9) Thrombosis Flashcards by Aqeel Nabijohn

What is the class for Unfractionated heparin

Indirect thrombin inhibitors

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What is the mechanism for Unfractionated heparin

Bind antithrombin, potentiating formation of antithrombin-coagulation factor complex (Xa, IIa)

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What are the therapeutics for Unfractionated heparin

Prevention and treatment of venous thromboembolism

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What are the important side effects for Unfractionated heparin

HIT, bleeding

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What are the other side effects for Unfractionated heparin

Osteoporosis

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What are the miscellaneous for Unfractionated heparin

Given parenterally; monitored via PTT (want 2-2.5X normal value); reversed by protamine

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What is the class for Dalteparin (Fragmin)

Indirect thrombin inhibitors

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What is the mechanism for Dalteparin (Fragmin)

LMWH that inhibits thrombin less effectively than Xa

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What are the therapeutics for Dalteparin (Fragmin)

Prevent thrombosis and embolism from clots

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What are the important side effects for Dalteparin (Fragmin)

Bleeding

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What are the miscellaneous for Dalteparin (Fragmin)

Monitored by heparin assay (anti-factor Xa); longer half-life than heparin (1-2/day); reversed by protamine

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What is the class for Enoxaparin (Lovenox)

Indirect thrombin inhibitors

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What is the mechanism for Enoxaparin (Lovenox)

LMWH that inhibits thrombin less effectively than Xa

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What are the therapeutics for Enoxaparin (Lovenox)

Drug of choice in pregnancy; prevention and treatment of venous thromboembolism

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What are the important side effects for Enoxaparin (Lovenox)

HIT; bleeding; osteoporosis and thrombocytopenia uncommon

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What are the miscellaneous for Enoxaparin (Lovenox)

Can be monitored by heparin assay (anti-factor Xa); longer half-life than heparin (1-2/day); reversed by protamine

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What is the class for Tinzaparin (Innohep)

Indirect thrombin inhibitors

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What is the mechanism for Tinzaparin (Innohep)

LMWH that inhibits thrombin less effectively than Xa

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What are the important side effects for Tinzaparin (Innohep)

HIT; osteoporosis and thrombocytopenia uncommon

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What are the other side effects for Tinzaparin (Innohep)

Bleeding

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What are the miscellaneous for Tinzaparin (Innohep)

Monitored by heparin assay (anti-factor Xa); longer half-life than heparin (1-2/day); reversed by protamine

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What is the class for Fondaparinux (Arixtra)

Indirect thrombin inhibitors

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What is the mechanism for Fondaparinux (Arixtra)

Synthetic polysaccharide that binds active site of antithrombin; inhibits Xa

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What are the therapeutics for Fondaparinux (Arixtra)

Given for HIT

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What are the other side effects for Fondaparinux (Arixtra)

Bleeding

What are the miscellaneous for Fondaparinux (Arixtra)

No antidote

What is the class for Warfarin (Coumadin)

Vitamin K antagonist

What is the mechanism for Warfarin (Coumadin)

Blocks vitamin K-dependent gamma-carboxylation of factors II, VII, IX, X, Protein C and S (does not affect already synthesized factors)

What are the therapeutics for Warfarin (Coumadin)

Long-term anticoagulation

What are the important side effects for Warfarin (Coumadin)

Thrombosis (Protein C depression)

What are the other side effects for Warfarin (Coumadin)

Bleeding

What are the miscellaneous for Warfarin (Coumadin)

Metabolism enhanced by drugs that induce P450 activity (e.g., barbiturates); monitored by PT/INR; reversed by vitamin K and factor concentrates; contraindicated in pregnancy (teratogen)

What is the class for Bivalirudin (Angiomax)

Direct thrombin inhibitor

What is the mechanism for Bivalirudin (Angiomax)

Inactivate fibrinogen-bound AND unbound thrombin; irreversible

What are the therapeutics for Bivalirudin (Angiomax)

Percutaneous coronary intervention (PCI)

What are the important side effects for Bivalirudin (Angiomax)

Bleeding

What are the miscellaneous for Bivalirudin (Angiomax)

