Pharmacology I Flashcards
types of Anticoagulants ?
Parentarally and orally
Heparin?
Parenterally administered
derived from pig intestines or cow lungs.
Administed parenteraly to prevent the formulation of blood clots and have many indications.
have poor oral absortion so onyl given by IV
what is the differences between Haparin and LMWH?
LMWH can be dosed less frequently than heparin yet are equally effective.
Orally administered anticoagulants?
Warfarin and Dabigatran
prevent clot formation by inhibiting clotting factors at different areas of the clotting pathway.
What does Warfarin do?
interferes with the formation of citamin K-dependent clotting factors.
max effect of warfain are not achieved until 4-5 days after initiating therapy.
Warfain interferes with..
the formation of vitamin K-dependent clotting factors.
what are the test used to determine how well warfarin works?
PT(prothrombin time) or INR (international normalized ratio
Anticoahulants should not be combined with..
antiplatelet drugs, aspirin, NSAIDs, vitamin supplement and herbs
Warfarin overodse can be reversed by..
giving vitamin K
Warfarin brand name?
Coumadin
Dalteparin brand name?
Fragmin
Enoxaparin brand name?
Lovenox
Heparin brand name?
Heparin Leo
Dabigatran brand name?
Pradaxa
What do thrombolytics do?
are drugs that can dissolve blood clots. They are given in the early stages of stoke to open blood veesels in the brain. also used in the treatment of acute myocardial infarction.
work by activating the fibrinolytic system which is the body’s normal system for preventing excess clotting. increase the activity of plasmin and ancyme that digests fibrin and other clotting factors.
how well does thrombolytics work?
work rapidly and repoen obstructed blood vessel within 90 mins of administration.
lose shelf life rapidly after reconstitution.
must be stored in the fridge and used within 24 hours.
when do these drugs need to be given after a stroke occurs?
first 1-3 hours otherwise the risk of hemorrhage exceeds the benfit
Alteplase brand name?
Activase
Tenecteplase brand name?
TNKase
Drugs to treat hyperlipidemia?
Hyperlipidemia
HMG COA Reductase Inhibitors
Fibric Acid Derivatives
Bile acid sequestrants
Nicotinic Acid Derivatives
What does hyperlipdemia do?
is the excessive buildup of fat in the blood which is a significant risk factor for stroke and myocardial infarction.
What is the emphasis of treating hyperlipidemia?
Reducing LDLs (bad chloesterol- promotes plaque buildup) and raising HDLs (good cholesterol which transports cholesterol from cells in the artery wall back to the liver for removal)
What is HDL?
act as an antioxidant, has protective anti-inflammatory properties and also has antithrombotic, vasodilatory, and anti-infectious properties.
What do HMG COA Reductase inhibitors do?
also called “statins”
they are the most effective at lowering LDL however they only minimally elevate HDL
is an enyme that is invloved in the final step of cholesterol synthesis.
increase LDL clearance
Adverse effects of statins?
Myositis (inflammation of muscle) and rhadbomyolysis (breakdown of muscle fibers)
also elevate liver enzymes, resulting in liver dysfunction
Atorvastatin brand name?
Lipitor
Fluvastatin brand name?
Lescol
Lovastatin brand name?
Mevacor
Pravastatin brand name?
Pravachol
Rosuvastatin brand name?
Crestor
Simvastatin brand name?
Zocor
What do Fibric Acid Derivatives do?
increase the clearance of very-low density lipoproteins. Fibrates are less effective than statins at reducing LDL and in elevating HDL
Fibrates decrease LDL & triglycerides and increase HDL by activating a protein called peroxisome proliferator-activated recetor alpha
What happens if statins and fibrates are given together?
they interact and may increase the likelihood of development of myopathies