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2a Pharmacology > Haematology > Flashcards

Haematology Flashcards

1
Q

PO Aspirin

MofA

A

Irreversibly inhibits COX –> so decreased thromboxane –> so decreased platelet aggregation

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2
Q

PO Aspirin

Uses

A
  • Long term prevention of cardiovascular, cerebrovascular and peripheral vascular disease
  • 2nd line for emboli/ thrombus in AF (when warfarin=CI)
  • ACS treatment –> rapid inhibition of aggregation can prevent or limit arterial thrombosis
  • Stroke treatment
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3
Q

PO Aspirin

Side effects

A
  • GI irritation (NSAID) or haemorrhage if severe
  • Tinnitus
  • Overdose
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4
Q

PO Aspirin

Contraindications

A
  • Children under 16yrs –> Reye’s syndrome
  • 3rd trimester of pregnancy –> early ductus arteriosus closure
  • Peptic ulceration
  • Gout
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5
Q

PO Aspirin

Interactions

A
  • Acts synergistically with other anti platelet agents (working together to produce enhanced result)
  • Caution if used with anti-coagulants, e.g. if blood thinning disorder
  • Lasts for lifetime of platelet (7-10 days) so discontinue 10 days before surgery
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6
Q

PO Clopidogrel

MofA

A
  • Binds to ADP receptors (P2Y12) on platelets surface, so inhibits aggregation
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7
Q

PO Clopidogrel

Uses

A
  • Long term prevention of cardiovascular, cerebrovascular and peripheral vascular disease
  • 2nd line for emboli/ thrombus in AF (when warfarin=CI)
  • ACS treatment –> rapid inhibition of aggregation can prevent or limit arterial thrombosis
  • Prevents occlusion of coronary artery stents
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8
Q

PO Clopidogrel

Side effects

A
  • Bleeding
  • Thrombocytopenia
  • GI upset
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9
Q

PO Clopidogrel

Contraindications

A
  • Significant active bleeding

- Stop 7 days before elective surgery

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10
Q

PO Clopidogrel

Interactions

A
  • Effects reduced by cytochrome p450 inhibitors (omeprazole, ciprofloxacin, erthryomycin, SSRI’s) since it is a prodrug.
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11
Q

PO Dipyridamole

MofA

A
  • Increases cAMP to inhibit platelet aggregation

- Prolongs the effect of adenosine on blood vessels –> vasodilaton

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12
Q

PO Dipyridamole

Uses

A
  • 1st line therapy following TIA

- 2nd line therapy for ischaemic stroke - when clopidogrel is CI

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13
Q

PO Dipyridamole

Side effects

A
  • Headache
  • Flushing
  • Dizziness
  • GI upset
    (All above from vasodilation)
  • Bleeding
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14
Q

PO Dipyridamole

Contraindications

A
  • Causes vasodilation and tachycardia, so use with caution in HF, IHD, aortic stenosis
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15
Q

PO Dipyridamole

Interactions

A
  • Inhibits cellular uptake of adenosine so prolongs the effect on heart - reduce dose!
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16
Q

SC Heparin

Types

A
  • Unfractioned
  • Low molecular weight, e.g. Dalteparin
  • Fondaparinux
17
Q

SC Heparin

Uses

A
  • Venous thromboembolism prophylaxis
  • DVT and PE treatment
  • ACS treatment
18
Q

SC Heparin

Side effects

A
  • Bleeding
19
Q

SC Heparin

Contraindications

A
  • Clotting disorders
  • Uncontrolled hypertension
  • Recent surgery
  • Renal impairment - LMWH or fondaparinux may accumulate so use lower dose or unfractioned
20
Q

SC Heparin

Interactions

A
  • Combining anti-thrombotic drugs increases the risk of bleeding
  • Special reasons for combined therapy - use of LMWH when initiating warfarin or in ACS
  • Reversal = Protamine
21
Q

Unfractioned Heparin

MofA

A

Activates antithrombin, which inactivates factor Xa and thrombin

22
Q

LMW Heparin

MofA

A

Preferentially factor Xa inhibition

23
Q

Fondaparinux

MofA

A

Factor Xa only

24
Q

PO Warfarin

MofA

A

Inhibits production of Vitamin K-dependent coagulation factors (inhibits Vit-K epoxide reductase)

25
Q

PO Warfarin

Uses

A
  • Prevents clot extension and reocurrence in DVT and PE
  • Prevents embolic complications in AF/ heart valve
    replacement
26
Q

PO Warfarin

Side effects

A
  • Bleeding

- Epistaxis or retroperitoneal haemorrhage if XL

27
Q

PO Warfarin

Contraindications

A
  • Trauma/surgery
  • Liver disease –> less metabolism
  • 1st trimester of pregnancy –> abnormalities, and maternal haem towards term
28
Q

PO Warfarin

Interactions

A
  • Cytochrome p450 inhibitors decreases metabolism so increase bleeding risk
  • Vice versa for p450 inducers –> clots!
  • Reversal = Vitamin K
29
Q

Examples of anti-platelets (3)

A
  • Aspirin (NSAIDs)
  • Clopidogrel
  • Dipyridamole
30
Q

Examples of anti-coagulants (2)

A
  • Heparin

- Warfarin

31
Q

What does DOAC stand for?

A

Direct Acting Anti-Coagulant

32
Q

Examples of DOACS?

A
  • Rivaroxiban

- Apixaban

33
Q

DOAC

MofA

A

Inhibit factor Xa in the clotting cascade

34
Q

DOAC

Benefit

A

Do not need to monitor (INR) when on this

2a Pharmacology (9 decks)

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