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PHARM/MHD - Exam #4 > Pharm #2 - Anti-Platelet Drugs / Anti-Thrombolytic Drugs > Flashcards

Pharm #2 - Anti-Platelet Drugs / Anti-Thrombolytic Drugs Flashcards

1
Q

State the following for Streptokinase:

  1. MOA
  2. Route
  3. Indications
  4. Side effects
A
  1. Fibrinolytic
    - converts plasminogen to plasmin to aid in degradation of fibrin & thrombin
  2. IV
  3. thrombolysis, stroke, MI, PE
  4. BLEEDING
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2
Q

What are the indications of Streptokinase?

What other drug has similar indications?

A

thrombolysis, stroke, MI, PE

Urokinase

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3
Q

State the following for Urokinase:

  1. MOA
  2. Route
  3. Indications
  4. Side effects
A
  1. Fibrinolytic
    - converts plasminogen to plasmin to aid in degradation of fibrin & thrombin
  2. IV
  3. thrombolysis, stroke, MI, PE
  4. BLEEDING
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4
Q

State the following for tPA (tissue Plasminogen activator):

  1. MOA
  2. Route
  3. Indications
  4. Side effects
A
  1. Fibrinolytic
    - converts plasminogen to plasmin to aid in degradation of fibrin & thrombin
  2. IV
  3. thrombolysis, stroke, MI, NO PE!!! (unlike Urokinase & streptokinase)
  4. BLEEDING
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5
Q

State the following for Epsilon Amino Caproic Acid - EACA (AMICAR)

  1. MOA
  2. Route
  3. Indication
  4. Side effect
A
  1. MOA:

ANTI - Fibrinolytic (inhibits conversion of plasminogen to plasmin)

  • Iv
  • Reversal of bleeding!
  • Hypotension is a side effect of AMICAR
    (when you sit in my car your BP falls)
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6
Q

State the following for Aprotonin (Trasylol)

  1. MOA
  2. Route
  3. Indication
  4. Side effect*
A
  • Anti-fibrolytic (antagonist for thrombolytic agents)
  • IV
  • reversal of bleeding
  • GRAFT THROMBOSIS!!
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7
Q

What are the 3 thrombolytic antagonists?

A
  1. EACA
    Epsilon Amino Caproic Acid
  2. Tranexemic Acid
  3. Aprotonin (trasylol)
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8
Q

What is the side effect of Aprotonin

A

GRAFT THROMBOSIS!!

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9
Q

State the following for Ancrod (snake venom)

  1. MOA
  2. Route
  3. Indication *
  4. Side effect *
A
  1. FIBRINOLYTIC! (converts plasminogen to plasmin)
  2. IV
  3. STROKE
  4. Allergic reaction
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10
Q

Which drug is indicated for stroke but is likely to cause an allergic reaction?

A

Ancrod

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11
Q

State the following for Tranexamic Acid (AMCHA)

  1. MOA
  2. Route
  3. Indication
  4. Side effect *
A
  1. Anti - fibrinolytic
  2. IV
  3. Reversal of bleeding
  4. RETINOPATHY
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12
Q

What is the adverse effect of tranexamic acid?

A

RETINOPATHY

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13
Q

What are the 3 eiconasoid drugs?

A
  1. Monteleukast
  2. Zafirleukast
  3. Zileuton
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14
Q

What are the fibrinolytic drugs? (4)

A
  1. Streptokinase
  2. Urokinase
  3. tPA
  4. Ancrod
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15
Q

What is the MOA of moteleukast & zafirleukast

A

Leukotriene receptor inhibitor

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16
Q

What is the MOA of Zieuton

A

lipooxygenase inhibitor

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17
Q

What is the common route of administration of the 3 eiconasoid drugs:

  1. Monteleukast
  2. Zafirleukast
  3. Zieuton

What is their main SIDE EFFECT?

A

ORAL

  • Hypotension!!

( Monteleukast also has behavioral changes)

18
Q

Indication for monteleukast?

A

Allergic reaction

19
Q

Indication for zafirleukast & ZIEUTON

MOA? (review)

A

asthma

  • leukotriene receptor inhibitor = zafirleukast
  • lipooxygenase inhibitor zileuton
20
Q

What 3 drugs can be used for the treatment of asthma?

Which is specifically for seasonal allergies?

