Stroke Drugs Flashcards
Abciximab
Anti platelet drug
Binds to glycoprotein IIb/IIIa receptor of platelets
Inhibits platelet aggregation by preventing the binding of fibrinogen and von willebrand factor.
SE:
Hypotension, nausea, back pain, major hemorrhage.
Clopidogrel
Anti platelet drug
Prevents binding of ADP to its platelet receptor
Imparing ADP mediated activation of glycoprotein IIB/IIIA complex.
Aggregation of platelets reduced due to lack of fibrinogen binding to them.
SE: headaches, nausea, dyspepsia(indigestion) increased bleeding, nosebleeds.
Dipyridamole
Anti platelet drug
Inhibits both adenosine deaminaise and phosphodiesterase (PDE) preventing the degradation of cAMP (an inhibitor of platelet function).
Decreases platelet aggregation.
SE: dizziness, stomach pain, headache, rash, vomiting, flushing, itching.
Anti thrombin
Anti coagulant
Inhibitor of blood coagulation
Endogenous can be limited
Exogenous then given to correct deficiency. Can also aid heparin.
Inactivates fibrinolytic enzyme plasmin.
Heparin
Anticoagulant
Iv or sub cut , poor oral absorption
Is present in liver, lungs, FROM mast cells and is a natural anticoagulant
Binds reversibly to anti thrombin III and accelerates the rate at which this inactivates thrombin.
Activates anti thrombin
ENOXAPARIN/DALTEPARIN
SE: blood blisters, irritation, chest pain, fever, chills, nausea.
Warfarin
Anticoagulant
Oral
Inhibits vitamin k dependant synthesis of active forms of clotting factors.
Can pass placenta - miscarriage, bleeding
Slow onset, risk of haemorrhage
Bivalirudin
Thrombin inhibitor
Binds to active site, thrombin cannot activate fibrinogen to fibrin.
Given I.v
Must monitor hematocrit as blood can stagnate
Lepirudin
Thrombin inhibitor
Binds to thrombin to break up clots or prevent them forming.
SE: nausea, pale skin, bleeding from wound, bloody stools, constipation
DALTEPARIN
Low molecular weight heparin
Can be safely used in pregnant women.
Greater bioavailability
Protamine sulphate
Anti coagulant therapy
Drug that reverses anticoagulant effects of heparin by binding to it.
Can be used after heart surgery when effects are no longer needed.
SE: may cause allergic reaction as comes from fish
Vitamin k
Essential for the coagulation process.
Promotes hepatic formation of active prothrombin
Given if too much bleeding, in newborns to increase their clotting ability.
SE: jaundice, anaemia
Alteplase
Thrombolytic agent
Binds to fibrin rich clots
Converts entrapped plasminogen to plasmin which degrades the fibrin.m
Iv or intra coronary- fast acting
Most effective if used in 6 hours for dissolving clot
SE: hemorrhage, bleeding gums, headache, breathlessness.
Streptokinase
Thrombolytic agent
Fast acting iv or intra coronary. Clot buster !!
Promotes formation of plasminogen to plasmin which degrades fibrin aka clot
Urokinase
Thrombolytic agent
Fast acting clot buster drug!
Enzyme produces by the kidneys but can be given iv or intra coronary to promote plasminogen conversion to plasmin.
This then degrades fibrin
SE: hemorrhage, headache, nose bleeds, bleeding gums.
Aprotinin
Systemic haemostatic agent
Bovine pancreatic trypsin inhibitor.
Administered by injection to reduce bleeding during complex surgery
Slows down fibrinolysis, which breaks down colts.
Reduction in inflammatory response
Was withdrawn 2007 as high death rate in surgery
SE: atrial fibrillation, MI, hypotension, tachycardia.
