Reverse Pharm Heme Flashcards

1
Q

Activator of antithrombin leading to decr. thrombin and factor X

Short half life

Immediate anticoag for PE, acute coronary syndrome, MI, DVT
Used during pregnancy

Follow PTT

Bleeding, HIT, osteoporosis, drug drug interaction

Protamine sulfate (positively charge molecule bind neg)

A

Heparine\

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2
Q

LMWH

Same mechanisms and use as heparin

Act more on factor Xa
Have better bioavailability
Longer halflife
Can be administered Sub w/o monitoring
Not easily reversible
A

Enoxaparin, dalteparin

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3
Q

Factor Xa inhibitor

Very similar to LMWHs

A

Fondaparinux

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4
Q

Development of IgG antibodies against heparin bound platelet factor 4.

The complex activates platelets

Thrombosis and thrombocytopenia

A

HIT

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5
Q

Inhibit thrombin directly

1=related to hirudin, anticoag used by leaches

Alternatives to heparinn for pts. with HIT

A

argatroban, bivalirudin (1), and dabigatran

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6
Q

Interferes with gamma carboxylation of vitamin k clotting factors II, VII, IX, X and proteins C and S (epoxide reductase)

Long half life

Chronic anticoag
Not used in pregnant women

Follow PT/INR

Bleeding, teratogenic, skin/tissue necrosis

Rapid reversal=FFP
reversal=vitamin K

Giving heparin before starting warfarin to avoid a pro coag state.

A

Warfarin

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7
Q

Direct factor Xa inhibitors

Bind to and directly inhibit factor Xa

Treatment and prophylax for DVT
Stroke prophylaxis in pts with a fib
1=treatment and prophylaxis of PE

Oral agents do not require monitoring

Bleeding
No reversal agent

A

apixaban and rivaroxaban (1)

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8
Q

thrombolytics

Directlly or indirectly aid conversion of plaminogen to plasmin, which cleaves thrombin and fibrin clots, inhibits other factors
Incr. PT
Incr. PTT
No change in platelet count

Early MI
Early ischemic stroke
direct thrombolysis of severe PE

Bleeding
CI=pts w/ active bleeding, history of IC bleeding, recent surgery, known bleeding diathesis, or severe hypertension

Aminocaproic acid, an inhibitor of fibrinolysis
FFP to correct factor deficiencies

A

alteplase, reteplase, streptokinase, and tenecteplase

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9
Q

Irreversibly inhibit COX-1 and COX-2 enzyme by covalent acetylation
Platelets cannot synthesize new enzyme, so more platelets must be formed
Incr. bleeding time, decr. TXA2 and PGs, no effect on PT or PTT

Antipyretic, analgesic, anti-inflammatory, antiplatelet

Gastric ulceration, tinnitus

Acute renal failure, interstitial nephritis, upper GI bleed

Reye syndrome in children w/ viral infection

Hyperventilation and respiratory alk then transitions to mixed metabolic acidosis/resp alk

A

Aspirin

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10
Q

ADP receptor Inhibitors

Inhibit platelet aggregation by irreversibly blocking ADP receptors
Prevent expression of IIb/IIIa on platelet surface (no fibrinogen aggregation)
1=reversible

Acute coronary syndrome
coronary stinting
Decr. incidence or recurrence of thrombotic stroke

2=Neutropenia
TTP maybe

A

clopidogrel, prasugrel, ticagrelor (1), and ticlodipine (2)

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11
Q

Phosphodiesterase III inhib
Incr. cAMP in platelets=inhibition of platelet aggregation
vasodilators

Intermittent claudication,
coronary vasodilation
Prevention of stroke and TIAs (with aspirin)
Angina prophylaxis

nausea, headache, facial flushing, hypotension, abdominal pain

A

Cilastazol

Dipyridamole

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12
Q

GP IIb/IIIa inhib

Bind to GP IIb/IIIa on activated platelets, preventing aggregation

Unstable angina
Percutaneous transluminal coronary angioplasty

Bleeding, thrombocytopenia

A

abciximab , eptifibatide, and tirofiban

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