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Pharmacology > Unit 4- Blood > Flashcards

Unit 4- Blood Flashcards

1
Q

Vein Thrombosis

A

Red thrombi of RBC embedded in fibrin, treat with anticoagulants

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2
Q

Coronary Artery Thrombosis

A

White thrombi of platelets embedded in fibrin, treat with antiplatelets

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3
Q

Phases of Hemostasis

A

Vascular spasm where blood vessel is damaged, clotting factors cleave prothrombin into thrombin, platelet plug forms, thrombin IIa cleaves fibrinogen into insoluble fibrin, coagulation occurs

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4
Q

Platelet Pathway

A

NO, prostacyclin, or ADPase activate platelets that produce TXA2 and ADP, activating more platelets, activated platelets aggregate due to clotting factors, fibrin deposits and it becomes a clot

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5
Q

The Clotting Cascade

A

Vascular injury releases tissue factor, factor VIIa is produced, factor X is activated, activating factor II prothrombin to factor IIa thrombin, that cleaves fibrinogen into fibrin

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6
Q

Zymogens

A

Precursor proteins, most clotting factors

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7
Q

Factor IV

A

Ca++, cofactor for thrombin activation and fibrinogen to fibrin

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8
Q

Blood Coagulation

A

Activation of prothrombin activators, thrombin activation, and fibrin formation, 12 zymogen factors work together

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9
Q

Antithrombin III

A

AT, inhibits coagulation through fibrinolysis

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10
Q

Conditions Requiring Anticoagulant

A

Thrombosis, coronary syndrome, arterial fibrillation, stroke, ischemic heart disease, thromboembolic disease in IMHA, antithrombotic prophylaxis

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11
Q

Anticoagulatns

A

Modify the coagulation cascade, heparin and LMWHs, warfarin and coumarin derivatives, thrombin inhibitors, and factor Xa inhibitors

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12
Q

Heparin

A

Binds AT and enhances inhibitory effects, inactivating IIa and Xa, found in mast cells

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13
Q

Heparin Use

A

Excessive clotting or risk of clotting, thromboembolic disease, venous thrombosis, disseminated intravascular coagulopathy, pulmonary thromboembolism, laminitis, endotoxic shock, burns

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14
Q

Unfractionated Heparin

A

Inactivates thrombin and factor Xa

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15
Q

Low Molecular Weight Heparin

A

Inactivates factor Xa, dalteparin and enoxaparin

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16
Q

Heparin Dosing

A

AT levels affect efficacy, variable PK, activated partial thromboplastin time test

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17
Q

Heparin Adverse Effects

A

Bleeding problems, thrombocytopenia, overdose causes excessive anticoagulation and bleeding

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18
Q

Heparin Overdose Reversal

A

Protamine sulfate binds acidic heparin to create inactive salt

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19
Q

LMWH Advantages

A

Greater activity and safety, predictable PK

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20
Q

Dalteparin

A

LMWH, binds AT to increase AT mediated inhibition of synthesis and activity of factor Xa

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21
Q

Dalteparin Adverse Effects

A

Bleeding, hematoma from IM admin, prolonged elimination from renal disease, drug interactions

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22
Q

Enoxaparin

A

LMWH, binds AT to increase AT mediated inhibition of synthesis and activity of factor Xa

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23
Q

Enoxaparin Adverse Effects

A

Bleeding, hematoma from IM, prolonged elimination from renal disease, drug interactions

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24
Q

Vitamin K

A

Essential for hepatic synthesis of prothrombin factors II, VII, IX, and X

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25
Q

Coumarin Derivatives

A

Anticoagulants, warfarin, dicumarol, acenocoumarol, reduce production of vitamin K dependent factors by inhibiting vitamin K regeneration

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26
Q

Coumarin Derivative Uses

A

Decrease thrombosis tendency in dogs, treat clots in vein or artery, reduce risk of stroke or heart attack

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27
Q

Coumarin Derivative Adverse Effects

A

Decreased blood clotting, spontaneous bleeding, excessive bleeding, drug interactions with aspirin and clopidogrel

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28
Q

Vitamin K Deficiency

A

Excessive bleeding due to failure of fibrin clot formation, poisoning by warfarin, treat with menadione

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29
Q

Heparin Characteristics

A

Accelerates antithrombin activity, immediate onset, short duration, parenteral admin, treat overdose with protamine, test with clotting time

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30
Q

Warfarin Characteristics

A

Inhibits hepatic synthesis of vitamin K dependent clotting factors, delayed onset, long duration, oral admin, treat overdose with vitamin K, test with prothrombin time

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31
Q

Factor Xa Inhibitors

A

Rivaroxaban and apixaban, predictable PK, no monitoring needed, less affected by diet, short half life and unable to be reversed

32
Q

Thrombin Inhibitors

A

Dabigatran, less drug interaction, reversed with Idarucizumab, can cause bleeding and GI problems

33
Q

Hemophilia

A

Inherited deficiency of clotting factors, diagnosed by blood test and coagulation time test

34
Q

Hemophilia Treatment

A

Blood transfusion, cryoprecipitate from blood, factor VIII

35
Q

Hemophilia A

A

Lack of factor VIII, X linked and common in males, spontaneous bleeding into muscle, joints, or under skin, hemorrhage in chest or abdomen, excessive bleeding after surgery

