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Pharmacology > Pharmacology - Anticoagulant, Anti-platelet & Thrombolytic Drugs > Flashcards

Pharmacology - Anticoagulant, Anti-platelet & Thrombolytic Drugs Flashcards

1
Q

Anti-platelet

A

Most effective for ARTERIAL thrombosis

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2
Q

Anticoagulant

A

Most effective for VENOUS thrombosis

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3
Q

Anti-platelet Drugs

A
  • Aspirin

- clopidogrel (Plavix)

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4
Q

Anticoagulant Drugs

A
  • warfarin (Coumadin)
  • heparin (UFH)
  • enoxaparin (Lovenox) LMWH
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5
Q

Thrombolytics

A

Agent that remove thrombi that have already formed

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6
Q

Thrombolytic Drugs

A

streptokinase (Streptase)

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7
Q

Sequence of Clot Formation

A

1) platelet aggregation (plug formation)
2) coagulation (fibrin production)
3) physiologic removal of clots
4) thrombosis

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8
Q

Coagulation activation pathways

A

Contact activation pathway (INTRINSIC) & Tissue factor pathway (EXTRINSIC)

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9
Q

Physiologic clot removal

A

Plasminogen –> plasmin

Plasmin = enzyme that degrades mesh network of clot

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10
Q

Aspirin - ACTION

A

.

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11
Q

Aspirin - INDICATION

A

.

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12
Q

Aspirin - DOSAGE

A

Route-

Onset-

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13
Q

clopidogrel (PLAVIX)

A

Action-

Indication-

Onset

Duration

Route

Labs

Antidote

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14
Q

warfarin (COUMADIN)

A

.

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15
Q

heparin (UFH)

A

.

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16
Q

enoxaparin (LOVENOX) LMWH

A

.

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17
Q

streptokinase (STREPTASE)

A

.

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18
Q

Warfarin Antidote

A

.

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19
Q

Heparin Antidote

A

.

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20
Q

Enoxaparin Antidote

A

.

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21
Q

Streptokinase Antidote

A

.

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22
Q

Anemia

A

A decrease in the number, size or hemoglobin content of erythrocytes

23
Q

Causes of Anemia

A

Blood loss
Hemolysis
Bone marrow dysfunction
Deficiencies: Iron, folic acid, B12

24
Q

Ways iron is eliminated

A

Excretion (minimal
Menorrhagia
Hemorrhage
Blood donations

25
Q

Sources of Iron

A 
Liver
Egg yolk
Brewers yeast
Wheat germ
Muscle meat
Fish
Fowl
Whole grain cereals
Beans
Green leafy veggies
26
Q

Types of Anemia

A

Iron deficiency
Vitamin B12 deficiency
Folic acid Anemia

27
Q

Iron deficiency anemia

A

RBCs are MICROCYTIC HYPOCHROMIC

Absence of hemosiderin in bone marrow

28
Q

Ferrous Sulfate

A

Oral preparation to Tx iron deficiency anemia

  • Least expensive
  • AE: GI disturbances, staining of teeth, toxicity

HARMLESS DARK OR GREEN COLOR STOOLS

29
Q

Iron Dextran

A 
PARENTAL
 For pts who:
do not tolerate/respond to PO Fe
Unable to absorb bc GI disease
Severe blood loss

AE: anaphylactic reaction

30
Q

Vitamin B12 Anemia

A

Megaloblastic Anemia
Injury to the nervous system (pts can develope peripheral neuropathy or anesthesia)
GI disturbances
Impaired WBC and platelets

31
Q

Folic Acid & Vit. B12 Link

A

Folic acid (inactive)—>Vit. B12—> Folic acid (active)—> DNA synthesis —> normal maturation of RBCs (&other cells)

32
Q

Sources of Vitamin B12

A

Liver & Dairy Sources

33
Q

Cause of Vit. B12 deficiency

A
  • impaired absorption

- absence of intrinsic factor (pernicious anemia)

34
Q

How to diagnose Vit b12 deficiency

A 
Measurement of plasma B12 content
Schilling Test (measures B12absorption)
35
Q

Cyanobalamin

A

Vit b12 deficiency drug

AE: HYPOKALEMIA
D-D: drugs that also cause hypokalemia
Used for long term Tx

36
Q

Folic acid

A

Essential factor for DNA synthesis

37
Q

Sources of Folic acid

A 
Green veggies (peas, lentils, broccoli, asparagus, spinach)
Oranges
Whole wheat
Beats
Liver
38
Q

Causes & diagnosis of Folic acid anemia

A

Causes: poor diet (alcoholism), malabsorption syndromes (sprue)

Diagnosis: Folic acid (folate) levels

39
Q

Consequences of Folic acid anemia

A
  • Megaloblastic anemia

- neural tube defects

40
Q

Folic acid supplements

A

Types: active & inactive

Indications:
Tx of Megaloblastic anemia due to Folic acid deficit
Prophylaxis during pregnancy
initial Tx of severe Megaloblastic anemia from Vit b12 deficit

41
Q

Folic acid supplement WARNING

A

Adequate doses of folic acid can mask Vit B12 deficiency

Folic acid does NOT protect against damage to the nervous system from lack of B12

42
Q

Who should be treated for obesity?

A

BMI >30 (obese)
BMI 25-29.9 (overweight) that have 2 risk factors
Waist circumference >40” (men), >35” (women) plus 2 risk factors

43
Q

Modes of treatment for obesity

A 
Diet therapy
Exercise
Behavior modification
Drug therapy
Bariatric surgery
44
Q

Long term obesity drug

A

orlistat (XENICAL)

45
Q

orlistat (XENICAL)

A
  • Lipase inhibitor
  • reduces absorption of fat in GI tract

AE: GI effects (oily spotting, flatulence, urgency, oily stools, increase frequency of stools, fecal incontinence) & decreased absorption of fat soluble vitamins

Caution: due to decreased absorption of vitamin K+ the effects of warfarin may be increased

46
Q

Erectile Dysfunction Medications

A

Phosphodiesterase type 5 (PEDS5) inhibitors I

47
Q

sildenafil (VIAGRA)

A

Inhibits PDE5, causes mild vasodilation

Use: ED, pulmonary HTN
-little or NO effect on men who do not have ED

Not approved for use in women
AE: hypotension, priapism, nonarteritic ischemic optic neuropathy (NAION), sudden hearing loss
D-D: nitrates, alpha blockers, inhibitors cytochrome P450
ABSOLUTE CONTAINDICATION IF TAKING NITROGLYCERIN

48
Q

S/S of BPH

A 
Urinary hesitancy
Urinary urgency
Increase frequency of urination
Dysuria
Nocturnal
Straining to void
Post void dribbling
Decrease force/caliber of stream
Sensation of incomplete bladder emptying
49
Q

BPH Drug therapies

A

1) 5-alpha-reductase inhibitor
2) alpha 1-adrenergic antagonists

COMBINED THERAPY is more effective than either drug alone

50
Q

finasteride (PROSCAR)

A

5-alpha-reductase inhibitor
Reduces level of DHT & PSA levels
AE:teratogenic to male fetus (Cat.X)

51
Q

hytrin (TERAZOSIN) & flomax (TAMULOSIN)

A

Alpha1-adrenergic antagonists
Tx BPH
Relax smooth muscle in bladder neck, prostate capsule and prostatic urethra

52
Q

Anticoagulant with RAPID onset

A

Heparin (onset minutes)

53
Q

PT/INR labs should be drawn for which anticoagulant?

A

Warfarin (Coumadin)

54
Q

Anticoagulant that lasts days

A

Warfarin (Coumadin)

Pharmacology (6 decks)

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