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kekw > PCOL MIDTERM 1 > Flashcards

PCOL MIDTERM 1 Flashcards

1
Q

A complex process involving multiple steps and many clotting factors

A

Hemostasis

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2
Q

The balance between clot formation and clot breakdown

A

Hemostasis

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3
Q

Steps in Hemostasis

A
  1. Vascular Phase
  2. Platelet Phase
  3. Coagulation Phase
  4. Clot formation
  5. Fibrinolysis
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4
Q

Cutting or damaging blood vessels leads to vascular spasm that produces a vasoconstriction which will slow or even stop blood flow

A

Vascular Phase

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5
Q

In larger blood vessels, platelets begin to stick to the surfaces of endothelial cells.

A

Platelet Phase

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6
Q

Aggregation of platelets leads to the formation of a platelet plug.

A

Platelet Phase

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7
Q

The overall process involves the formation of the insoluble protein Fibrin from the plasma protein Fibrinogen through the action of the enzyme Thrombin. Fibrin forms a network of fibers which traps blood cells and platelets forming a thrombus or clot

A

Coagulation phase

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8
Q

Forms a network of fibers which traps blood cells and platelets forming a thrombus or clot

A

Fibrin

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9
Q

Two pathways leading to the formation of the thrombus

A
  1. Extrinsic pathway
  2. Intrinsic pathway
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10
Q

Extrinsic pathway process

A
  • Initiated with material outside of the blood
  • Very rapid process
  • Smaller clots
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11
Q

Intrinsic pathway process

A
  • Initiated by the blood coming in contact with exposed collagen in the blood vessel wall
  • Slower process
  • Larger clots
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12
Q

Extrinsic pathway Factors

A

VIIa, and Tissue Factor

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13
Q

Intrinsic pathway Factors

A

VIIIa, IXa, XIa, calcium, and phospholipids

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14
Q

Prothrombinase complex Factors

A

Va, X, calcium, and phospholipids

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15
Q

Blood Clotting Factors

(Foolish People Try Climbing Long Slopes After Christmas, Some People Have Fallen)

A

I Fibrinogen
II Prothrombin
III Tissue Factor
IV Calcium (Ca2+)
Va Proaccelerin
VII Proconvertin
VIII Antihemophilic Factor
IX Christmas Factor
XI Stuart Factor
XII Plasma thromboplastin antecedent
XIII Hageman factor
XIII Fibrin Stabilizing Factor

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16
Q

After 2 or 3 days, the clot begins to contract. Platelets in the clot contain contractile proteins.

A

Clot Retraction

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17
Q

Platelets in the clot contain contractile proteins

A

Clot Retraction

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18
Q

These proteins pull the edges of the wound together and reduces the chance of further hemorrhage

A

Clot Retraction

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19
Q

Platelets in the clot contain ___________

A

contractile proteins

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20
Q

This activity also assists the repair processes.

A

Clot Retraction

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21
Q

Dissolution of the clot

A

Fibrinolysis

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22
Q

The breakdown of the clot is due to the production of a powerful proteolytic enzyme Plasmin.

A

Fibrinolysis

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23
Q

Removing a blood clot is essential to restoring normal circulation.

A

Fibrinolysis

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24
Q

The breakdown of the clot is due to the production of a powerful proteolytic enzyme ______

A

Plasmin

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25
Q

Once a stationary clot forms (thrombus), it often grows larger as more fibrin is added.

A

Blood Clots

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26
Q

Pieces of the clot may break off and travel in the blood stream to possibly lodge elsewhere.

A

Blood Clots

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27
Q

When clots or emboli form, drug therapy becomes necessary.

A

Blood Clots

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28
Q

A traveling clot is known as an

A

Embolus

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29
Q

Used to prevent the formation of clots

A

Anticougulants

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30
Q

Used to inhibit platelet aggregation

A

Antiplatelets

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31
Q

Used to dissolve such life – threatening clots

A

Thrombolytics

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32
Q

Used to speed clot formation, or to limit bleeding from a surgical site.

A

Hemostatics

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33
Q

Drugs for Coagulative and Bleeding Disorder

A
  • Anticoagulant
  • Antiplatelets
  • Thrombolytics
  • Hemostatics
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34
Q

Prevent the formation and enlargement of clots.

