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Cardio Drugs > thromboembolic drugs. > Flashcards

thromboembolic drugs. Flashcards

1
Q

TPA drugs

A

Alteplase
reteplase
tenecteplase

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2
Q

Plase suffix

A

Tissue plasminogen activators

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3
Q

Urokinase

A

a urokinase type plasminogen activator that is a fibrinolytic drug

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4
Q

Steptokinase

A

a Fibrinolytic thrombolytic drug that is from streptokinase preparations.

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5
Q

LMW heparin

A

has to be given subcutaneously
indirect inhibitor
binds to antithrombin III and inactivated Factor X
partially inactivates thrombin because it doesn’t bind it.

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6
Q

HMW heparin

A

binds to antithrombin III as well as factor X and Thrombin.
Indirect inhibitor of clot formation
also called unfractionated heparin.
Can cause HIT (heparin induced thrombocytopenia)

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7
Q

fondaparinux

A

A indirect inhibitor that is smaller than LMW heparin
Binds only to Antithrombin III and will inactivate factor X
rarely induces HIT
Not reversed by protamine sulfate
Used in DVT and PE
also used in conjunction with Warfarin.
a synthetic pentasaccharide

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8
Q

How to monitor heparins

A

aPTT -> monitors intrinsic and common pathway

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9
Q

HIT

A

Heparin induced thrombocytopenia
causes by immunogenicity of the complex of heparin with the platelet factor 4 (PF4)
leads to a hyper coagulable state
often have venous and arterial thrombosis
treat by giving a direct thrombolitic inhibitor

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10
Q

how to reverse heparin

A

protamine sulfate

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11
Q

Heparin sodium

A

HMW heparin

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12
Q

Enocaparin

A

LMW heparin

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13
Q

Tinzaparin

A

LMW heparin

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14
Q

Dalteparin

A

LMW heparin

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15
Q

Direct thrombin inhibitors (parenteral)

A

Lepirudin
Bivalirudin
Argatorban

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16
Q

Lepirudin

A

A direct thrombin inhibitor that is given parenterally
will cause irreversible inhibition of thrombin
repeated use can cause a anaphylactic reaction.

17
Q

Bivalirudin

A

a direct thrombin inhibitor that is given parenterally
Reversibally inhibits thrombin
also causes platelet aggregation

18
Q

Agatroban

A

A direct thrombin inhibitor that is given parenterally
Short acting drug
A small molecular weight inhibitor

19
Q

Use of DTI

A

(direct thrombolytic inhibitor)

used in HIT and coronary angioplasty

20
Q

Warfarin

A

oral anticoagulant
Inhibits vitamin K epoxide reductase which presents Vit. K’s reduction. This prevents the carboxylation of the decarboxyled-prothrombin into prothrombin by inhibiting GGCX enzyme that needs reduced Vit. K.

also effect factors X, IX, VII, II
difficult to dose
we use INR to measure effectiveness. we want level of 2-3. (normal .9-1.3) (.5 = high change of thrombosis) (4.0-5 = high change of bleeding)

S isomer more potent that R isomer
metabolized by liver
99% bound to albumin
used in thromboembolism prevention, A. fib, and prosthetic heart valves

important to know that warren is teratogenic

21
Q

Rivaroxaban

A 
a NOAC factor Xa inhibitor 
given at fixed doses orally and doesn't need monitoring 
Rapid onset (unlike warfarin) 
No antidote

monitored by Anti-Xa (common pathway)

22
Q

Apixaban

A 
a NOAC factor Xa inhibitor 
given at fixed doses orally and doesn't need monitoring 
Rapid onset (unlike warfarin) 
No antidote

monitored by Anti-Xa (common pathway)

23
Q

Enoxaban

A 
a NOAC factor Xa inhibitor 
given at fixed doses orally and doesn't need monitoring 
Rapid onset (unlike warfarin) 
No antidote

monitored by Anti-Xa (common pathway)

24
Q

Dabigatran

A

NOAC direct thrombin inhibitor
used to reduce risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation and DVT.

Antidote = idarucizumab

monitored by diluted thrombin time (TT) (common pathway)

25
Q

Idarucizumab

A

A NOAC Direct thrombin inhibitor antidote for dabigatran

26
Q

aspirin

A

inhibits COX and causes decrease TxA2 which leads to uncreased coagulability.

27
Q

protamine sulfate

A

reverses HMW heparin and LMW heparin

28
Q

Vitamin K treatment

A

Reverses the effects of Warfarin

29
Q

clopidogrel

A

ADP receptor blocker
Inhibits AC by alpha I -> leads to increased production of cAMP

metabolized by CYP 2C19 -> not functional in 50% of chinese, 34% african, 25% caucasians and 19% mexicans.

used in Prevention of thrombosis in patients with ACS and recent AMI, stroke and peripheral arterial disease

30
Q

Prasugrel

A

ADP receptor blocker
Inhibits AC by alpha I -> leads to increased production of cAMP

metabolized by CYP 2C19 -> not functional in 50% of chinese, 34% african, 25% caucasians and 19% mexicans.

used in Prevention of thrombosis in patients with ACS and recent AMI, stroke and peripheral arterial disease

31
Q

Ticlopidine

A

ADP receptor blocker
Inhibits AC by alpha I -> leads to increased production of cAMP

metabolized by CYP 2C19 -> not functional in 50% of chinese, 34% african, 25% caucasians and 19% mexicans.

used in Thrombosis prevention in stroke patients

32
Q

Ticagrelor

A

ADP receptor blocker
Inhibits AC by alpha I -> leads to increased production of cAMP

metabolized by CYP 2C19 -> not functional in 50% of chinese, 34% african, 25% caucasians and 19% mexicans.

used in Prevention of thrombosis in patients with ACS and recent AMI, stroke and peripheral arterial disease

33
Q

Abciximab

A

Platelet glycoprotein receptor antagonist
used as a anti-platelet drug

prevents the binding of a ligand which causes the formation of platelets

used in unstable angina and other acute coronary syndromes

Given IV because of short half life.

can cause hypotension, myalgia, and thrombocytopenia

34
Q

Eptifibatide

A

Platelet glycoprotein receptor antagonist
used as a anti-platelet drug

prevents the binding of a ligand which causes the formation of platelets

used in unstable angina and other acute coronary syndromes

Given IV because of short half life.

can cause hypotension, myalgia

35
Q

tirofiban

A

Platelet glycoprotein receptor antagonist
used as a anti-platelet drug

prevents the binding of a ligand which causes the formation of platelets

used in unstable angina and other acute coronary syndromes

Given IV because of short half life.

can cause hypotension, myalgia, and thrombocytopenia

Cardio Drugs (3 decks)

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