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Module 2 - Hematology > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What is the mechanism of action for ASA

A

Anti platelet - cyclooxygenase inhibitor, prevents synthesis of TXA2 to inhibit platelet aggregation

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2
Q

What are the primary indications for ASA

A

prevention of thrombosis, MI, thrombotic stroke

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3
Q

What monitoring is required for ASA

A

none

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4
Q

Does ASA have an antidote? If so what?

A

no - effect is irreversible for life of platelet (7-10days)

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5
Q

What is the mechanism of action for unfragmented Heparin

A

Antithrombin activator - QUICKLY helps antithrombin inactivate clotting factors thrombin & Xa to prevent formation of fibrin

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6
Q

What route can Heparin be administered

A

Sub q or IV

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7
Q

What are the major AEs associated with Heparin

A

Hemorrhage, Heparin-induced thrombocytopenia

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8
Q

Which anticoagulant is safe in pregnancy?

A

Heparin

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9
Q

What monitoring is required for patients on Heparin

A

platelet counts, aPTT, anti-Xa

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10
Q

What is the antidote for Heparin?

A

Protamine sulfate - 1mg for every 100mg of heparin in the last 2hrs

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11
Q

What is the mechanism of action for fragmented Heparin (LMW Heparin)

A

antithrombin activator - helps antithrombin inactivate Xa (segments too small to also inactivate thrombin)

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12
Q

What route can LMW Heparin be administered

A

ONLY sub q

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13
Q

What the the common AEs associated with LMW Heparin?

A

Bleeding, immune-mediated thrombocytopenia

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14
Q

What are the common indications for use of LMW Heparin

A

prevention of DVT, prevention of ischemic complications due to unstable angina

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15
Q

When should a provider adjust the standard dose of LMW Heparin

A

Dose should be adjusted in pts with Cr clearance of <30ml/min

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16
Q

What monitoring is required for LMW Heparin

A

None required, may do anti-Xa

17
Q

What is the antidote for LMW Heparin

A

Protamine sulfate - not fast reversal because cannot reverse antiXa activity & half life of LMW Hep is 3-6hrs

18
Q

What is the mechanism of action for Warfarin

A

Anticoagulation via inhibition of the enzyme that activates Vitamin K (VKORC1). This in turn decreases production of Vit K dependent clotting factors (VII, IX, X & prothrombin)

19
Q

What the the common AEs associated with Warfarin

A

hemorrhage, fetal hemorrhage & teratogenesis/death

20
Q

What is the indication for Warfarin (Coumadin)

A

long term prevention of thrombus

21
Q

What tests are required for pts on Warfarin

A

INR 2-3 (2.5-3.5 if artificial valve), PT (11-13s)

22
Q

What is the antidote for warfarin

A

Vit K (if doesn’t work may give blood/blood concentrate transfusion)

23
Q

What is the mechanism of action for Apixaban

A

Direct inhibition of factor Xa

24
Q

What are common AEs associated with Apixaban

A

bleeding, spinal/epidural hematoma

25
Q

what are the common indications for apixaban

A

atrial fibrillation, knee/hip replacement

26
Q

When are dose adjustments needed for Apixaban

A

Reduce in mild/mod renal impairment. Stop in use of severe renal or any hepatic impairment.

27
Q

What monitoring is required for Apixaban

A

none

28
Q

What is the antidote for Apixaban

A

Andexnet alfa

29
Q

What is the mechanism of action for Dabigatran

A

Direct, reversible inhibition of thrombin (prevents conversion of fibrinogen into fibrin & factor XIII activation which prevents soluble fibrin converting to insoluble fibrin

30
Q

What are the common AEs related to Dabigatran

A

Bleeding, GI distrubance (dispepsia gastritis)

31
Q

What are indications for use of Dabigatran

A

atrial fibrillation, knee/hip replacement, treat/prevent DVTs&PEs

32
Q

When is dabigatran contraindicated

A

Renal failure, Cr. clearance <30ml/min

33
Q

What monitoring is required for Dabigatran

A

none

34
Q

What is the antidote for Dabigatran

A

Idarucuzumab

35
Q

What factors require vit K for synthesis

A

10, 9, 7 &2

Module 2 - Hematology (3 decks)

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