathway activates clotting factor X which combines with factor V in the presence of Ca2+ to form the active enzyme __________

A

Prothrombinase

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22
Q

More complex; occurs more slowly (in minutes) (Coagulation cascade pathways)

A

Intrinsic pathway

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23
Q

__________ is a plasma protein that inhibits coagulation factors of the intrinsic and common pathways

A

Antithrombin

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24
Q

____________ are synthesized by endothelial cells and stimulate the activity of antithrombin

A

Heparan sulfate proteoglycans

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25
Blood clot can become invaded by __________, which subsequently form connective tissue all through the clot
Fibroblasts
26
The process of fibrin digestion by the fibrin-specific protease, plasmin (fibrinolysin)
Fibrinolysis
27
Fibrinolysis is the process of fibrin digestion by the fibrin-specific protease, __________
Plasmin (fibrinolysin)
28
An abnormal clot that develops in a blood vessel
Thrombus
29
An abnormal clot flowing with the blood
Embolus
30
Leads to the tendency to form thrombi (Risks for venous thromboembolism)
Inherited disorders
31
Includes atrial fibrillation, prolonged bed risk, high-risk surgical procedures, cancer, and antiphospholipid antibody syndrome (Risks for venous thromboembolism)
Acquired disease
32
Drugs that inhibit either the action of the coagulation factors or interfere with the synthesis of the coagulation factors
Anticoagulants
33
Exerts antithrombotic effect via antithrombin (Indirect thrombin inhibitors)
Heparins
34
A glycosylated, single-chain polypeptide that inhibits clotting factor proteases by forming equimolar stable complexes with them; targeted by heparins
Antithrombin
35
Catalyzes inhibition of coagulation proteases by antithrombin by 1000-fold (Types of heparin)
Unfractionated heparin
36
Initial treatment of venous thrombosis and pulmonary embolism because of rapid onset of action (Types of heparin)
Unfractionated heparin
37
DOC for anticoagulation in pregnancy (Types of heparin)
Unfractionated heparin
38
Antidote for unfractionated heparin
Protamine sulfate
39
A highly basic, positively charged peptide that combines with negatively charged heparin; an antidote for unfractionated heparin toxicity
Protamine sulfate
40
LOVENOX (Low molecular-weight heparin drug)
Enoxaparin
41
FRAGMIN (Low molecular-weight heparin drug)
Dalteparin
42
INNOHEP, others (Low molecular-weight heparin drug)
Tinzaparin
43
NORMIFLO (Low molecular-weight heparin drug)
Ardeparin
44
FRAXIPARINE (Low molecular-weight heparin drug)
Nadroparin
45
CLIVARINE (Low molecular-weight heparin drug)
Reviparin
46
Catalyzes inhibition of factor Xa by antithrombin (Types of heparin)
Low molecular-weight heparin (LMWH)
47
Used for prevention of venous thromboembolism and treatment of venous thrombosis, pulmonary embolism, and unstable angina (Types of heparin)
Low molecular-weight heparin (LMWH)
48
A synthetic heparin derivative that mediates inhibition of factor Xa by antithrombin (Types of heparin)
Fondaparinux (Arixtra)
49
A synthetic heparin derivative used for thromboprophylaxis of patients undergoing hip or knee surgery (Types of heparin)
Fondaparinux (Arixtra)
50
A recombinant derivative of hirudin, a direct thrombin inhibitor present in the salivary glands of the medicinal leech (Direct thrombin inhibitors)
Lepirudin (Refludan)
51
Used for treatment in patients with HIT (Direct thrombin inhibitors)
Lepirudin (Refludan)
52
A synthetic, 20-amino-acid polypeptide that directly inhibits thrombin (Direct thrombin inhibitors)
Bivalirudin (Angiomax)
53
Used as an alternative to heparin in percutaneous coronary angioplasty (Direct thrombin inhibitors)
Bivalirudin (Angiomax)
54
A synthetic compound based on the structure of L-Arg; binds reversibly to the catalytic site of thrombin (Direct thrombin inhibitors)
