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Pharm I > Hemostatics, Anticoagulants, Fibrinolytics, and Anti-platelet Drugs > Flashcards

Hemostatics, Anticoagulants, Fibrinolytics, and Anti-platelet Drugs Flashcards

1
Q

Thromboplastin MOA

A

hemostatic
promotes conversion of prothrombin to thrombin

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2
Q

Thromboplastin therapeutic use

A

used in labs to measure prothrombin time during anticoagulant therapy

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3
Q

Where is thromboplastin from?

A

naturally priduced by platelets/tissues
powder extracted from bovine brain/acetone-extracted lungs

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4
Q

How is thromboplastin applied?

A

applied by a spray or a sponge

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5
Q

Thrombin MOA

A

hemostatic
converts endogenous fibrinogen to fibrin for clot formation

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6
Q

Thrombin therapeutic use

A

control bleeding from parenchymatous tissue, cancellous bone, dental sockets, laryngeal/nasal surgery, reconstructive surgery
adhesive agent for fixation of skin grafts

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7
Q

Thrombin adverse effects

A

not recommened for parenteral administration
IV administration = extensive intravascular clotting
SC/IM = local ischemia

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8
Q

How is thrombin applied?

A

applied topically as a powder/solution

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9
Q

Fibrinogen MOA

A

hemostatic
requires endogenous thrombin for conversion of fibrinogen to fibrin

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10
Q

Fibrinogen therapeutic use

A

control bleeding from denuded mucous membranes
adhesive in skin grafts
massive blood loss/acute hypofibrinogemia

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11
Q

Fibrin foam MOA

A

hemostatic
traps blood oozing from the surface area

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12
Q

Fibrin foam therapeutic use

A

applied directly with pressure after pre-soaking in thrombin solution

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13
Q

Is fibrin foam soluble?

A

NO - insoluble substance

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14
Q

Describe fibrin foam

A

strips of white sponge like material prepared from human fibrinogen

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15
Q

Absorbable geltatin sponge (Gelfoam) MOA

A

hemostatic
absorbs several times its weight of whole blood

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16
Q

Absorbable gelatin sponge therapeutic use

A

capillary/venous bleeding

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17
Q

How is absorable gelatin sponge applied?

A

soaked in bovine thrombin and applied over the bleeding area

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18
Q

How long does it take for gelfoam to liquify and then absorb?

A

liquifies in 3-5 days
completely absorbs in 4-6 weeks

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19
Q

Oxidized cellulose MOA

A

hemostatic
facilitates coagulation reaction between hemoglobin and cellulosic acid
forms a gummy matrix to facilitate clot formation

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20
Q

Oxidized cellulose therapeutic use

A

used as temporary packing

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21
Q

Oxidized cellulose adverse effects

A

permanent implantation may interfere with bone regeneration and epithelialization
cyst formation
can delay wound healing

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22
Q

How is oxidized cellulose applied?

A

surgical gauze/sponge

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23
Q

Microcrystalline collagen MOA

A

hemostatic
surface hemostatic agent

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24
Q

Microcrystalline collagen therapeutic use

A

treatment of clotting factor deficiencies
surgery of liver and spleen

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25
Q

Application and duration of microcrystalline collagen

A

abdorable sponge - 6 weeks

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26
Q

Epinephrine MOA

A

hemostatic
alpha 1 agonist
produces immediate vasoconstriction

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27
Q

Epinephrine therapeutic use

A

vasoconstrictor - controls bleeding from small vessels

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28
Q

Hemostatic dressing - alginate therapeutic use

A

excessive bleeding

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29
Q

Describe the hemostatic dressing - quikclot

A

non-antigenic kaolin impregnanted polyester gauze

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30
Q

Hemostatic dressing - quikclot MOA

A

factor XII activation

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31
Q

Describe the hemostatic dressing - chitosan

A

organic polymer from crustacean shells

32
Q

Styptics MOA

A

locally acting hemostatic
astringent substances
precipitates blood proteins and soft tissue and seals off ruptured vessels

33
Q

Styptics adverse effects

A

high concentrations = sloughing of tissues/hemorrhage

34
Q

How are styptics applied?

