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Pharm Unit 2 > Thrombosis > Flashcards

Thrombosis Flashcards

1
Q

Unfractionated heparin

A

Class: Indirect thrombin inhibitors
MOA: Bind antithrombin, potentiating formation of antithrombin-coagulation factor complex (Xa, IIa)
Uses: Prevention and treatment of venous thromboembolism
SE: HIT, osteoporosis (long-term); Bleeding
Misc: Given parenterally; monitored via PTT (want 2-2.5X normal value); reversed by protamine

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2
Q

Dalteparin (Fragmin)

A

Class: Indirect thrombin inhibitors
MOA: LMWH that inhibits thrombin less effectively than Xa
Uses: Prevent thrombosis and embolism from clots
SE: Bleeding
Misc: Monitored by heparin assay (anti-factor Xa); longer half-life than heparin (1-2/day); reversed by protamine

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3
Q

Enoxaparin (Lovenox)

A

Class: Indirect thrombin inhibitors
MOA: LMWH that inhibits thrombin less effectively than Xa
Uses: Drug of choice in pregnancy; prevention and treatment of venous thromboembolism
SE: HIT; osteoporosis and thrombocytopenia uncommon; Bleeding
Misc: Can be monitored by heparin assay (anti-factor Xa); longer half-life than heparin (1-2/day); reversed by protamine

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4
Q

Tinzaparin (Innohep)

A

Class: Indirect thrombin inhibitors
MOA: LMWH that inhibits thrombin less effectively than Xa

SE: HIT; osteoporosis and thrombocytopenia uncommon; Bleeding
Misc: Monitored by heparin assay (anti-factor Xa); longer half-life than heparin (1-2/day); reversed by protamine

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5
Q

Fondaparinux (Arixtra)

A 
Class: Indirect thrombin inhibitors
MOA: Synthetic polysaccharide that binds active site of antithrombin; inhibits Xa
Uses: Given for HIT patients 
SE: Bleeding
Misc: No antidote
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6
Q

Warfarin (Coumadin)

A

Class: Vitamin K antagonist
MOA: Blocks vitamin K-dependent gamma-carboxylation of factors II, VII, IX, X, Protein C and S
Uses: Long-term anticoagulation
SE: Thrombosis (Protein C depression); Bleeding
Misc: Metabolism enhanced by drugs that induce P450 activity (e.g., barbiturates); monitored by PT/INR; reversed by vitamin K and factor concentrates or fresh frozen plasma; contraindicated in pregnancy (teratogen)

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7
Q

Lepirudin (Refludan)

A

Class: Direct thrombin inhibitor
MOA: Inactivate fibrinogen-bound AND unbound thrombin; irreversible

Misc: Administered parenterally; monitored by PTT; no antidote

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8
Q

Bivalirudin (Angiomax)

A

Class: Direct thrombin inhibitor
MOA: Inactivate fibrinogen-bound AND unbound thrombin; irreversible

Misc: Administered parenterally; monitored by PTT; no antidote

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9
Q

Argatroban (Acova)

A

Class: Direct thrombin inhibitor
MOA: Inactivate fibrinogen-bound AND unbound thrombin; irreversible

Misc: Administered parenterally; monitored by PTT; no antidote

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10
Q

Dabigatran (Pradaxa)

A

Class: Direct thrombin inhibitor
MOA: Inactivate fibrinogen-bound AND unbound thrombin; competitive (reversible)

Misc: Oral; no antidote

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11
Q

Rivaroxaban (Xarelto)

A

Class: Direct Xa inhibitor
MOA: Reversible bind active site of Xa

Misc: Oral; no antidote

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12
Q

Apixaban (Eliquis)

A

Class: Direct Xa inhibitor
MOA: Reversible bind active site of Xa

Misc: Oral; no antidote

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13
Q

Streptokinase (Streptase)

A

Class: Fibrinolytic
MOA: Lyse already formed clots by activating circulating plasminogen (not clot specific)
Uses: Acute MI, acute stroke, central DVT, multiple PE

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14
Q

Urokinase (Kinlytic)

A

Class: Fibrinolytic
MOA: Lyse already formed clots by activating circulating plasminogen
Uses: Acute MI, acute stroke, central DVT, multiple PE

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15
Q

Reteplase (Retavase)

A

Class: Fibrinolytic
MOA: Lyse already formed clots; more clot specific, less systemic activation
Uses: Acute MI, acute stroke, central DVT, multiple PE

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16
Q

Tenecteplase (TNKase)

A

Class: Fibrinolytic
MOA: Lyse already formed clots; more clot specific, less systemic activation
Uses: Acute MI, acute stroke, central DVT, multiple PE

17
Q

Aspirin

A

Class: Antiplatelet
MOA: Irreversibly inhibits platelets, preventing thromboxane A2 formation
Uses: Often as “baby aspirin” to prevent and treat MI and stroke

18
Q

Dipyridamole (Persantine)

A

Class: Antiplatelet
MOA: PDE inhibitor –> increase in platelet cAMP
Uses: Weak antiplatelet effect
Misc: Given parenterally

19
Q

Clopidogrel (Plavix)

A

Class: Antiplatelet
MOA: Inhibits platelet ADP receptors

SE: TTP (rare)
Misc: Reversed by platelet transfusion

20
Q

Abciximab (Reopro)

A

Class: Antiplatelet
MOA: Monoclonal antibody against GP IIb/IIIa

SE: May elicit immune response
Misc: Given parenterally

21
Q

Eptifibatide (Integrilin)

A

Class: Antiplatelet
MOA: Fibrinogen analog which competes with endogenous fibrinogen for IIb/IIIa

Misc: Given parenterally

22
Q

Tirofiban (Aggrastat)

A

Class: Antiplatelet
MOA: Fibrinogen analogs which compete with endogenous fibrinogen and vWF for IIb/IIIa

Misc: Given parenterally

Pharm Unit 2 (11 decks)

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