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Pharmacology > Haematological drugs > Flashcards

Haematological drugs Flashcards

1
Q

Aspirin

A

COX inhibitor

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2
Q

Aspirin MoA

A
  • Blocks conversion of arachidonic acid to thromboxane A2, PGE2, PGI2 and PGF2 - this stops platelet aggregation
  • Low-dose:
    • This will inhibit platelet aggregation via thromboxane A2 - will not affect PGI2, PGE2, PGF2
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3
Q

Contraindications for aspirin

A
  • NSAIDs
  • Warfarin
  • Low vitamin K
  • Anaemia
  • Haemophilia
  • vWF disease
  • Low platelets
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4
Q

Indications for aspirin

A
  • Prevention of stroke
  • Prevention of MI
  • Post MI
  • Post surgery
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5
Q

Adverse effects of aspirin

A
  • GI irritation
  • Asymptomatic blood loss
  • Increased bleeding time
  • Overdose
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6
Q

Clopidogrel

A

P2Y12 antagonist

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7
Q

Clopidogrel MoA

A
  • Inhibits ADP-induced activation of platelets by inhibiting ADP binding to the platelet P2Y12 receptor - prolongs bleeding time
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8
Q

Contraindications of clopidogrel

A
  • Clotting disorder
  • Thombotic thrombocytopenia purpura
  • Stomach/intestinal ulcer/bleeding
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9
Q

Indications for clopidogrel

A
  • Prevention of thromboembolism atrial fibrillation
  • Symptomatic carotid artery stenosis
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10
Q

Clopidogrel adverse effects

A
  • Bleeding
  • Diarrhoea
  • Rash
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11
Q

What are abciximab and tirofiban?

A

They are glycoprotein 2b/3a antagonists

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12
Q

Abciximab and tirofiban MoA

A
  • Block receptor of glycoprotein 2b and 3a which stops fibrinogen binding to platelets - no clot can be formed
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13
Q

Abciximab and tirofiban adverse effects

A
  • Nausea
  • Vomiting
  • Back pain
  • Vision changes
  • Stomach upset
  • Abdominal pain
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14
Q

What is heparin?

A

Anti-thrombin III accelerator

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15
Q

Heparin MoA

A
  • Binds to antithrombin III to accelerate activity and to inhibit factors 2, 9, 10, 12
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16
Q

Contraindications for heparin

A
  • Heparin-induced thrombocytopenia
  • Active bleeding
  • Bleeding disorders
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17
Q

Indications for heparin

A
  • Acute treatment
  • Pregnant woman
  • VTE prevention
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18
Q

Heparin adverse effects

A
  • Bleeding, haemorrhage, bruising
  • Epistaxis, melena
  • Hyperkalaemia
  • Thrombocytopenia

NOTE: antidote = protamine

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19
Q

What are dalteparin and enoxaparin?

A

Low-molecular weight heparins; antithrombin III accelerator

20
Q

Contraindications of dalteparin and enoxaparin

A
  • Active major bleeding
  • Hx of heparin-induced thrombocytopenia
21
Q

Indications for dalteparin and enoxaparin

A
  • DVT prophylaxis
  • Treatment of VTE in pregnancy
  • Treatment of DVT in pregnancy
22
Q

Dalteparin and enoxaparin adverse effects

A
  • Bleeding, haemorrhage, bruising
  • Epistaxis, melena
  • Hyperkalaemia
  • Thrombocytopenia
23
Q

What is warfarin?

A

Vitamin K antagonist

24
Q

Warfarin MoA

A
  • Inhibits vit K to inhibit hepatic production of 2, 7, 9, 10
25
Q

Warfarin contraindications

A
  • Alcoholism
  • Pregnancy (teratogen)
  • Oesophageal varices
26
Q

Warfarin indications

A
  • Atrial fibrillation
  • Venous thromboembolism
  • Prosthetic heart valve
27
Q

Warfarin adverse effects

A
  • Bleeding
  • Teratogenicity
  • Red/brown urine
  • Black/bloody stool
  • Coughing/vomiting blood
28
Q

What is dabigatran?

A

Direct thrombin inhibitor

29
Q

Dabigatran MoA

A
  • Binds directly and reversibly to active site of free and fibrin-bound thrombin
  • Prevents conversion of fibrinogen to fibrin and stops a stable clot forming
30
Q

Dabigatran contraindications

A
  • Pregnancy
  • Breastfeeding
  • Bleeding disorders
  • Active bleeding
31
Q

Dabigatran indications

A
  • DVT
  • Pulmonary embolism
  • Reduce risk of DVT and PE reccurrence
32
Q

Dabigatran adverse effects

A
  • Gastritis
  • Dyspepsia
  • GI bleeding
  • Increased liver enzymes and bilirubin
33
Q

Rivaroxiban MoA

A

It is a factor 10a inhibitor - blocks commencement of the common pathway

34
Q

What is alteplase?

A

It is a recombinant human tissue plasminogen activator

35
Q

Alteplase MoA

A
  • Binds to fibrin-bound plasminogen and catalyses its conversion to protease plasmin
  • This dissolves the clots and inhibits factors V, VIII and fibrinogen
36
Q

Alteplase contraindications

A
  • Disease states with increased bleeding risk
  • Severe active bleeding disorders
37
Q

Alteplase indications

A
  • Pulmonary embolism
  • Myocardial infarction (STEMI)
  • Ischemic stroke
38
Q

Alteplase adverse effects

A
  • Bleeding
  • GI bleeding
  • Genitourinary bleeding
  • Bruising
  • Epistaxis
  • Hypotension
  • Dizziness, fever, nausea, vomiting
  • Stroke
39
Q

What is streptokinase?

A

It is a fibrinolytic

40
Q

Streptokinase MoA

A
  • Will bind to plasminogen and promotes to cleavage of the peptide to form the proteolytic enzyme plasmin
41
Q

Streptokinase contraindications

A
  • Active internal bleeding
  • Recent cerebrovascular accident
  • Intracranial neoplasm
  • Severe uncontrolled hypotension
42
Q

Streptokinase indications

A
  • AMIs
  • PE
  • DVT
  • Arterial thrombosis or embolism
  • Occlusion of arteriovenous cannula
43
Q

Streptokinase adverse effects

A
  • Nauseas
  • Headache
  • Dizziness
  • Hypotension
  • Mild fever
  • Bleeding
  • Rash
  • Itching
44
Q

Tranexamic acid MoA

A
  • It is an anti-fibrinolytic
  • Works by inhibiting plasmin to stop the breakdown of the clot
  • Also stops inhibition of factors V and VIII
45
Q
A

Pharmacology (10 decks)

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