A

powders dusted onto the bleeding area

35
Q

Blood therapeutic use (as a hemostatic)

A

emergency treatment of acute hemorrhagic syndrome with deficiency of clotting factors/platelets

36
Q

Vitamin K MOA

A

hemostatic
aids in the production of clotting factors II, VII, IX, and X
produces active protein C and S - anticoagulants

37
Q

Vitamin K therapeutic uses

A

ingestion of vitamin K antagonist
sweet clover poisoning
rodenticide poisoning

38
Q

Vitamin K adverse reactions

A

IV administration can cause anaphylaxis

39
Q

Unique feature of Vitamin K

A

safe for parenteral administration
fatty meals enhance oral absorption

40
Q

Desmopressin acetate MOA

A

hemostatic
releases stored vonWillebran factor from endothelial cells and macrophages

41
Q

Desmopressin acetate therapeutic use

A

controls capillary bleeding from wounds
vWF diease
hemophillia A
thrombocytopenia

42
Q

Desmopressin acetate adverse effects

A

repeated administration reduces effectiveness of drugs

43
Q

Protamine sulfate MOA

A

hemostatic
interferes with the reaction of thrombin and fibrinogen

44
Q

Protamine sulfate therapeutic use

A

antagonize heparin-induced hemorrhagic action

45
Q

Where does protamine sulfate come from?

A

fish sperm

46
Q

How is protamine sulfate administered?

A

slow IV

47
Q

Heparin MOA

A

anticoagulant
binds reversibly to antithrombin III - inhibits thrombin and factor Xa
binds to endothelial cells - neg charge - inhibits platelet adhesion and aggregation
increases plasminogen activator and tissue factor inhibitor

48
Q

Heparin therapeutic use

A

disseminated intravascular coagaulation
arterial thrombi - cats
decrease risk factors during heartworm adulticide treatment
thromboemboli
prevent thrombosis and pulmonary embolism

49
Q

Heparin adverse effects

A

hemorrhage
IV = hematoma
equines - anemia

50
Q

Where is heparin metabolized?

A

liver

51
Q

Antitode for heparin toxicity

A

protamine supplemented with fresh blood

52
Q

Examples of vitamin K antagonists

A

dicumarol
warfarin sodium

53
Q

Vitamin K antagonist MOA

A

anticoagulant
inhibition of hepatic synthesis of Vit K dependent clotting factors (factors II, VII, IX, and X)
anticoagulant activity after 12-24 hours

54
Q

Duration of action of Vitamin K antagonists

A

2-5 days

55
Q

Vitamin K antagonist therapeutic use

A

prophylaxis and treatment of venous thrombosis

56
Q

Vitamin K antagonist adverse effects

A

hemorrhage

57
Q

Where are vitamin K antagonists metabolized and stored?

A

metabolized and stored in the liver

58
Q

Streptokinase MOA

A

fibrinolytic
complexes with plasminogen to produce plasmin

59
Q

Streptokinase therapeutic use

A

eczema
dermatitis
cellulitis
hematoma
trauma
sinusitis
cysts
fractures with fistulous tracts

60
Q

Streptokinase adverse effects

A

systemic fibrinolysis

61
Q

Where does streptokinase come from?

A

from beta-hemolytic streptococcus spp.

62
Q

How long does it take for streptokinase to work?

A

liquifation of blood clot occurs in 30min-12hours

63
Q

Tissue plasminogen and Aletplase MOA

A

fibrinolytic
selectively acts on plasminogen in fibrin clots

64
Q

Tissue plasminogen and Aletplase therapeutic use

A

lysis on aortic thromboemboli in cats
good for acute myocardial infraction or brain stroke

65
Q

Antidote for tissue plasminogen toxicity

A

antiplasmin

66
Q

Urokinase MOA

A

fibrinolytic
activator of plasminogen

67
Q

Urokinase therapeutic use

A

used in dogs to prevent post-op adhesions when administered as a lavage into peritoneal cavity

68
Q

Where is urokinase from?

A

isolated from human urine

69
Q

Asprin MOA

A

anti-platelet drug
irreversibly binds COX - inhibits prostaglandin production and thromboxane A2 production

70
Q

Asprin therapeutic use

A

NSAID
used in dogs to decrease the severity of heartworm emboli
blood thinner in dogs and cats

71
Q

Ticlopidine MOA

A

anti-platelet drug
P2Y12 receptor inhibitor on platelets - inhibits aggregation

72
Q

Clopidogrel MOA

A

anti-platelet
prodrug - biotransformed into active drug

73
Q

Clopidogrel therapeutic use

A

commonly used with asprin
safe to use in cats for arterial thrombi

74
Q

Dipyridamole MOA

A

anti-platelet
inhibits phosphodiesterase - increase cAMP in platelet - prevents aggregation

75
Q

Dipyridamole therapeutic use

A

synergistic with asprin
little effect if used alone

Pharm I (15 decks)

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