Week 6: thrombolytics, anticoagulants and anti-platelet drugs

Question 1

What are the 4 categories of antiplatelet drugs?

Answer 1

COX inhibitor, ADP receptor agonist, GPIIb/IIIb receptor inhibitors, adenosine reuptake inhibitor

Question 2

What is the example of COX inhibitor?

Answer 2

Aspirin

Question 3

What are the examples of ADP receptor antagonists?

Answer 3

clopidogrel, ticlopidine, prasugrel

Question 4

What drugs are GPIIb/IIIa receptor inhibitors?

Answer 4

abciximab, eptifibatide, tirofiban

Question 5

What are the adenosine reuptake inhibitor?

Answer 5

Dipyridamole

Question 6

What are the 4 categories of anticoagulants?

Answer 6

indirect thrombin inhibitors, direct thrombin inhibitors, Vit K analogue, factor Xa inhibitor

Question 7

What drugs are indirect thrombin inhibitors?

Answer 7

heparin, LMW heparin, fondaparinux

Question 8

What drugs are direct thrombin inhibitors?

Answer 8

bivalirudin, argatroban, dabigatran, etexilate

Question 9

What is the vitamin K analogue?

Answer 9

warfarin

Question 10

What drug is factor Xa inhibitor?

Answer 10

Rivaroxaban

Question 11

Name tissue plasminogen activators

Answer 11

alteplase, reteplase, tenecteplase

Question 12

What are adverse effects of ADP receptor antagonists? (clopidogrel, ticlopidine, prasugrel)

Answer 12

Bleeding, thrombotic thrombocytopenic purpura

Question 13

What ADP receptor antagonists have the least side effects?

Answer 13

clopidogrel and Prasugrel

Question 14

Does clopidogrel require activation via CYP2C19?

Answer 14

Yes

Question 15

What are adverse side effects of GPIIb/IIIa receptor inhibitors? (abciximab, eptifibatide, tirofiban)

Answer 15

bleeding, thrombocytopenia from chronic use

Question 16

What class is dipyridamole?

Answer 16

adenosine reuptake inhibitor

Question 17

What drugs is dipyridamole treated with?

Answer 17

aspirin or warfarin

Question 18

Which drugs are indirect thrombin inhibitors?

Answer 18

Heparin, LMW heparin, fondaparinux

Question 19

What is the MOA of indirect thrombin inhibitors?

Answer 19

bind to antithrombin to activate, which binds and inhibits thrombin and Xa

Question 20

Is LMW heparin or heavy heparin better at inhibiting Xa?

Answer 20

LMWH

Question 21

What drug is used to reverse heparin?

Answer 21

Protamine

Question 22

What is the mechanism of bivalirudin and argatroban (direct thrombin inhibitors?

Answer 22

bind directly to and inhibit thrombin

Question 23

What is MOA of warfarin?

Answer 23

blocks synthesis of vitamin K dependent clotting factors (2, 7 9 and 10) by inhibiting VKORC1

Question 24

What are AE of warfarin?

Answer 24

bleeding, drug interactions

Question 25

What enantiomer of warfarin is more active?

Answer 25

S enantiomer

Question 26

What physiological processes affect warfarin dosing?

Answer 26

polymorphisms in VKORC1 and CYP2C9

Question 27

How do you reverse too much warfarin?

Answer 27

IV Vitamin K, prothrombin complex concentrates, or recombinant factor VIIa

Question 28

what is the ending of all fibrinolytic drugs?

Answer 28

“plase”

Question 29

What is MOA of fibrinolytic drugs? Alteplase, reteplase, tecteplase?

Answer 29

preferentially activate plasminogen that is bound to fibrin which confines it to the thrombus rather than systemic activation

Question 30

AE of fibrinolytic drugs? (Alteplase, reteplase, tecteplase)

Answer 30

Bleeding

Question 31

What is the antidote for tPA drugs?

Answer 31

aminocaproic acid