Thrombolytics Flashcards
Ticlopidine
Ticlid , Thienopyidine class
Used for TIA, stroke, post stent with aspirin
Aplastic anemia, neutropenia, TTP
Inhibits ADP pathway , GPIIb/IIIa receptors
Aspirin
Acetylsalicylic acid
Permanent, irreversible inactive of COX1, Modified COX2 function
Complete inact at 160mg, low dose is 80 mg
Half life 3.5 hours, 5X in high toxic doses
Cannot release ADP, thromboxane, PROSTAGLANDIN
pain, fever, inflammation
DVT, PE, TIA, increases chance of hemorrhagic stroke
Bleeding, gastric/SI ulcers, interstitial nephritis
Clopidogrel
Plavix , Thienopyidine class
No neutropenia, no aplastic anemia, some TTP
Used mostly for cardiac therapy
Prasurgel
Effient, Thienopyidine class
Good but can be too powerful, hemorrhage
Sequelae associated with d/c
Abciximab
Reopro
GPIIb/IIIa blocker class
Eptifibatide
Integrilin
GPIIb/IIIa blocker
Tirofiban
Aggrastat
GPIIa/IIIb blocker
Dipyridamole
Persantine
Coronary vasodilator
Blocks cAMP , no thromboxane synthesis, No PG effect
Adjunct to aspirin or warfarin, valve rep or Afib
Dextran 70 , Dextran 40
Macrodex , Rheomacrodex Dilutes coag factors V, VIII, IX Binds cellular components making them less sticky Less sturdy clots Bleeding, volume overload, anaphylaxis
Dextran dosages
Infants: 0.5 g/Kg , 5mL/Kg
Children: 1 g/kg , 10 mL/kg
Adults: 1-2 g/kg , 10-20 mL/kg
MAX IS 2g or 20 mL/kg
Hespan
Starch polymers
Significantly reduces factor VIII
ARF, coagulopathy, anaphylaxis. NEVER GOES AWAY
Max is thought to be 20mL/kg
Streptokinase
Streptase , thrombolytic class
Formation of plasmin, destroys II, V, VII
< 30 min half life , monitored via TT
PE, MI, DVT, thrombosed shunts
Urokinase
Kinlytic
Used for PE
Half life is 20 min
tPA
Alteplase , Activase
MI, stroke, PE
half life 5-30 min
Naturally occurring from cancer cells
Reteplase
Retavase
Synthetic tPA, much cheaper
Less specific