A

Anticoagulant

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35
Q

Drugs example of Anticoagulants

A
  • Warfarin
  • Heparin
  • LMWH / Low Molecular Weight Heparin
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36
Q

Anticoagulants Action

A
  1. Inhibit certain clotting factors
  2. Lengthen clotting time
  3. Prevent thrombi from forming or growing larger
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37
Q

Warfarin Chemistry

A

Coumarin

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38
Q

Warfarin Mechanism Of Action

A

Inhibits vitamin K synthesis

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39
Q

Warfarin Route

A

Oral or IV

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40
Q

Warfarin Monitoring

A

PT - INR

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41
Q

Warfarin Target

A

INR 2-3

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42
Q

Warfarin Uses

A

Prophylactic for acute MI, prevention of progression or recurrence of acute deep vein thrombosis or pulmonary embolism

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43
Q

Warfarin Side effects

A

Bleeding and Teratogenic

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44
Q

Warfarin Antidote

A

Vitamin K

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45
Q

Heparin Chemistry

A

Sulfated glycosaminoglycan

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46
Q

Heparin Mechanism Of Action

A

Activates antithrombin III

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47
Q

Heparin Route

A

IV or SC
IM is contraindicated = Hematoma

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48
Q

Heparin Monitoring

A

aPPT

49
Q

Heparin Target

A

1.5-2.5x control

50
Q

Heparin Uses

A

prevention of venous thrombosis, tx of pulmonary embolism and acute myocardial infarction

51
Q

Heparin Side effects

A

Bleeding, allergy, and thrombocytopenia

52
Q

Heparin Antidote

A

Protamine SO4

53
Q

A procoagulant used as antidote for Warfarin toxicity.

A

Vitamin K

54
Q

Foods high in Vitamin K (must be avoided during Warfarin Therapy):

A
  • Green leafy vegetables
  • Milk and milk products
  • Some cereals
  • Orange juice
  • Cauliflower
  • Cucumbers
55
Q

What food must be avoided during WarfarinTherapy

A

Foods High in Vitamin K

56
Q

Drugs of Low Molecular Weight Heparin (LMWH)

A
  • Enoxaparin (Lovenox)
  • Tinzaparin (Fragmin)
  • Dalteparin (Innohep)
57
Q

Anticoagulants of choice for treating pregnant women with prosthetic heart valves or venous thromboembolism

A

LMWH

58
Q

LMWH Notes:

A
  • Do not require intense monitoring
  • Longer half - life than heparin
  • With less bleeding
59
Q

Drugs of Direct Thrombin Inhibitors

A
  • LEPIRUDIN
  • ARGATROBAN
  • FONDAPARINUX
60
Q

Polypeptide that is closely related to hirudin

A

Lepirudin

60
Q

Polypeptide that is closely related to hirudin

A

Lepirudin

61
Q

Effective in the treatment of HIT (Heparin‐induced thrombocytopenia)

A

Lepirudin

62
Q

Lepirudin CI:

A

Streptokinase or Alteplase

63
Q

Directly inhibits thrombin

A

Argatroban

64
Q

Prophylactic for the treatment of thrombosis in patients with HIT (Heparin‐induced thrombocytopenia)

A

Argatroban

65
Q

First in a new class of pentasaccharide anticoagulants that is purely synthetic

A

Fondaparinux

66
Q

Prophylaxis of deep - vein thrombosis

A

Fondaparinux

67
Q

Adverse Effects of Anticoagulants

A
  • Bleeding (Most common)
  • Bruising
  • Bleeding gums
  • Nosebleed
  • Blood in urine or stool
68
Q

_____ agents prolong bleeding time by interfering
with platelet aggregation

A

Antiplatelets

69
Q

4 Primary Subclasses

A
  1. Aspirin
  2. Adenosine diphosphate (ADP) receptor blockers
  3. Glycoprotein IIb / IIIa receptor blockers
  4. PDE inhibitors
70
Q

Acetylsalicylic Acid or Aspirin
Mechanism Of Action

A

Irreversible inhibition of COX

71
Q

Prophylactic for transient cerebral ischemia and to reduce the incidence of recurrent MI

A

Aspirin

72
Q

Aspirin Dose

A

100 - 325 mg

73
Q

Adverse Effects of Aspirin

A
  • Increased incidence of hemorrhagic stroke
  • Gastrointestinal bleeding
  • Salicylism = Tinnitus
74
Q

Contraindication of Aspirin

A
  • Anticoagulants - increase bleeding
  • Ibuprofen - antagonize platelet inhibition
75
Q

