Pharmacology of VTE

Question 1

Vitamin K

Answer 1

Group of fat soluble essential factors for modification of protein for blood coag

Question 2

Vitamin K1

Answer 2

Phylloquinone/Phytonadione

Question 3

Vitamin K2

Answer 3

Menaquinone

Question 4

Role of Vitamin K

Answer 4

Required to add carboxyl groups on Factors II, VII, IX< X and protein C/S

Question 5

Factors II, VII, XI, X need

Answer 5

to be carboxylated to become Ca binding active froms

Question 6

Enzyme for activation of factors is?

Answer 6

Gamma-glutamyl carboxylase

Question 7

Vitamin K defieciency

Answer 7

Increased tendency to bleed

Induction of fetal bone abnormalities via osteocalcin not getting activated

Question 8

Vitamin K Antagonists

Answer 8

Warfarin/Coumadin

Block VKOR which takes the oxygenated form of Vitamin K back to regular Vitamin K

Question 9

Which form of warfarin enantiomers is most potent?

Answer 9

S

Question 10

Warfarin has no direct effect on

Answer 10

Previously circulating clotting factors

Question 11

Warfarin A & PK

Answer 11

Oral
Hepatic + CYP (esp 2C9)
Teratogenic

Question 12

Warfarin dosing

Answer 12

Based on continual clinical and laboratory monitoring (INR)

Question 13

Prothrombin Time

Answer 13

Extrinsic pathway
Monitor warfarin dose
Vitamin K depedent clotting factor sensitivity varies though

Question 14

INR

Answer 14

Correction for differences in teh sensitivity of thromboplastin reagents
Allows for comparison of results between labs and standardizes reporting of the prothrombin time!!!!!

Question 15

ISI

Answer 15

The higher the ISIS, the less sensitive the thromboplastin

Question 16

Warfarin AE

Answer 16

Bleeding (Vit K = antidote or immediate effect = frozen plasma)
Osteoporosis
Purple toe syndrome
Warfarin-induced skin necrosis
Teratogenic (X)

Question 17

Purple Toe Syndrome

Answer 17

Small deposits of cholesterol breaking loose and flowing into the blood vessels in the skin of the feet

Question 18

Conditions that reduce warfarin activity?

Answer 18

Cholestyramine (bile acid sequestrant)
Nephrotic syndrome: reduced half life
Barbiturates, Rifampin, Phenytoin, alcohol (P450)
Vitamin K
Pregnancy

Question 19

Conditions that increase warfarin activity?

Answer 19

Antimicrobials (reduce vitamin K)
Vit K Deficiency
Impaired hepatic function
Age