Heme/Oncology I Flashcards
heparin
activator of antithrombin
decreased thrombin and factor Xa - anticoagulant
immediate anticoagulation
heparin
monitor with heparin
PTT
HIT
heparin induce thrombocytopenia
IgG Abs against heparin bound platelet factor 4 (PF4)
Ab-heparin-HP4 - activate platelet - thrombosis and thrombocytopenia
argatroban
thrombin inhibitor
bivalirudin
thrombin inhibitor
dabigatran
thrombin inhibitor
protamine sulfate
reversal of heparin
positive charbe - binds negative heparin
enoxaparin
LMWH
dalteparin
LMWH
fondaparinux
LMWH
LMWH
act more on factor Xa
-better bioavailability
longer half life
no lab monitoring
not reversible
warfarin
interfere with gamma carboxylation vit K factors
II, VII, IX, X, protein C and S
monitor with warfarin
PT and INR
chronic anticoag
warfarin
warfarin pregnancy
no - teratogen
transient hypercoag with warfarin
protein C and S - shorter half lives
-so get hypercoag when start warfarin therapy
reversal of warfarin
vit K
rapid reversal of warfarin
fresh frozen plasma
heparin bridging
heparin used when starting warfarin
-to get anticoag during transient hypercoag of warfarin use
apixaban
direct factor Xa inhibitor
rivaroxaban
direct factor Xa inhibitor
alteplase
thrombolytic
reteplase
thrombolytic
streptokinase
thrombolytic
tenecteplase
thrombolytic
thrombolytics
aid conversion plasminogen to plasmin
plasmin - cleaves thrombin and fibrin clots
changes with thrombolytic therapy
increased PT and PTT
no change platelet count
adverse thrombolytic
bleeding
CI if pt with recent bleeding
aminocaproic acid
tx of thrombolytic toxicity
-inhibitor of fibrinolysis
aspirin
irreversible COX inhibitor
covalent acetylation
changes with aspirin therapy
increased bleeding time
decreased TXA2 and PGs
no effect PT and PTT
adverse aspirin
tinnitus - CN VIII
gastric ulcer
upper GI bleed
interstitial nephritis
reye syndrome
reye syndrome
child with viral infection - takes aspirin
acid-base status with aspirin OD
hyperventilation - respiratory alkalosis
eventual mixed with metabolic acidosis
clopidogrel
ADP receptor inhibitor
prasugrel
ADP receptor inhibitor
ticagrelor
ADP receptor inhibitor
ticlopidine
ADP receptor inhibitor
ADP receptor inhibitors
inhibit platelet aggregation
- irreversible block ADP receptor
- prevent expression glycoprotein IIb/IIIa
adverse ticlopidine
neutropenia
cliostazol
phosphodiesterase inhibitor
- increased cAMP in platelets
- inhibit platelet aggregation
vasodilator
dipyrimadole
phosphodiesterase inhibitor
vasodilator
adverse of phosphodiesterase inhibitors
nausea, headache, flushing, hypotension, abdomen pain
abciximab
GP IIb/IIIa inhibitor
eptifibatide
GP IIb/IIIa inhibitor
tirofiban
GP IIb/IIIa inhibitor
GP IIb/IIIa inhibitor
prevent platelet aggregation