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Pharmacology > Anticoagulants > Flashcards

Anticoagulants Flashcards

1
Q

What are the clotting factors that are inhibited by antithrombin 3?

A

2a, 7a,9a and 10a

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2
Q

Inhibit platelets aggregation.

A

Prostacyclin (PGI2) + NO

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3
Q

What is tissue plasminogen activator?

A

it catalyzes the conversion of plasminogen to plasmin, the major enzyme responsible for clot breakdown.

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4
Q

What are the factors that are inhibited by protein C and S?

A

5a and 8a

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5
Q

Why anticoagulant drugs cannot be given IM?

A

To avoid risk of hematoma (blood in muscles)

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6
Q

Anticoagulant drug, which can be used in vivo and in vitro.

A

Heparin

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7
Q

Which anticoagulant drug is safe during pregnancy?

A

Heparin

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8
Q

Describe the MOA of heparin?

A

Binds to antithrombin 3 and potentiate its effect ( inhibiting 2a, 7a, 9a and 10a factors)

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9
Q

Produces rapid onset of action because it acts on preformed clotting factors.

A

Heparin

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10
Q

What is the expected range of active partial thromboplastin time (APTT) in a patient taking heparin?

A

Should be 1.5 - 2.5 times normal

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11
Q

List two LMW heparins?

A

Dalteparin + Enoxaparin

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12
Q

Describe the MOA of LMW heparin?

A

It works by increasing the action of AT3 on factor 10a ( but cannot do something to the other factors )

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13
Q

What are the advantages over unfractionated heparins?

A
  • Greater availability.
  • Longer 1/2 life. (Good for noncompliant patients)
  • Less thrombocytopenia.
  • Given SC.
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14
Q

List three indications of heparin?

A

CV surgeries - unstable angina - during coronary angioplasty

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15
Q

List two adverse effects of heparin?

A

Bleeding - Alopecia

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16
Q

Antidote of heparin.

A

Protamine sulfate

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17
Q

Describe the MOA of warfarin?

A

Inhibits vitamin K dependent clotting factors (vitamin K antagonist) and inhibit the activity of vitamin K reductase.

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18
Q

Anticoagulant drug, which is active only in vivo.

A

Warfarin

19
Q

Anticoagulant drug, which is contraindicated during pregnancy.

A

Warfarin

20
Q

What is the difference between the onset of action of warfarin and heparin?

A

Heparin: has rapid onset because it acts on preformed clotting factors.
Warfarin: has delayed onset because the presence of preformed clotting factors ( it acts on V. K reductase)

21
Q

How does warfarin is monitored?

A

By prothrombin time + international normalized ratio (PT of patient/ PT of untreated)

22
Q

List two indications of warfarin?

A

Complications of stroke ( DVT + atrial fibrillation )

23
Q

List three side effects of warfarin?

A

Bleeding - teratogenicity - fat necrosis

24
Q

What is the antidote of warfarin?

A

Vitamin K ( phytonadione )

25
Q

What is the INR range that indicate a bleeding risk?

A

> = 5

26
Q

List three drugs which can decrease the action of warfarin?

A

Barbiturates - Phenytoin - rifampicin

27
Q

List 3 drugs which can increase the action of warfarin?

A

Aspirin - metronidazole - 3rd gen cephalosporins

28
Q

List four direct antithrombin inhibitors?

A

Hirudin - lepirudin - bivalirudin (IV)

Dabigatran (orally)

29
Q

In patients with thrombosis related to Heparin induced thrombocytopenia. Which drug is used?

A

Lepirudin

30
Q

A patient had percutaneous coronary angioplasty. Which drug is used?

A

Bivalirudin

31
Q

Drugs which impair or prevent the aggregation of platelets.

A

Antiplatelets

32
Q

Used for treating consequences of arterial thrombosis.

A

Antiplatelets

33
Q

List three antiplatelets agents?

A

Cox inhibitors- phosphodiesterase inhibitors - inhibition of platelets binding or adhesion.

34
Q

Give an example of COX inhibitor that is used as antiplatelet drug?

A

Aspirin at low doses

35
Q

What are the indications of low dose aspirin?

A
  • prevention of stroke.
  • prevention of MI.
  • Post MI.
  • unstable angina.
  • following bypass or angioplasty.
36
Q

Describe the MOA of Dipyridamole?

A

Phosphodiesterase inhibitor which inhibit ADP induced platelets aggregation.

37
Q

Describe the MOA of Clopidogrel?

A

Blocks ADP receptor and inhibit ADP induced platelets aggregation.

38
Q

Describe the MOA of Abciximab?

A

Monoclonal antibody which prevents binding of fibronogen to platelets.

39
Q

Antiplatelet drug can cause nausea and headache.

A

Dipyridamole

40
Q

Anti-platelet drug which causes thrombocytopenia.

A

Abciximab

41
Q

Drugs which facilitate fibrinolysis by catalysing the production of plasmin.

A

Fibrinolytic drugs

42
Q

List three fibrinolytic drugs?

A

Streptokinase + Urokinase + Alteplase

43
Q

The most fibrin selective drug.

A

Alteplase

Pharmacology (9 decks)

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