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Pharm Midterm 1 > Reduce Clotting > Flashcards

Reduce Clotting Flashcards

1
Q

What are platelet aggregation inhibitors used for

A

Primary Hemostasis

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2
Q

What are anticoagulants used for

A

Secondary Hemostais

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3
Q

What are the Platelet Aggregation Inhibitors

A 
Aspirin
Clopidogrel
Ticlopidine
Dipyridamole
Cilostazol
Abciximab
Eptifibatide
Eirofiban
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4
Q

What are the Anticoagulants

A 
Heparin
Enoxaparin
Dalteparin
Tinzaparin
Fondaparinux
Leupirudin
Bivalirudin
Argatroban
Warfarin
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5
Q

What are Thrombolytics used for

A

Tertiary Hemostasis

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6
Q

What do Thrombolytics activate

A

Plasmin

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7
Q

What are the Thrombolytics

A 
Streptokinase
Urokinase
Alteplase
Reteplase
Tenecteplase
Anistreplase
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8
Q

COX inhibitor

A

Aspirin

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9
Q

ADP receptor blockers

A

Clopidogrem

Ticlopidine

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10
Q

PDE inhibitors

A

Dipyridamole

Cilostazol

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11
Q

GPIIb/IIIa blockers

A

Abciximab
Eptifibatide
Tirofiban

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12
Q

Synthetic pentasaccharide

A

Fondaparinux

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13
Q

Direct thrombin inhibitors

A

Lepirudin
Bivalirudin
Argatroban

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14
Q

Coumarin Anti-coagulant

A

Warfarin

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15
Q

Made by beta-hemolytic strep

A

Streptokinase

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16
Q

Recombinant tPA

A

Alteplase

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17
Q

Purified human plasminogen with bacterial streptokinase

A

Anistreplase

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18
Q

Which clotting reducers are irreversible

A

Aspirin
Clopidogrel
Ticlopidine
Abciximab

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19
Q

What does Aspirin do

A

Block TXA2 - Prolong BT

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20
Q

What does TXA2 do

A

Increase affinity of GPIIb/IIIa for fibrinogen

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21
Q

When do you give Aspirin to stop clotting

A

Cerebral Ischemia
Stroke
MI

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22
Q

How long before new COX2 can be synthesized

A

10 days

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23
Q

How do ADP receptor blockers act

A

Inhibit P2Y12 receptor on platelets

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24
Q

When do you use ADP receptor blockers

A

Recent Stroke, MI, acute coronary syndrome

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25
Q

Why do you prefer Clopidogrel over Ticlopidine

A

Less AE

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26
Q

What do you NEVER give with Clopidogrel and why

A

Omeprazole (inactivates 2C19, 3A4)

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27
Q

ADP receptor blockers AE

A

Inhibit P450

Thrombocytopenic purpura

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28
Q

Which ADP receptor blockers can cause neutropenia

A

Ticlopidine

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29
Q

What do you coadminister PDE inhibitors with

A

Aspirin or warfarin

30
Q

What do PDE inhibitors do

A

Increase cAMP

Coronary vasodilation

31
Q

What are PDE inhibitors used for

A

Angina prophylaxis

32
Q

Which GPIIb/IIIa blocker is an irreversible monoclonal Ab

33
Q

Which GPIIb/IIIa blocker is a reversible cyclic peptide antagonist

A

Eptifibatide

34
Q

Which GPIIb/IIIa blocker is a non-peptide reversible antagonist

35
Q

What are GPIIb/IIIa blocker used for

A

Acute coronary syndrome

Angioplasty

36
Q

Which clotting blockers do you give for acute coronary syndrome

A 
Clopidogrel (preferred)
Ticlopidine
Abciximab
Eptifibatide
Tirofiban
37
Q

Which do you give IV ONLY

38
Q

What is a lack of GPIIb/IIIa

A

Glanzmann’s Thrombasthemia

39
Q

What is the DOC clotting reducer in pregnancy

40
Q

What is UFH

A

Unfractionated Heparin

Straight chain anionic GAGs

41
Q

What is LMWH

A

Low Molecular Weight Heparin
Pentasaccharide (binds ATIII)
Higher therapeutic index

42
Q

How does UFH act

A

Binds AT-III increasing activity

AT-III complexes with IX and X to inhibit thrombin

43
Q

How does LMWH act

A

Inhibit X

Less effect on thrombin

44
Q

What are Heparins used for

45
Q

How do you treat excess Heparin

A

Protamine sulfate

46
Q

What is Heparin-induced Thrombocytopenia (HIT)

A

IgG binds Heparin/PF4 complex
Bind to FcR on platelets
Degranulation and PF4 release
Thrombosis and thrombocytopenia

47
Q

Tx for HIT

A

Discontinue Heparin

Give DTI or Fondaparinux

48
Q

What is a selective PF-10 inhibitor

A

Fondaparinux

49
Q

What does Fondaparinux bind

50
Q

What is Fondaparinux used for

A

DVT Tx and prevention

51
Q

What binds the active site of thrombin

A

Direct thrombin inhibitors

52
Q

What are direct thrombin inhibitors used for

A

HIT thrombosis

Coronary angioplasty

53
Q

Which clotting reducers are given parenterally

A

GPIIb/IIIa inhibitors

Direct thrombin inhibitors

54
Q

How often should Warfarin be monitored

A

2-4 weeks via PT

INR

55
Q

What do you monitor with PTT

A

Heparins

Direct thrombin inhibitors

56
Q

What does Warfarin do

A

Inhibit Vit K epoxide reductase

57
Q

What factors does Warfarin affect

A

II, VII, IX, X

58
Q

Which factor is first affected by Warfarin

59
Q

How can you reverse Warfarin action

60
Q

Which is Pregnancy Category X

61
Q

How is Warfarin administered

62
Q

Warfarin AE

A

Narrow therapeutic window
Drug interactions
Hemorrhage

63
Q

Why can Warfarin cause cutaneous necrosis

A

Decreased Protein C activity

Paradoxical hypercoagulability

64
Q

What does Streptokinase do

A

Catalyses PF-V and VII degradation

Activates Plasmin

65
Q

What does Urokinase do

A

Plasminogen to Plasmin conversion

66
Q

Where is Urokinase made

67
Q

When is Urokinase given

A

Lysis of PE

68
Q

What is tPA

A

Serine protease that activates Plasminogen bound to fibrin

69
Q

When is recombinant tPA used

A

2nd line for acute MI and ischemic stroke

70
Q

1st line for acute MI and ischemic stroke

A

Angioplasty

71
Q

Less selective tPA

72
Q

Mutant tPA

A

Tenecteplase

Pharm Midterm 1 (36 decks)

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