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Pharm > hemeonc > Flashcards

hemeonc Flashcards

hemeocn

1
Q

lowers the activity of thrombin and factor Xa

A

heparin (short half life)

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2
Q

use of heparin:

A

immediate anticoagulation for pulm embolism, acute coronary syndrome, MI, DVT

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3
Q

heparin or warfarin in pregnancy

A

heparin (does not cross placenta)

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4
Q

this drug prolongs PTT

A

heparin

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5
Q

SE of heparin

A

bleeding, thrombocytopenia (HIT), osteoporosis, drug-drug interactions

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6
Q

rapid reversal of heaprin use:

A

protamine sulfate (pos charged molecule to bind neg charged heparan)

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7
Q

heparin induced thrombocytopenia (HIT)

A

development of IgG ab against heparin bound platelet factor 4 (PF4).

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8
Q

antibody heparin PF4 complex activates platelts

A

HIT (thrombosis and thrombocytopenia)

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9
Q

LMW heparins

A

enoxaparin, dalteparin)

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10
Q

which heparins act predominantly on factor Xa

A

enoxaparin, dalteparin

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11
Q

fondaparinux acts only on

A

factor Xa

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12
Q

which has better bioaviality and a 2-4x longer half life. lmw heparin or unfractionated hparin

A

low molecular weight hpearin

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13
Q

direct thrombin inhibitors inlcude

A

bivalirudin, argatroban, dabigatran

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14
Q

the only oral in the direct thrombin inhibitor class is

A

dabigatrin

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15
Q

Use of direct thrombin inhibitors

A

Venous thromboembolism
atrial fibrilatiion
HIT

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16
Q

how do you reverse dabigatran

A

idarucizumab

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17
Q

if no reversal agent avaible for dabigatran, use

A

PCC, and/or antifibrinolytics (eg tranexamic acid)

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18
Q

serious side effect of direct thrombin inhibitor

A

bleeding

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19
Q

how does enoxparin function

A

binds ATIII via pentasaccharide sequence. once activated, ATIII binds to facotr Xa and strips factor Xa from converting protrhombin to thrombin

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20
Q

more molecules than LMWH

A

unfractionated heparin: allows it to bind factor Xa and thrombin; more effective than LMWH in activaitng thrombi

21
Q

gene for vitamin K epoxide reductase complex

A

VKORC1

22
Q

warfarin crosses placenta

A

true

23
Q

adverse effects of warfarin

A

bleeding, teratogenic, skin/tissue necrosis, drug drug Iinteractsion

24
Q

rapid reversal of warfarin

A

FFP or PCC

25
Q

does fresh frozen plasma (FFP) contain all coagulation factors

A

yes

26
Q

for reversal of warfarin,

A

give vitamin K

27
Q

Why is ffp ineffective in heparin overdose

A

it contains ATIII; which enhances hparin affect

28
Q

longer duration of action warfarin or hpearin

A

warfarin (days)

29
Q

site of action in liver: heparan or warfarin

A

warfarin

30
Q

heparin is in the blood and is parenteral

A

true

31
Q

warfarin is oral

A

true

32
Q

direct factor Xa inhibitors

A

apiXaban, rivaroXaban

33
Q

direct factor xa inhibiotr use

A

treatment and prophylaxis for dvt and pe; stroke prophylaxis in pt’s with atriabl fibrillation.

34
Q

thrombolytics drugsa

A

alteplase (tPA), reteplase (rPA), streptokinase, tenecteplase (TNK-tPA)

35
Q

thrombolytics increase

A

PT , PTT, no change in platelet count

36
Q

directly or indirectly aid conversion of plasminogen to plasmin, which cleaves thrombin and fibrin clots

A

thrombolytics

37
Q

use of thrombolytics

A

early MI, early ischemic stroke, direct thrombolysis of severe PE

38
Q

clopidogrel, prasugrel, ticagrelor, ticlopidine

A

ADP receptor inhibtors

39
Q

ADP receptor inhibitors mechanism

A

inhibit platelet aggregation by irreversibly blocking ADP (P2Y12) receptor. prevents expression of glycoproteins IIb/IIIa on platelet surface

40
Q

use of adp receptor inhibitors

A

acute coronary syndrome; coronary stenting. decrease incidence or recurrrence of thrombotic storke

41
Q

SE of ticlopidine

A

neutropenia

42
Q

ADP receptor inhibots se

A

TTP

43
Q

cilostazol, dipyridamole

A

PDE inhibitors; increase cAMP in platelts, resulting in inhibiton of platelt aggregation; vasodilators

44
Q

use of cilostazol, dipyradimaloe

A

intermittent claudication, coronary vasodilation, prevention of stroke or TIAs (combined with aspirin)

45
Q

se of cilostazol, dipyridamole

A

nausea, headache, facial flushing, hypotension, abdominal pain

46
Q

GPIIb/IIIa inhibitors

A

abciximab, eptifibatide, tirofiban

47
Q

GP IIB/IIa inhibitors

A

binds to GP IIb/IIIa on activated platelets, preventign aggregation

48
Q

use of GpIIb/IIIa inhibitors

A

unstable angina, PCI

49
Q

SE of gp2b/3a inhibitors

A

bleeding thrombocytopenia

Pharm (13 decks)

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