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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
Why do you prefer Clopidogrel over Ticlopidine
Less AE
26
What do you NEVER give with Clopidogrel and why
Omeprazole (inactivates 2C19, 3A4)
27
ADP receptor blockers AE
Inhibit P450 | Thrombocytopenic purpura
28
Which ADP receptor blockers can cause neutropenia
Ticlopidine
29
What do you coadminister PDE inhibitors with
Aspirin or warfarin
30
What do PDE inhibitors do
Increase cAMP | Coronary vasodilation
31
What are PDE inhibitors used for
Angina prophylaxis
32
Which GPIIb/IIIa blocker is an irreversible monoclonal Ab
Abciximab
33
Which GPIIb/IIIa blocker is a reversible cyclic peptide antagonist
Eptifibatide
34
Which GPIIb/IIIa blocker is a non-peptide reversible antagonist
Tirofiban
35
What are GPIIb/IIIa blocker used for
Acute coronary syndrome | Angioplasty
36
Which clotting blockers do you give for acute coronary syndrome
``` Clopidogrel (preferred) Ticlopidine Abciximab Eptifibatide Tirofiban ```
37
Which do you give IV ONLY
Heparins
38
What is a lack of GPIIb/IIIa
Glanzmann's Thrombasthemia
39
What is the DOC clotting reducer in pregnancy
Heparins
40
What is UFH
Unfractionated Heparin | Straight chain anionic GAGs
41
What is LMWH
Low Molecular Weight Heparin Pentasaccharide (binds ATIII) Higher therapeutic index
42
How does UFH act
Binds AT-III increasing activity | AT-III complexes with IX and X to inhibit thrombin
43
How does LMWH act
Inhibit X | Less effect on thrombin
44
What are Heparins used for
DVT PE MI
45
How do you treat excess Heparin
Protamine sulfate
46
What is Heparin-induced Thrombocytopenia (HIT)
IgG binds Heparin/PF4 complex Bind to FcR on platelets Degranulation and PF4 release Thrombosis and thrombocytopenia
47
Tx for HIT
Discontinue Heparin | Give DTI or Fondaparinux
48
What is a selective PF-10 inhibitor
Fondaparinux
49
What does Fondaparinux bind
AT-III
50
What is Fondaparinux used for
DVT Tx and prevention
51
What binds the active site of thrombin
Direct thrombin inhibitors
52
What are direct thrombin inhibitors used for
HIT thrombosis | Coronary angioplasty
53
Which clotting reducers are given parenterally
GPIIb/IIIa inhibitors | Direct thrombin inhibitors
54
How often should Warfarin be monitored
2-4 weeks via PT | INR
55
What do you monitor with PTT
Heparins | Direct thrombin inhibitors
56
What does Warfarin do
Inhibit Vit K epoxide reductase
57
What factors does Warfarin affect
II, VII, IX, X
58
Which factor is first affected by Warfarin
VII
59
How can you reverse Warfarin action
Vit K
60
Which is Pregnancy Category X
Warfarin
61
How is Warfarin administered
Oral
62
Warfarin AE
Narrow therapeutic window Drug interactions Hemorrhage
63
Why can Warfarin cause cutaneous necrosis
Decreased Protein C activity | Paradoxical hypercoagulability
64
What does Streptokinase do
Catalyses PF-V and VII degradation | Activates Plasmin
65
What does Urokinase do
Plasminogen to Plasmin conversion
66
Where is Urokinase made
Kidneys
67
When is Urokinase given
Lysis of PE
68
What is tPA
Serine protease that activates Plasminogen bound to fibrin
69
When is recombinant tPA used
2nd line for acute MI and ischemic stroke
70
1st line for acute MI and ischemic stroke
Angioplasty
71
Less selective tPA
Reteplase
72
Mutant tPA
Tenecteplase

Pharm Midterm 1 (36 decks)

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