Increase bleeding

A

Anticoagulants

76
Q

Antagonize platelet inhibition

A

Ibuprofen

77
Q

ADP (Adenosine Diphosphate) Receptor Blockers
Mechanism Of Action

A

Irreversibly inhibit the binding of ADP to its receptors on platelets

78
Q

ADP Receptor Blockers aka

A

Thienopyridines

79
Q

Drugs example of ADP Receptor Blockers

A
  • Clopidogrel (Plaxix)
  • Ticlopidine (Ticlid)
  • Prasugrel (Effient)
80
Q

ADP Receptor Blockers Notes:

A
  • Clopidogrel is the preferred agent in ischemic heart disease events
  • Clopidogrel is safer than ticlopidine
  • Ticlopidine causes neutropenia / agranulocytosis, thrombotic thrombocytopenic purpura (TTP), and aplastic anemia
81
Q

Drugs example of Lycoprotein IIA or IIB Blockers

A
  • Abciximab (Reopro)
  • Eptifibatide (Integrilin)
  • Tirofiban (Aggrastat)
82
Q

Chimeric monoclonal antibody Given IV along with heparin or ASA as an adjunct for patients undergoing angioplasty

A

Abciximab

83
Q

Adverse Effect of Glycoprotein IIA or IIB

A

Bleeding

84
Q

Drug example of Phospodiesterase Inhibitor

A

Dipyridamole

85
Q

Used to dissolve existing clots. Prescribed for disorders in which a clot has already formed

A

Thrombolytics

86
Q

Thrombolytics are used in

A
  1. Acute MI
  2. Pulmonary embolism
  3. Cerebrovascular accident (CVA)
  4. DVT (Deep Vein Thrombosis)
  5. Arterial or Coronary thrombosis
87
Q

Streptokinase Brand name

A

Streptase

88
Q

Protein from streptococci

A

Streptokinase

89
Q

Streptokinase Side effects

A

Allergy, and Bleeding

90
Q

Derived from cultured human melanoma cells

A

Tissue Plasminogen Activators

91
Q

Drugs example of Tissue Plasminogen Activators

A
  • Alteplase (Activase)
  • Reteplase ( Retavase )
92
Q

Reteplase Brand name

A

Retavase

93
Q

Alteplase Brand name

A

Activase

94
Q

More selective than streptokinase

A

Tissue Plasminogen Activators

95
Q

Side effect of Tissue Plasminogen Activators

A

Bleeding

96
Q

Anisoylated plasminogen streptokinase activator complex a prodrug

A

Anistreplase

97
Q

Side effect of Anistreplase

A

Bleeding

98
Q

Used to promote the formation of clots.

A

Hemostatics

99
Q

A consequence of a deficiency in plasma coagulation factors

A

Hemophilia

100
Q

A rare disorder in which your blood doesn’t clot normally because it lacks sufficient blood clotting proteins (clotting factors)

A

Hemophilia

101
Q

Types of Hemophilia

A
  • Hemophilia A
  • Hemophilia B
  • Von Willerbrand Disease
102
Q

Factor of Hemophilia A

A

VIII (FVIII)

103
Q

Deficiency or classic hemophilia

A

Hemophilia A

104
Q

Hemophilia occurs in approximately 1 in 5,000 live births

A

Hemophilia A

105
Q

4x as common as hemophilia B while more than half of patients with hemophilia _ have the severe form of hemophilia

A

Hemophilia A

106
Q

Deficiency or Christmas disease

A

Hemophilia B

107
Q

Factor of Hemophilia B

A

IX (FIX)

108
Q

Genetic disorder caused by missing or defective ________ factor, a clotting protein.

A

Von Willebrand Disease

109
Q

A key clotting protein, and platelets in blood vessel walls, which help form a platelet plug during the clotting process

A

Von Willebrand Disease

110
Q

Factor of Von Willerbrand Disease

A

VIII

111
Q

Type 1 VWD

A

-60% -80% of patients

112
Q

Type 2 VWD

A

-15% -30% of patients

113
Q

Type 3 VWD

A

-5% -10% of patients

114
Q

Results after a diagnosis of an autoimmune disease, such as lupus, or from heart disease or some types of cancer. It can also occur after taking certain medications

A

Acquired VWD

115
Q

Measurement of the intrinsic power of the blood to convert fibrinogen to fibrin

A

Coagulation Time Test

116
Q

Measures how quickly your blood clots. aka pro time test or PT test, INR

A

Prothrombin Time Test

117
Q

Drugs example of Hemostatics

A
  • Aminocaproic
  • Tranexamic Acid
  • Aprotinin
118
Q

Aminocaproic & Tranexamic Acid

A
  • Synthetic
  • Inhibit plasminogen activation
  • Potential side effect of treatment is intravascular thrombosis

kekw (5 decks)

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