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FINALS - HAEM > pharmacology > Flashcards

pharmacology Flashcards

1
Q

function aspirin

A

inhibit coX 1 and 2

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2
Q

action COX

A

synthesises PGE and thromboxane

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3
Q

how does aspirin work as an antiplatelet

A

inhibits formation of thromoxane A2 -> reduces platelet ability to aggregate

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4
Q

what condition is aspirin 1st line

A

IHD

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5
Q

what drugs potentiate aspirin

A

hypoglycaemics, warfarin, steroids

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6
Q

why should aspirin not be used in children + what exception

A

risk of reyes // except kawasaki

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7
Q

why should aspirin not be used in children + what exception

A

risk of reyes // except kawasaki

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8
Q

how long does aspirin need to be stopped before suregry

A

1 week

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9
Q

what other drugs are the same class as clopidogrel

A

prasugrel, ticagrelor, ticlopidine

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10
Q

mechanism clopidogrel and how does it inhibit platelets

A

antagonist ADP (blocks) –> reduces platelet aggregation

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11
Q

when is clopidogrel used 1st line

A

following stroke // PAD

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12
Q

what drugs make clopidogrel less effective

A

PPI

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13
Q

2 other common antiplatelets

A

dipyramidole and abcximab

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14
Q

how does unfractionated heparin work as an anticoagulant

A

inhibits thrombin, X, IX, XI, and XII

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15
Q

how does LMWH anticoag

A

activates antithrombin III (and inhibits Xa)

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16
Q

how is standard heparin given and what is the duration of action

A

IV, long

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17
Q

how how is LMWH given and what is the duration of action

A

subcut, long

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18
Q

SE heparin

A

bleeding // thrombocytopenia // osteoporosis // hyperkalaemia

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19
Q

how is heparin monitored

A

standard = longer APTT // (LMWH = anti Xa)

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20
Q

what is heparin induced thrombocytopenia

A

antibodies to heparin // is prothrombotic (causes more clots)

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21
Q

when does heparin induced thrombocytopenia develop

A

5-10 days after treatment

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22
Q

symptoms heparin induced thrombocytopenia

A

lwo platelets, thrombosis, skin allergy

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23
Q

mx heparin induced thrombocytopenia

A

thrombin inhibitor eg argatroban // danaparoid

24
Q

mx heparin overdose

A

protamine sulphate (only LMWH)

25
Q

indications DOACs

A

prophlyaxis VTE after MSK surgery // stroke prevention in AF

26
Q

when are DOACs indicated for stroke prevenetion in AF

A

previous stroke, TIA, embolism // LVEF <40 // HF class II // 75 // 65 + DM, coronary heart disease, HTN

27
Q

how does dabigratan work

A

(oral) direct thrombin inhibitor (DOAC)

28
Q

contraindications dabigatran

A

reduce dose in CKD, do not prescribe if creatinine clearance <30 // recent mechanical heart valve

29
Q

mx overdose dabigatran

A

Idarucizumab

30
Q

mechanism riveroxaban, apixapan, edoxaban

A

direct Xa inhibitor

31
Q

where is apixian and edoxaban excreted

A

faecal

32
Q

riveroxaban antidote

A

Andexanet alfa*

33
Q

apixipan antidote

A

Andexanet alfa*

34
Q

what type of drug is bivalirudin

A

direct thrombin inhibitor (IV)

35
Q

mechanism fondaperinux

A

activate antithrombin III (sub cut)

36
Q

mechanism wardarin

A

inhibits vit K (1972) (IX + X, VII, II)

37
Q

indications warfarin

A

mechanical heart valve // 2nd line to DOACs

38
Q

what does the INR measure

A

patients prothrombin time : normal PT time

39
Q

SE warfarin

A

bleeding // tetarogenic (OK IN BREASTFEEDING) // skin necrosis // purple toes

40
Q

what can potientiate warfarin (generally)

A

liver disease // P450 enzyme inhibitors // cranberry juice // NSAIDs

41
Q

which drugs (P450 inducers) decrease INR and effects of warfarin

A

phenytoin, carbamezepine, phenobarbitol // rifampicin // st johns // chronic alcohol // smoking

42
Q

which drugs (P450 inhibitors) increase INR and effects of warfarin

A

cipro, clarithro, erythro, isoniazid // omeprezole // amiodarone // allopurinol // ketconazaol, fluclonazole // fluxoetine + sertraline // sodium valproate // ritonavir // acute alcohol

43
Q

mx warfarin + major bleed

A

stop // IV VitK 5mg // PT complex (or FFP)

44
Q

mx warfarin INR >8 (minor bleed)

A

stop // IV VitK 1-3mg // if still high after 24hrs give again // restart warfarin INR <5

45
Q

mx warfarin INR >8, no bleed

A

stop // VitK 1-5mg oral // repeat vitK at 24hrs if needed // restart <5

46
Q

mx warfarin INR 5-8 minor bleed

A

stop // IV vitK 1-3mg // restart when INR <5

47
Q

mx warfarin INR 5-8 no bleed

A

withhold 1-2 doses

48
Q

when might antiplatelets and anticoag be prescribed togetehr

A

CVD + AF/ DVT/ valvular disease

49
Q

mx for patients with stable CVD and AF

A

anticoag only

50
Q

platelet and coag mx post ACS (eg MI)

A

2 antiplatelets + 1 anticoag for 4-6 weeks // then 1 antiplatelet + 1 anticoag to complete 12 months

51
Q

mechanism tranexamic acid

A

binds to plasmingogen to prevent breakdown of fibrin clot

52
Q

how is tranexamic acid administered after major haemorrhage

A

IV bolus –> infusion

53
Q

what are thrombolytic drugs

A

activate plasminogen –> plasmin (break down fibrin)

54
Q

indication thrombolysis

A

stroke, PE

55
Q

examples thrombolytic drugs

A

alteplase, streptokinase, tenecteplase

56
Q

contraindications thrombolysis

A

active bleed // recent bleed // coagulation + bleeding disorders // intracranial tumour // severe hypertension // aortic dissection // stroke < 3months

FINALS - HAEM (18 decks)

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