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Pharm Test 3 > L 18 Anti Coagulants > Flashcards

L 18 Anti Coagulants Flashcards

1
Q

What is Blood Hemostasis?

A

regulated process of maintaining blood fluidity

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2
Q

What is primary hemostasis?

A

platelet plug

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3
Q

What is secondary coagulation?

A

thrombus

-> fibrin containing blood clot

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4
Q

What is Fibrinolysis?

A

degradation of blood clot

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5
Q

What is TXA2?

A

synthesized from arachidonic acid by COX1

potent vasoconstrictor
platelet activator

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6
Q

What results in fibrinogen binding?

A

conformational change in Glycoprotein 2b/3a receptor

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7
Q

What role does Vitamin K play?

A

secondary hemostasis

cofactor in the maturation of clotting factors

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8
Q

What is Secondary Hemostasis?

A

thrombin activation

deposition of fibrin fibers to stabilize platelet plug

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9
Q

What role does Thrombin play in coagulation cascade?

A

final target

stabilizes the clot

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10
Q

What is t-PA?

A

secreted by endothelial cells

converts
plasminogen > plasmin

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11
Q

What do thrombolytic drugs do?

A

mimic pathway

t-PA
Plasminogen
Plasmin
Plasmin degrades fibrin
break up clots
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12
Q

What is Thrombomodulin?

A

binds thrombin

inactivation of Factors 10, 13

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13
Q

What is Prostacyclin?

A

inhibits

platelet degranulation
aggregation
vasoconstriction

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14
Q

What is Antithrombin 3?

A

inactivates clotting factors

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15
Q

What is the main SE of Anti-thrombotic drugs?

A

hemorrhage risk

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16
Q

What do Antiplatelet drugs do?

A

prevent primary hemostatic plug formation

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17
Q

What do Anticoagulant drugs do?

A

inhibit clotting cascade

prevent fibrin clot formation

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18
Q

What do Thrombolytics do?

A

digest fibrin to break up existing clot

19
Q

What are the Antiplatelet drugs?

A

Aspirin

Clopidogrel
Ticlopidine

Abciximab
Eptifibatide

Dipyridamole

20
Q

What is Aspirin MOA?

A

selectively inhibits TXA2 synthesis

by

irreversible acetylation of COX-1 enzyme

21
Q

What does a high dose of Aspirin do?

A

inhibition of prostacyclin

Dec efficacy of ASA therapy

22
Q

What is the Antiplatelet drug of choice?

A

Aspirin

23
Q

What are Aspirin SE?

A

resistance

inc incidence of hemorrhagic stroke

GI bleed

tinnitus

24
Q

What is Aspirin’s contraindications?

A

in children and adolescents accompanying viral illnesses

leads to Reyes syndrome

25
Q

What is Clopidogrel MOA?

A

irreversible inhibitor of P2Y12 receptor

26
Q

Clopidogrel therapeutic uses?

A 
reduction rate of:
stroke
MI
unstable angina
death in pt w/ recent MI or stroke

PAD
Acute Coronary Syndrome

27
Q

What drug is Clopidogrel equivalent to?

A

Apririn in prevention of stroke

28
Q

Clopidogrel adverse effects?

A

hemorrhage

TTP

CYP2C19 poor metabolizers have Inc risk of tx failure

29
Q

What is Ticlopidine MOA?

A

P2Y12 irreversible inhibitor

30
Q

Ticlopidine therapeutic uses?

A

standard in combo w/ ASA

to prevent stent thrombosis

31
Q

Ticlopidine adverse effects?

A

nausea/ vomit

diarrhea

hemorrhage

neutropenia severe

TTP

32
Q

What is

Abciximab & Epitifbatide MOA?

A

GP 2b/3a inhibitors

33
Q

What are therapeutic uses of Abciximab & Epitifbatide?

A

w/ ASA & heparin

tx coronary thrombosis or
during coronary angioplasty

reduces restenosis
recurrent MI

34
Q

Abciximab & Epitifbatide adverse effects?

A

hemorrhage

thrombocytopenia

35
Q

Between Abciximab & Epitifbatide, what drug is preferred? Why?

A

Abciximab is preferred in renal disease

Eptifibatide is eliminated by kidney

36
Q

What is Dipyridamole MOA?

A

inhibits PDE

  • > inhibits thrombus formation
  • > inhibits adenosine uptake
37
Q

What is Dipyridamole therapeutic use?

A

combo w/ ASA

prevent cerebrovascular ischemia

38
Q

What drugs are Anticoagulants?

A

Direct Thrombin Inhibitors

HMW Heparin

LMW Heparin

Fondaparinux

39
Q

What can’t Anticoagulants do?

A

dissolve a thrombus that has already formed

like anti platelets

40
Q

What drug is a Direct Thrombin Inhibitor?

A

Dabigatran Etexilate

41
Q

What is Dabigatran Etexilate MOA?

A

converted to active form

binds to exosite 1 on thrombin

-> prevents fibrinogen cleavage to mature fibrin

42
Q

Dabigatran Etexilate therapeutic uses?

A

prevent stoke in pt w/ atrial fib

DVT
Pul Embolism

equal efficacy to warfarin

43
Q

What are the benefits of Dabigatran Etextilate?

A

no pt monitoring

rapid onset

less SE

44
Q

Dabigatran Etexilate adverse effects?

A

hemorrhage

heartburn

stomach upset

Pharm Test 3 (8 decks)

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