week 3

Question 1

What is primary haemostasis?

Answer 1

Formation of the platelet plug after bleeding

Question 2

What is secondary haemostasis?

Answer 2

Formation of the fibrin clot

Question 3

What are the indications for anticoagulant drugs?

Answer 3

Venous thrombosis

Atrial fbrillation

Question 4

What part of the clotting do anticoagulant drugs target

Answer 4

the fibrin clot

Question 5

How does Heparin work?

Answer 5

Potentiates Antithrombin

Question 6

How is heparin administered ?

Answer 6

Iv or SC

Question 7

What blood test would you look at to monitor heparin?

Answer 7

APTT

Activated partial thromboplastin time

Question 8

What are the common complications from heparin use?

Answer 8

Bleeding

heparin induced thrombocytopenia

osteoporosis

Question 9

How can you reverse the effects of heparin?

Answer 9

Protamine Sulphate

Question 10

What does heparin do to stop clots?

Answer 10

Activates antithrombin III which stops thrombim and a bunch of the coag cascade which are required to make a fibrin clot

Question 11

What is heparin induced thrombocytopenia?

Answer 11

auto immune reaction to platelet factor 4

results in prothrombic condition 10 days after starting treatment

Question 12

What side effect can heparin sometimes cause?

Answer 12

Hyperkalaemia

Question 13

Name some coumarin anticoagulants

Answer 13

Warfarin

Phenindione

Acenocoumarin

Question 14

How does warfarin work?

Answer 14

Antagonist of vitamin K

Results in synthesis of non function prothrombin and factors 7,9 and 10

Question 15

How is Vitamin K absorbed?

Answer 15

Fat soluble vitamin found in leafy greens

Requires bile to be absorbed within the upper intestine

Question 16

What does vitamin K do?

Answer 16

It is used to make prothrombin , and factors 7,9 and 10

Question 17

What is important to remember when taking warfarin?

Answer 17

Narrow theraputic range so should be monitored carefully

Dose to be taken at the same time everyday

Question 18

What does INR look at?

Answer 18

Patients prothrombin time vs normal prothrombin time

Question 19

How do you reverse wafarins effect if for example the patient sustaines massive haemorrage?

Answer 19

Stop warfarin

give oral Vitamin K

give clotting factor concentrate

Question 20

How long does giving vitamin K as an antidote take to kick in?

Answer 20

6 hours

Question 21

What is dabigatran?

Answer 21

Direct thrombin inhibitor

Question 22

How does rivaroxaban work?

Answer 22

Direct factor X inhibitor

Question 23

Whats the problem with using new anticoagulants?

Answer 23

no current antidote

long term side effects unkown

Question 24

What do platelets need to bind on to exposed collagen?

Answer 24

Glycoprotein 1b

and

Von Willebrand Factor

Question 25

How does Aspirin work?

Answer 25

Inhibits cyclo-oxygenase which is required to make thromboxane A2 ( a platelet agonist granule )

Question 26

What are the side effects of aspirin?

Answer 26

Bleeding

Reduced prostaglandin - GI ulceration and bronchospasm

Question 27

How does Clopidogrel work?

Answer 27

Adenosine diphosphate receptor antagonist

Question 28

What is Dipryridamole?

Answer 28

Antiplatelet drug

Question 29

How does Dipyridamole work?

Answer 29

Reduces production of cAMP wich is a messanger in platelet activation

Question 30

What is abciximab?

Answer 30

Anti platlet drug which inhibtis GP 11b/111a

Question 31

What does GP11b111a do?

Answer 31

Helps platelets stick together

Question 32

What drug acts of GP11b111a?

Answer 32

abciximab

Question 33

How long will it take for you to notice anychange after stopping antiplatelet drugs?

Answer 33

Needed to wait 7-10 days

(thats how long platelets live for)