Hematological Agents I and II

Question 1

Where does the E1 site on thrombin bind?

Answer 1

Binds to fibrin!

Question 2

What specific effect does aspirin block that prevents platelet activation?

Answer 2

Aspirin reduces thromboxane A2 production leading to reduced aggregation.

Question 3

What is the use of the drug dipyridamole when given with Warfarin?

Answer 3

This drug prevents the embolization from mechanical heart valves when given with warfarin.

Question 4

Describe the drugs Clopidogrel and prasurgrel as well as Tocagrelor and Cangrelor?

Answer 4

These grelor drugs are p2Y12 antagonists.

Clopidogrel and prasurgrel must be activated by the liver first.

Tocagrelor and Cangrelor both do not need to be activated by the liver.

Question 5

What are the use of the drugs Abciximab and eptifibatide?

Answer 5

These are adjunct tools to be used in anticoagulant therapy to prevent ischemic complications.

Question 6

How does Abciximab work?

Answer 6

This works by preventing GPIIb/IIIa interactions!

This prevents platelet binding stopping fibrinogen cross-bridges from forming between platelets.

Question 7

What are the functions of the drugs eptifibatide and tirofiban?

Answer 7

These are both GPIIb/IIIa inhibitors!

Question 8

Which factors are vitamin K dependent?

Answer 8

Factors 2,7,9, and 10.

these are all involved with warfarin and the PT test.

Question 9

What is considered a normal INR?

Answer 9

1.0-1.2

Therapeutic INR with warfarin therapy is usually 2.0-3.0

Question 10

How does heparin help with anticoagulation?

Answer 10

Heparin works to increase the effects of antithrombin!

Increases factor X and thrombin sequestration.

Question 11

What platelet count would idicate thrombocytopenia?

Answer 11

Platelet count below 100,000.

Remember that heparin can cause this!

Question 12

What is unique about the anticoagulant Fondaparinux?

Answer 12

This is a synthetic analog of the anti thrombin binding pentasacharide that ONLY INHIBITS FACTOR Xa.

Question 13

What is the available antidote of heparin?

Answer 13

Protamine

Question 14

What would be the only method of measuring anticoagulation by fondaparinux and low molecular weight heparin?

Answer 14

You would measure anti-factor Xa assay.

This is because both of these medications act only on factor Xa.

Question 15

What is unique about the direct thrombin inhibitors compared to heparin?

Answer 15

Heparin is not able to stop bound antithrombin.

Direct thrombin inhibitors however are able to interact with fibrin bound thrombin.

Question 16

What are the targets of the drugs Rivaroxaban and Apixaban as well as Dabigatran?

Answer 16

Rivaroxaban and Apixaban are both factor Xa inhibitors.

Dabigitran binds thrombin directly.

Question 17

The drug Idarucizumab has a very important effect for those with what sort of overdose?

Answer 17

Idarucizumab is the antidote for Dabigatran overdose.

Question 18

When comparing warfarin and heparin, which are allowed to be taken when pregnant?

Answer 18

Only heparin is approved to be used during pregnancy.

Warfarin is extremely contraindicated in the use of pregnancy.

Question 19

What are alteplase, reteplase, and tenecteplase?

Answer 19

These are all t-PA agents that work with fibrinogen.

Question 20

The drugs Aminocaproic acid and Tranexamic acid are both used for what causes?

Answer 20

These are both inhibitors of fibrinolysis and block plasmins interaction with fibrin.