Hem/onc pharm Flashcards
activates anti thrombin, decr thrombin & factor Xa
use: immediate anti coag for PE, acute coronary syndrome, MI, DVT
ok with pregnancy
monitor PTT
heparin
inhibit thrombin directly
altn to heparin for anti coag in pt with heparin induced thrombocytopenia
argatroban, bivalirudin, dabigatran
interferes with gamma carboxyl of vitK dependent factors 2, 7, 9, 10 & protein C & S
increases PT
use: chronic anti coag, a-fib, not for pregnant
warfarin
reversal of heparin
protamine sulfate
reversal of warfarin
vitK, FFP
apixaban, rivaroxaban
use: tx & prophyl of DVT & PE, stroke prophyl in a-fib
direct factor Xa inhibitors
alteplase, reteplase, streptokinase, tenecteplase
thrombolytics (clot busters)
direct or indirectly aid conversion of plasminogen to plasmin - cleaves thrombin & fibrin clots
increases PT & PTT, no change in platelet count
use: early MI, early ischemic stroke, thrombolysis of severe PE
thrombolytic MOA
irreversibly inhib COX1 & COX2 via covalent acetylation - effects last until new platelets made
incr bleeding time, lowers TXA2, lowers PGs
use: anti pyretic, analgesic, anti inflam, anti platelet aggreg
aspirin
inhib platelet aggregation via irreversibly blocking ADP receptors - prevent expression of GpIIb/IIIa on platelet surface
use: acute coronary syndrome, coronary stenting, decr incidence of thrombotic stroke
ADP receptor inhibitors: clopidogrel, prasugrel, ticagrelor, ticlopidine
phosphodiesterase III inhibitor, incr cAMP in platelets - inhib platelet aggreg; vasodilators
use: intermittent claudication, coronary vasodilation, prevent stroke or TIA, angina prophyl
cilostazol, dipyridamole
bind to GpIIb/IIIa on activated platelets to prevent aggregation
use: unstable angina, percutan transluminal coronary angioplasty
GpIIa/IIIa inhibitors: abciximab, eptifibatide, tirofiban
abciximab - made from MoAb Fab fragments