Argatroban
55
Used as an alternative to lepirudin for prophylaxis or treatment of patients with or at risk of developing HIT (Direct thrombin inhibitors)
Argatroban
56
Binds to the active site of thrombin (Direct thrombin inhibitors)
Dabigatran etexilate mesylate
57
Used for prevention of stroke and systemic embolism in patients with atrial fibrillation (Direct thrombin inhibitors)
Dabigatran etexilate mesylate
58
Antidote for dabigatran etexilate mesylate toxicity
Idarucizumab
59
Humanized monoclonal antibody Fab fragment that binds to dabigatran and reverses the anticoagulant effect; approved for use in emergent surgery
Idarucizumab
60
Natural form (Vitamin K antagonists)
Bishydroxycoumarin
61
Synthetic derivative (Vitamin K antagonists)
Dicoumarol
62
Drug coined by Wisconsin Alumni Research Foundation, with "arin" coming from coumarin (Vitamin K antagonists)
Warfarin (Coumadin)
63
Used for prophylaxis and treatment of thrombotic disease (Anticoagulant drugs)
Vitamin K antagonists
64
Antidote for vitamin K antagonist toxicity
Vitamin K1 (phytonadione) (PO, IV)
65
Blocks the active site of factor Xa (Anticoagulant drugs)
Xa inhibitors
66
Used for the prevention of venous thromboembolism following hip or knee surgery (Anticoagulant drugs)
Xa inhibitors
67
Drugs that inhibit platelet function
Antiplatelets
68
Its MOA is irreversible acetylation of COX-1 (Antiplatelet drugs)
Aspirin
69
Used as primary prophylaxis of myocardial infarction and secondary prevention of vascular events (Antiplatelet drugs)
Aspirin
70
Irreversibly inhibit the binding of ADP to its receptors on platelets; inhibit the activation of GP IIb/IIIa receptors (Antiplatelet drugs)
ADP-induced platelet aggregation inhibitors
71
Ticlopidine, clopidogrel, prasugrel, and ticagrelor are examples of __________ (Antiplatelet drugs)
ADP-induced platelet aggregation inhibitors
72
Used for prevention of stroke in patients with a history of a transient ischemic attack (Examples of ADP-induced platelet aggregation inhibitors)
Ticlopidine
73
Used for patients with unstable angina or non-ST-elevation acute myocardial infarction (NSTEMI) (Examples of ADP-induced platelet aggregation inhibitors)
Clopidogrel
74
Is a receptor for fibrinogen and von Willebrand factor
GP IIB/IIIA
75
Abciximab, eptifibatide, and tirofibam are examples of __________ (Antiplatelet drugs)
GP IIB/IIIA blockers
76
Used in conjunction with percutaneous angioplasty for coronary thromboses (Examples of GP IIB/IIIA blockers)
Abciximab
77
Used for treatment of acute coronary syndrome and for angioplastic coronary interventions (Examples of GP IIB/IIIA blockers)
Eptifibatide
78
Has efficacy in non-Q-wave myocardial infarction and unstable angina (Examples of GP IIB/IIIA blockers)
Tirofiban
79
A vasodilator that inhibits platelet function by inhibiting adenosine uptake and phosphodiesterase activity; used in combination with warfarin and aspirin (Antiplatelet drugs)
Dipyridamole
80
A newer phosphodiesterase inhibitor that promotes vasodilation and inhibition of platelet aggregation; used as treatment of intermittent claudication (Antiplatelet drugs)
Cilostazol
81
Drugs that rapidly lyse thrombi by catalyzing the formation of plasmin from its precursor zymogen, plasminogen
Fibrinolytics
82
Synthesized by Group C beta-hemolytic streptococci (Examples of fibrinolytics)
Streptokinase
83
Used in acute pulmonary embolism, deep vein thrombosis, and acute myocardial infarction (Examples of fibrinolytics)
Streptokinase
84
A human enzyme synthesized by the kidney that directly converts plasminogen to active plasmin (Examples of fibrinolytics)
Urokinase
85
Used for lysis of pulmonary emboli (Examples of fibrinolytics)
Urokinase
86
Anisoylated plasminogen streptokinase activator complex (APSAC); considered to be a prodrug (Examples of fibrinolytics)
Anistreplase
87
