Lec 3

Question 1

What is the mechanism of antitrombin 3?

Answer 1

Inhibit thrombin from coagulation

Question 2

Does warfarin coagulation or antixcoagulation factor ?

Answer 2

It is anti-coagulation factor but in firs 36 hours it may cause thrombosis

Question 3

What warfarin cause thrombosis in first 36 hours ?

Answer 3

Due it it I hip it protein c and protein s

Question 4

Does estrogen increase or decrease coagulation?

Answer 4

Increase it

Question 5

Which coagulation pathway is faster ?

Answer 5

Extrinsic pathway

Question 6

Prothrombin test used 5o detect any pathway ?

Answer 6

Extrinsic pathway

Question 7

PTT used to detect any pathway of coagulation?

Answer 7

Intrinsic pathway

Question 8

When we give heparin, we used any test to detect if it is normal or not ?

Answer 8

PTT

Question 9

When we give warfarin we used any test to detect if there any abnormalities in blood clotting .

Answer 9

PT

Question 10

What is the factor the affected by heparin?

And what is factor affected by warfarin?

Answer 10

12,11,19,9,2

10,9,7,2

Question 11

What is the product that come from fibrinolysis?

Answer 11

D-dimmer

Question 12

What is the orally anticoagulant drug?

Answer 12

Warfarin & dicumarol

Question 13

What is the parenteral anticoagulant drug?

Answer 13

Heparin & hirudin

Question 14

Does heparin have direct or indirect effect on coagulation factor?

Answer 14

Indirect because it inhibit this coagulant by activation anti-coagulant factors

Question 15

Does hirudin & lepirudine have direct or indirect effect on coagulation?

Answer 15

Have direct effect by inhibit this coagulants factors

Question 16

Oral anticoagulant drug dependence on?

Answer 16

Vitamin k

Question 17

How oral anticoagulant drug acts?

Answer 17

By inhibit =it’s in k epoxied reductase enzyme , so it prevent carboxylation of factor 2,7,9,10 so it not activated

Question 18

Does warfarin given to pregnancy women ? And what is the anticoagulant drug given to it ?

Answer 18

No because it cross placenta and we used standers or low molecular weight heparin

Question 19

Does warfarin inhibit activation of vitamin k depending factor that found in blood ?

Answer 19

No , it prevent formation of this factor but other factor that found in blood befor given warfarin is still effect

Question 20

What is the antidote of warfarin?

Answer 20

If there minor bleeding we give patient vitamin k but if it sever bleeding we give fresh frozen plasma
Buuuut the most important is fresh frozen plasma

Question 21

Does aspirin increased or decrease activity of warfarin?

Answer 21

Increased it

Question 22

What is the drug-drug interaction between aspirin/phenylbutazone and warfarin ?

Answer 22

This drug replacement warfarin from albumins so it increased activation of warfarin. Also, it prevent platelet aggregation so it synergism with warfarin

Question 23

What is the interaction between antibiotics & warfarin?

Answer 23

If antibiotics kill normal flora it can reduced vitamins k so warfarin activation increased
Also it may inhibit metabolism of warfarin so increase activation of warfarin

Question 24

What is the interaction between barbiturates/rifampin and warfarin?

Answer 24

This two drug induced the metabolism of warfarin so it decreased its activity

Question 25

What is the antidote of heparin & LMWH ?

Answer 25

any thing have positively charge such as protamine sulfate

Question 26

What is the mechanism of heparin?

Answer 26

It activate anti-coagulant factors specially antithrombin 3

Question 27

Does heparin affected coagulation factor that found in blood before given heparin?

Answer 27

Yes because it affected anticoagulant conversely warfarin not inhibit it because it affected liver

Question 28

What is the activation of heparin on lipid ?

Answer 28

It increased lipoprotein lipase which destruction LDL

Question 29

What is the administration of heparin?

Answer 29

IV or SC , nooooot given IM

Question 30

Which is have longer half life , heparin of LMWH?

Answer 30

LMWH

Question 31

What is the adverse effect of heparin?

Answer 31

-bleeding, -thrombocytopenia, -hypersensitivity , -alopecia, -osteoporosis, -thrombosis

Question 32

When heparin caused thrombosis?

Answer 32

When we used it continuously

Question 33

What is contraindications to heparin?

Answer 33

Hemophilia, thrombocytopenia,hypertension , with aspirin, befor and after brain or eye surgery , aminoglycoside because it have positively charge

Question 34

What is the anti-coagulant drug which given parenteral and affected directly

Answer 34

Hirudin , lepirudin , dabigatran , argatroban

Question 35

What is the rout of administration of hirudin , lepirudin , dabigatran , argatroban

Answer 35

IV