A

Asthma

  • Montefleukast
  • Zafirleukast
  • Zileuton
21
Q

State the following for aspirin:

MOA
Route

A

COX inhibitor; ORAL

(Aspirin acts as an irreversible inhibitor of COX1 by acetylating Ser530
in the active site thereby preventing access to arachidonic acid substrate)

Aspirin also acetylates COX-2, but is a less potent inhibitor,
as the COX2 active site is larger and can still partially bind arachidonic acid

22
Q

State the following for aspirin:

Indications (3)
Adverse Effects (2)
A
  1. ACS
  2. Stroke
  3. Arterial Thrombosis
  4. Bleeding
  5. Gastric irritation
23
Q

State the following for Clopidogrel:

MOA
Route

A
  1. ADP receptor inhibitor

2. ORAL

24
Q

State the following for Clopidogrel:

Indications (3)
Adverse Effects (2)
A
  1. ACS
  2. Stroke
  3. In STENT THROMBOSIS

BLEEDING
& TTP!!

25
Q

Which drug has an adverse effect of Thrombotic Thrombocytopenic Purpura?

A

CLOPIDROGEL

decreased ADAMTS13 leading to large wf multimers occluding small vessels

26
Q

What 3 drugs are ADP inhibitors?

A
  1. Clopidrogel
  2. Prasugrel
  3. Ticagrelor
  • all oral
27
Q

State the following for Prasugrel, Ticagrelor :

MOA
Route

A

MOA: ADP inhibitors (same as clopidrogel)

route = ORAL

28
Q

What are the indications for Prasugrel and Ticagrelor
(3)

Side effect?

What is this similar to?

A
  1. ACS
  2. Stroke
  3. In STENT THROMBOSIS

BLEEDING

  • same as clopidrogel
29
Q

Wear drug is a reversible competitive inhibitor of COx1?

Which is irreversible non-competitive?

A
  1. NSAID

2. Aspirin

30
Q

NSAID:

MOA
Route
Indication
Side effect

A

MOA - cox inhibitor (reverisble)

Oral

Many indications - analgesic, antipyretic, anti-platelet

Side effect: BLEEDING, GI issues

31
Q

Dipyramidole:

MOA
Route

A

Phosphodiesterase Inhibitor

ORAL

32
Q

Dipyramidole:

Indications (2)
Side effect

A

Arterial thrombosis, stroke

BLEEDING

33
Q

What are the 2 phosphodiesterase inhibitors?

A

Dypyramidole, Cilostazol

34
Q

Cilostazol:

MOA
Route

A

MOA: phosphodiesterase inhibitor

Oral

35
Q

Cilostazol:

Indication
Side effect

A

INTERMITTENT CLAUDICATION

Adverse = HYPOTENSION!

(phosphodiesterase inhibitor ; Oral)

36
Q

What are the 3 pIIB/IIIa inhibitors?

How are they administered?

A
  1. Abciximab
  2. Eptifibatide
  3. Tirofiban

IV!!!

37
Q
  1. Abciximab
  2. Eptifibatide
  3. Tirofiban

What are the 2 indications for these drugs?
Adverse effect?
How do they function

A
  1. ACS (acute coronary syndrome)
  2. Percutaneous Coronary Intervention (angioplasty)
    - PCI

BLEEDING!!! (all anti-platelets cause bleeding)

MOA: GpIIb/IIIa inhibitors (no aggregation of platelets)

38
Q

What is the absolute contraindication of thrombolytic therapy (with streptokinase/urokinase)

3

Drug interactions?

A
  1. Intracranial bleeding
  2. Massive hemorrhage
  3. PREGNANCY

Drug interactions:
Antiplatelet Drugs
Heparin
Dextrans (coronary vasodilation)

39
Q

A elderly patient was accidently overdosed with streptokinase. Which of the following agent can be used to neutralize bleeding complications?

Protamine sulfate
Vitamin K
Epsilon aminocaproic acid 
Factor VIIa
Factor VIII concentrate
A

EACA

40
Q

Which of the following mechanisms represents the main effect of thrombolytic agents?

Reduces the circulating levels of platelets
Converts plasminogen to plasmin
Interacts with antithrombin
Interacts with heparin cofactor II
Decreases the synthesis of fibrinogen in the liver

A

Converts plasminogen to plasmin

PHARM/MHD - Exam #4 (20 decks)

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