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Pharmacology quiz 3 > Stroke and coagulants > Flashcards

Stroke and coagulants Flashcards

1
Q

What procedures call for use of coagulants?

A

oral anticoagulant overdoses, CABG, orthopedic procedures

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2
Q

What are 2 ways to enforce clotting?

A

Facilitate clot cascade, Prevent fibrinolysis

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3
Q

Factors given to hemophiliacs?

A

Hemophilia A- Factor 8, Hemophilia B- Factor 9

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4
Q

What drugs can prevent coagulopathies?

A

FEIBA, Novoseven, Prothrombin complex concentrate, Cryoprecipitate

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5
Q

what are uses for anti-inhibitors?

A

Hemophilia A and B patients for surgery, Pradaxa antidote

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6
Q

ADR for anti-inhibitors

A

Allergy, Thrombotic events- stroke

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7
Q

What is the MOA for anti-inhibitors?

A

precursor and activated forms of factors 2,7, 9, 10

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8
Q

Prothrombin complex mechanism?

A

contains factors 2, 7, 9, 10, protein C and S

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9
Q

Use of prothrombin?

A

warfarin reversal

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10
Q

how does factor VIIa work?

A

activates factors 9 and 10, injectable until bleeding stops

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11
Q

Indications for factor VIIa use?

A

hemophilia A and B, unapproved uses (bleeding from trauma or surgery, intracranial bleeds, warfarin reversal)

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12
Q

what drugs stop fibrinolysis?

A

aminocaproic acid, tranexamic acid

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13
Q

MOA of aminocaproic acid

A

binds with plasminogen so it can’t convert to plasmin and plasmin can’t breakdown fibrin

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14
Q

uses of aminocaproic acid

A

acute bleeding in a surgical setting

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15
Q

MOA of tranexamic acid

A

displaces plasminogen from fibrin and inhibits fibrinolysis inhibiting the proteolytic activity of plasmin

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16
Q

uses of tranexamic acid

A

hemophillia to reduce or prevent hemorrhage following tooth extraction, treatment of heavy menstrual bleeding

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17
Q

MOA of topical thrombin

A

activates platelets and converts fibrinogen to fibrin

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18
Q

MOA of cellulose (oxidized), ferric subsulfate, and gelatin absorbable

A

aids in clot formation

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19
Q

What is tisseal

A

fibrin sealant, combination of fibrinogen, fibrin and aprotinin used at surgical sites

20
Q

uses for desmopressin?

A

hemophilia and hemostasis

21
Q

how does desmopressin come as dosage forms?

A

IV infusion or nasal spray

22
Q

What does desmopressin increase?

A

VWF

23
Q

what are the risk factors for stroke?

A

HTN, hyperlipidemia, DM, smoking, unhealthy diet, lack of physical activity, obesity

24
Q

What are the types of hemorrhagic stroke?

A

intracerebral, subarachnoid hemorrhage, intracerebral aneurysm, arteriovenous malformation (AVMs)

25
Q

FAST

A

face, arm, speech, time

26
Q

etiology of intracerebral hemorrhage

A

spontaneous rupture of small vessel damage by chronic HTN

27
Q

Etiology of SAH?

A

underlying cerebrovascular malformation in an otherwise normal patient

28
Q

what type of stroke is most common?

A

ischemic

29
Q

etiology of intracerebral aneurysm

A

vessel rupture

30
Q

Etiology of AVM

A

congenital vascular anomaly

31
Q

how is intracerebral hemorrhage controlled and treated?

A

ABCs, BP control (not too low), analgesia, sedation

32
Q

How is SAH treated?

A

prophylactic antiseizure drugs, do NOT lower BP!, CCB (Nimodipine oral liquid)

33
Q

ADR of Nimodipine

A

HOTN, HA - greater effects on cerebral arteries than other arteries

34
Q

treatment goals of ischemic stroke?

A

prevent/reverse brain injury - ABCs, watch glucose, STAT non-contrast head CT, IV thrombolysis, antithrombotic treatments

35
Q

How soon do pts with ischemic stroke need to be treated?

A

3-4.5 hours from onset of sxs, must dx and treat within an hour of presentation, brain tissue not salvageable after 4.5 hours

36
Q

what gender is mor elikely to have stroke?

A

women

37
Q

Treatment of ischemic stroke (drug)?

A

alteplase (thrombolysis)

38
Q

what antiplatelet is used in stroke?

A

clopidogrel

39
Q

What LDL is it necessary to use atilipemics after stroke?

A

>120 - want to get it down to 70

40
Q

when is combination therapy of ASA and clopidogrel after stroke appropriate?

A

TIAs

41
Q

what stroke severity score is it not necessary to use alteplase?

A

<5 - use neuro opinion

42
Q

what is the oral liquid preparation of CCB for stroke?

A

Nymalize

43
Q

how long does it take brain cells to die from ischemia?

A

4-10 minutes

44
Q

what is considered high, caution, and low-risk on the stroke risk scorecard?

A

>3 from high risk, 4-6 from caution, 6-8 from low-risk

45
Q

what type of stroke has a better prognosis?

A

ischemic

46
Q

What coagulant is used in cervical bx?

A

ferric subsulfate

Pharmacology quiz 3 (4 decks)

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