Pharmacology

Question 1

Decreases thrombin and factor Xa

Answer 1

Heparin

Question 2

Toxicity of Heparin

Answer 2

Bleeding, HIT, osteoporosis

Question 3

Antidote for heparin

Answer 3

Protamine Sulfate

Question 4

Enoxaparin and Dalteparin

Answer 4

LMW heparin, act more on factor Xa, better bioavailability

Question 5

Explain HIT

Answer 5

development of IgG antibodies against heparin bound to platelet factor 4 (PF4)

Question 6

Derivatives of hirudin, the anticoagulant used by leeches, inhibit thrombin directly

Answer 6

Argatroban, Bivalirudin

Question 7

Affects extrinsic pathway and increases PT

Answer 7

Warfarin

Question 8

Used after STEMI, venous thromboembolism prophylaxis and prevents stroke in atrial fibrillation

Answer 8

Warfarin

Question 9

PT/INR

Answer 9

Warfarin

Question 10

Fresh Frozen plasma

Answer 10

for rapid reversal of severe warfarin overdose

Question 11

Vitamin K

Answer 11

reversal of warfarin overdose

Question 12

Apixaban, Rivaroxaban, Fondaparinux

Answer 12

Direct Factor Xa inhibitors

Question 13

Tx and prophylaxis of DVT and PE

Answer 13

Rivaroxaban (a direct factor Xa inhibitor)

Question 14

PT or PTT corrected with mixing study

Answer 14

Patient has a factor deficiency

Question 15

PT or PTT not corrected with mixing study

Answer 15

Standard plasma didn’t correct blood, patient has a factor inhibitor

Question 16

Site of action for Warfarin

Answer 16

Liver

Question 17

Deficiency in Protein C or S

Answer 17

Warfarin causes tissue necrosis

Question 18

Alteplase

Answer 18

Thrombolytic

Question 19

Directly or indirectly aid conversion of plasminogen to plasmin

Answer 19

Alteplase (tPA)

Question 20

C/I of Thrombolytics

Answer 20

Cerebral hemorrhage, bleeding diatheses, or severe HTN

Question 21

Tx of Thrombolytic Toxicity

Answer 21

Aminocaproic Acid

Question 22

Irreversibly inhibits cyclooxygenase by covalent acetylation

Answer 22

Aspirin

Question 23

Clinical Effects of Aspirin

Answer 23

Antipyretic, Analgesic, Anti-inflammatory, antiplatelet

Question 24

Reye Syndrome in children with Viral infection

Answer 24

Aspirin

Question 25

Gastric Ulcerationand tinnitis

Answer 25

Aspirin toxicity

Question 26

Thienopyridines

Answer 26

Clopidogrel, Ticlopidine, Prasugrel, ADP receptor inhibitors

Question 27

Non-thienopyridine

Answer 27

Ticagrelor, reversible ADP receptor inhibitor

Question 28

Inhibit platelet aggregation by irreversibly blocking ADP receptors this inhibiting fibrinogen binding by preventing gpIIb/IIIa from binding fibrinogen

Answer 28

Thienopyridines - Clopidogrel, Ticlopidine, Prasugrel

Question 29

C/I for Prasugrel

Answer 29

>75y/o, Hx of TIA or CVA, weighs <60kg

Question 30

A/E of Ticlopidine

Answer 30

TTP and neutropenia

Question 31

Ued for acute coronary syndrome and coronary stenting

Answer 31

ADP receptor inhibitors (clopidogrel and Prasugrel)

Question 32

Pro-drug that needs CYP-2C19 (30% pop are poor responders)

Answer 32

Clopidogrel

Question 33

Phosphodiesterase III inhibitor, increase cAMP in platelets to inhibit aggregation

Answer 33

Cilostazil, dipyridamole

Question 34

Used for Intermittent claudication

Answer 34

Cilostazil, dipyridamole

Question 35

Toxicity of Cilostazil, dipyridamole

Answer 35

nausea, HA, facial flushing, hypotension, abdominal pain

Question 36

GP IIb/IIIa inhibitors

Answer 36

Abciximab, Eptifibatide, tirofiban

Question 37

Used for Unstable angina, percutaneous transluminal coronary angioplasty

Answer 37

Abciximab, Eptifibatide, tirofiban

Question 38

Agent used to treat myocardial infarction (MI) and to reduce incidence of subsequent MI

Answer 38

Aspirin

Question 39

Antiplatelet drug reserved for patients allergic to aspirin

Answer 39

Ticlopidine

Question 40

Side effect for ticlopidine

Answer 40

Neutropenia and agranulocytosis

Question 41

Irreversible inhibitor of platelet P2Y12 receptors; effective in preventing transient ischemic attack

Answer 41

Clopidogrel and ticlopidine

Question 42

Route of administration of warfarin

Answer 42

Oral

Question 43

Contraindication of warfarin

Answer 43

Pregnancy

Question 44

Anticoagulant of choice in pregnancy

Answer 44

Heparin

Question 45

Heparin (PTT) increases activity of

Answer 45

Antithrombin 3

Question 46

Routes of administration of heparin

Answer 46

IV and SC

Question 47

Two anticoagulant used for prophylaxis and treatment of thrombosis in patients with heparin-induced thrombocytopenia

Answer 47

Bivalirudin, argatroban

Question 48

Side effect of tissue plasminogen activators

Answer 48

Cerebral hemorrhage

Question 49

Indications for thrombolytics

Answer 49

Pulmonary embolism, severe deep vein thrombosis

Question 50

Thrombolytic that can cause allergic reaction and non-selective systemic fibrinolysis

Answer 50

Streptokinase