36
Q

Hemophilia A Diagnosis

A

During surgery, in young animals with excessive bleeding, bleeding of gums, may be stillborn or die as neonate

37
Q

Factor VIII

A

Cofactor of factor IX to activate factor X

38
Q

Hemophilia B

A

Lack of factor IX, milder than hemophilia A, spontaneous bleeding, not noticed until emergency

39
Q

Hemophilia C

A

Extremely rare factor XI deficiency, bleeding induced by trauma or surgery and can be delayed

40
Q

Von Willibrand Disease

A

Most common inherited clotting disease, lack of vWB factor important for platelet adhesion

41
Q

Predisposition to Thrombosis

A

Injury to vessel wall, altered blood flow, abnormal coagulation

42
Q

Arterial Thrombus

A

Atherosclerosis, can cause ischemia, carotid emboli can cause stroke

43
Q

Venous Thrombus

A

Forms an embolus, venous emboli can go to pulmonary artery and cause pulmonary embolism

44
Q

Embolism

A

Thrombus that has traveled far from where it formed

45
Q

Thromboembolic Diseases

A

Feline cardiomyopathy, pulmonary endarteritis from heartworms, membranous glomerulonephritis, mild disseminated intravascular coagulopathy, pulmonary thromboembolism, vasculitis, laminitis, navicular disease

46
Q

Aspirin

A

Binds COX-1 preventing TXA2 synthesis that activates platelets, metabolized in liver, cats require less dosage, excreted by kidney

47
Q

Aspirin MOA

A

Binds platelet COX1 preventing TXA2 formation and preventing vasoconstriction at low doses, binds COX2 preventing prostaglandin production and causing analgesia at high doses

48
Q

Clopidogrel

A

Prodrug, metabolite blocks platelet aggregation, used with aspirin but preferred in vet med

49
Q

Clopidogrel Adverse Effects

A

Vomiting, anorexia, diarrhea

50
Q

Clopidogrel MOA

A

Active metabolite irreversibly binds P2Y12 ADP receptors on platelets, blocking platelet aggregation

51
Q

Ticlopidine

A

P2Y12 receptor inhibitor, rarely used in animals, causes adverse effects in cats

52
Q

Abciximab

A

Antibody to anti-glycoprotein IIb/IIIa receptor preventing thrombosis during percutaneous coronary intervention

53
Q

Abciximab MOA

A

Reversibly binds platelet IIb/IIIa receptor that binds fibrinogen, vWB factor, and other adhesive platelet molecules

54
Q

Fibrinolysis

A

Antithrombin III breaks down fibrin in blood clots, tPA and factor XIa and XIIa activate plasminogen to plasmin that degrades fibrin

55
Q

Streptokinase

A

Plasminogen activator, thrombolytic medication, combines with plasminogen to form activator complexes that convert plasminogen to plasmin

56
Q

Streptokinase Therapeutic Effects

A

Lysis of thrombi in cat heart attack, lysis of pulmonary embolism in dog, deep venous thrombosis in dog

57
Q

Streptokinase Adverse Effects

A

Systemic fibrinolysis, coagulopathy, serious hemorrhage, metabolic acidosis, bleeding, death

58
Q

Recombinant Tissue Plasminogen Activator

A

rt-PA, protease with specificity for fibrin within thrombi, causes less systemic bleeding problems, high mortality in cats

59
Q

Antifibrinolytics

A

Promote hemostasis, aminocaproic acid and tranexamic acid, lysine compounds that bind to fibrin to decrease fibrinolysis

60
Q

Regenerative Anemia

A

Bone marrow produces normal RBC but blood loss occurs

61
Q

Immune Mediated Hemolytic Anemia

A

Breakdown of RBC

62
Q

Nonregenerative Anemia

A

Deficiency of blood cell production

63
Q

Erythropoietin

A

Produced by kidneys, stimulates RBC production in bone marrow

64
Q

Iron Deficiency Anemia

A

Hemoglobin contains iron to bind to O2, most common in dogs and piglets after chronic blood loss

65
Q

Sickle Cell Anemia

A

Mutation in hemoglobin gene causes malformation of subunit, deformity of RBC restricts O2 carrying capacity

66
Q

Oxbryta

A

Inhibits hemoglobin beta polymerization and RBC sickling

67
Q

Vitamin B12 Anemia

A

Cobalamin creates heme portion, deficiency results in low RBC and hematological and neuro problems

68
Q

Ferdex B12

A

Injectable B12 for treatment of iron deficient anemia

69
Q

Azathioprine

A

Immune suppressant, decreases purine metabolism, treats IMHA and immune mediated thrombocytopenia

70
Q

Azathioprine Adverse Effects

A

Bone marrow suppression, CI toxicity, liver toxicity, pancreatitis in dogs

71
Q

Cyclophosphamide

A

Immunosuppressant with cytotoxic effects on lymphocytes

72
Q

Cyclophosphamide Adverse Effects

A

Bone marrow suppression and sterile hemorrhagic cystitis in dogs

73
Q

Cyclosporine

A

Inhibits T cell signal transduction, suppresses IL2, blocks T cell activation, treats IMHA and immune mediated thrombocytopenia

74
Q

Erythropoietin Stimulating Agents

A

Epoetin alpha and darbepoetin, stimulate erythropoiesis to treat anemia

75
Q

Chronic Non Regenerative Anemia

A

Common in cats, decreased erythropoietin production, treat with darbepoetin

Pharmacology (32 decks)

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