Includes alteplase, reteplase, and tenecteplase; are examples of fibrinolytics
Tissue plasminogen activators (t-PAs)
88
Recombinant human t-PA (Examples of tissue plasminogen activators)
Alteplase
89
Another recombinant human t-PA from which several amino acid sequences have been deleted (Examples of tissue plasminogen activators)
Reteplase
90
Mutant form of t-PA that has a longer half-life (Examples of tissue plasminogen activators)
Tenecteplase
91
Preferentially activate plasminogen that is bound to fibrin (Examples of fibrinolytics)
Tissue plasminogen activators (t-PAs)
92
Used for treatment of myocardial infarction, massive pulmonary embolism, and acute ischemic stroke (Examples of fibrinolytics)
Tissue plasminogen activators (t-PAs)
93
A synthetic inhibitor of fibrinolysis (Examples of antifibrinolytics)
Aminocaproic acid
94
An analog of aminocaproic acid and has the same properties; 10x more potent (Examples of antifibrinolytics)
Tranexamic acid (Hemostan)
95
A serine protease inhibitor that inhibits fibrinolysis by free plasmin (Examples of antifibrinolytics)
Aprotinin
96
Drugs used for adjunctive therapy in hemophilia and therapy for bleeding from fibrinolytic therapy
Antifibrinolytics
97
Disorders that may have their origin in naturally occurring pathologic conditions or as a result of fibrinolytic states
Bleeding disorders
98
Fat soluble substance found primarily in leafy green vegetables (Treatment for bleeding disorders)
Vitamin K
99
Also known as phytonadione; found in food (Natural forms of vitamin K)
Vitamin K1
100
Also known as menaquinone; synthesized by intestinal bacteria (Natural forms of vitamin K)
Vitamin K2
101
Is administered to all newborns and used for warfarin toxicity (Treatment for bleeding disorders)
Vitamin K
102
Used in hemophilia (Treatment for bleeding disorders)
Plasma fractions
103
Bleeding disorder that results from a congenital deficiency in a plasma coagulation protein
Hemophilia
104
Plasma fraction that contains all clotting factors
Fresh frozen plasma
105
Plasma fraction that contains fibrinogen, factor VIII, vWF, and factor XIII
Cryoprecipitate
106
Used for factor VII deficiency (Treatment for bleeding disorders)
Recombinant factor VIIa
107
Starts with tissue factor (Factor III) (Coagulation cascade pathways)
Extrinsic pathway
108
Starts with Hageman factor (Factor XII) (Coagulation cascade pathways)
Intrinsic pathway
109
Intrinsic and extrinsic pathways end with __________
Factor X (Stuart-Prower factor)
110
Common pathway starts with the formation of __________ from intrinsic and extrinsic pathways
Prothrombinase
111
Clotting factors X, IX, XII, and II are all part of the __________ group
Prothrombin
112
Triad that refers to the factors that contribute to thrombosis
Virchow's triad
113
3 factors under Virchow's triad (SEH)
Stasis, Endothelial injury, Hypercoagulability
114
__________ inhibits factor IIa, IXa, and Xa (Indirect thrombin inhibitors)
Heparin
115
2 source of unfractionated heparin (PB)
Porcine intestinal mucosa, Bovine lung
116
Quantity of heparin that prevents 1 mL of citrated sheep plasma from clotting for 1 hour
USP unit
117
DOc for surgery requiring cardiopulmonary bypass or percutaneous coronary intervention (balloon angioplasty or stent replacement) (Indirect thrombin inhibitots)
Heparin
118
Resistance wherein there is a failure to achieve therapeutic aPTT with daily doses of >35,000 U
Heparin resistance
119
Therapeutic anti-factor Xa but subtherapeutic aPTT (Types of heparin resistance)
Pseudoresistance
120
Subtherapeutic anti-factor Xa and aPTT (Types of heparin resistance)
True resistance
121
Occurs 5-10 days after initiation of heparin therapy; is a hypercoagulable state
Heparin-induced thrombocytopenia (HIT)
122
DOC for cancer-associated venous thromboembolism (Indirect thrombin inhibitors)
Low molecular weight heparin (LMWH)

PH 113 - Pharmacology 1 (22 decks)

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