Pharmacology - Chapter 51 - Anticoagulants, Antiplatelet Drugs, and Thrombolytics Flashcards
Hemostasis - def
Process by which the bleeding is stopped.
Hemostasis - Stage 1 - Formation of ….
platelet plug.
Hemostasis - Stage 2 - ?
Coagulation.
Hemostasis - Stage 1 - When platelets come in contact with ___ on surface of damaged blood vessels..Platelets adhere, become ___ and leads to platelet aggregation by building ___ ___…Plus is unstable without ____ reinforcement.
Collagen/activated/fibrinogen bridges/fibrin.
Hemostasis - Stage 2 - Coagulation - production of…
fibrin that reinforces platelet plug.
Intrinsic System - def
all necessary factors for clotting are present within the vascular system.
Extrinsic System - def
thromboplastin, a factor, comes from outside the vascular system.
Coagulation factors #, #, # and ___ require Vitamin __ for their synthesis.
7,9,10, Prothrombin, Vitamin K
Inactivation of factors by ___ 3.
Antithrombin 3.
Physiological removal of clot - done by ___.
Plasmin
Plasmin - an enzyme that ____.
Digests fibrin meshwork.
Thrombolytic Drugs - act by promoting conversion of ___ into ___.
Plasminogen into plasmin.
What are the 4 Thrombolytic Drugs?
Streptokinase, Urokinase, Alteplase, and Antistreplase.
Thrombosis - def
blood clot formed within a blood vessel or within the heart.
Arterial Thrombosis - def
begins with adhesion of platelets to the arterial wall.
Venous Thrombosis - def
develop at sites of slow blood flow.
Drugs used to treat thromboembolic disorders (3)
Antiplatelet Drugs (Aspirin, Tirofiban) Inhibit Platelet Aggregation.
Anticoagulations (heparin, warfarin) - disrupt coagulation cascade and suppress production of fibrin.
Thrombolytic Drugs - alteplase, streptokinase - promote lysis of fibrin and cause dissolution of thrombi.
Anti-platelet drugs - what do they do?
Suppress platelet aggregation. Used to suppress formation of thrombosis in arteries (as opposed to heparin and warfarin which are used to treat thrombi in veins).
What are the three major groups of antiplatelet drugs?
Aspirin (ASA), Ticlopidine (Ticlid), and Tirofiban (Aggrastat)
Aspirin - inhibits…
Cyclooxygenase, an enzyme necessary for platelets to produce TxA2 thromboxane A2.
Ticopidine - an ADP receptor ___.
antagonist.
Tirofiban - Gp2b/3A receptor ___.
Antagonist.
Heparin - a rapid-acting ____.
Anticoagulant.
What is Heparin used for?
Pulmonary Embolism, Stroke, and vein thrombosis.
What are the 3 adverse effects of Heparin?
Hemmorhage, Thrombocytopenia, Hypersensitivity Reactions.
Warfarin - is an ___ anticoagulant.
Oral.
Warfarin - suppressed coagulation by acting as an antagonist of ___ _ (blocks synthesis of __ _ by liver.)
Vitamin K.
What is the use of Warfarin?
Prevents thrombosis formation.
Adverse effects of Warfarin?
Hemmorhage
Thrombolytic Drugs - Streptokinase - what does it do?
Given to remove thrombi that have already been formed. There is a serious risk of bleeding with these drugs.
What is the use of Streptokinase?
MI, Deep vein thrombosis, massive pulmonary emboli.
What are the AE’s of Streptokinase?
Bleeding, Hypotension, and Fever.