Administered parenterally; monitored by PTT; no antidote

What is the class for Argatroban (Acova)

Direct thrombin inhibitor

What is the mechanism for Argatroban (Acova)

Inactivate fibrinogen-bound AND unbound thrombin

What are the therapeutics for Argatroban (Acova)

Percutaneous coronary intervention (PCI); HIT

What are the important side effects for Argatroban (Acova)

Bleeding

What are the miscellaneous for Argatroban (Acova)

Administered parenterally; monitored by PTT; no antidote

What is the class for Dabigatran (Pradaxa)

Direct thrombin inhibitor

What is the mechanism for Dabigatran (Pradaxa)

Inactivate fibrinogen-bound AND unbound thrombin; competitive (reversible)

What are the therapeutics for Dabigatran (Pradaxa)

DVT / PE; AFib

What are the important side effects for Dabigatran (Pradaxa)

Bleeding

What are the miscellaneous for Dabigatran (Pradaxa)

Oral; no antidote; renal fixed dose clearance

What is the class for Rivaroxaban (Xarelto)

Direct Xa inhibitor

What is the mechanism for Rivaroxaban (Xarelto)

Reversible bind active site of Xa

What are the therapeutics for Rivaroxaban (Xarelto)

DVT / PE prophylaxis

What are the important side effects for Rivaroxaban (Xarelto)

Bleeding

What are the miscellaneous for Rivaroxaban (Xarelto)

Oral; no antidote; renal fixed dose clearance

What is the class for Apixaban (Eliquis)

Direct Xa inhibitor

What is the mechanism for Apixaban (Eliquis)

Reversible bind active site of Xa

What are the therapeutics for Apixaban (Eliquis)

DVT / PE prophylaxis

What are the important side effects for Apixaban (Eliquis)

Bleeding

What are the miscellaneous for Apixaban (Eliquis)

Oral; no antidote; renal fixed dose clearance

What is the class for Alteplase

Fibrinolytic

What is the mechanism for Alteplase

Lyse already formed clots by activating circulating plasminogen

What are the therapeutics for Alteplase

Acute MI, acute stroke, central DVT, multiple PE

What is the class for Reteplase (Retavase)

Fibrinolytic

What is the mechanism for Reteplase (Retavase)

Lyse already formed clots; more clot specific, less systemic activation

What are the therapeutics for Reteplase (Retavase)

Acute MI, acute stroke, central DVT, multiple PE

What is the class for Tenecteplase (TNKase)

Fibrinolytic

What is the mechanism for Tenecteplase (TNKase)

Lyse already formed clots; more clot specific, less systemic activation

What are the therapeutics for Tenecteplase (TNKase)

Acute MI, acute stroke, central DVT, multiple PE

What is the class for Aspirin

Antiplatelet

What is the mechanism for Aspirin

Irreversibly inhibits platelets, preventing thromboxane A2 formation

What are the therapeutics for Aspirin

Often as "baby aspirin" to prevent and treat MI and stroke

What is the class for Dipyridamole (Persantine)

Antiplatelet

What is the mechanism for Dipyridamole (Persantine)

PDE inhibitor --> increase in platelet cAMP

What are the therapeutics for Dipyridamole (Persantine)

Weak antiplatelet effect

What are the miscellaneous for Dipyridamole (Persantine)

Given parenterally

What is the class for Clopidogrel (Plavix)

Antiplatelet

What is the mechanism for Clopidogrel (Plavix)

Inhibits platelet ADP receptors

What are the therapeutics for Clopidogrel (Plavix)

Prevent & treat ACS, stroke, peripheral vascular disease, angina, stent

What are the important side effects for Clopidogrel (Plavix)

Bleeding; TTP (rare)

What are the miscellaneous for Clopidogrel (Plavix)

Reversed by platelet transfusion

What is the class for Abciximab (Reopro)

Antiplatelet

What is the mechanism for Abciximab (Reopro)

Monoclonal antibody against GP IIb/IIIa

What are the important side effects for Abciximab (Reopro)

May elicit immune response

What are the miscellaneous for Abciximab (Reopro)

Given parenterally

What is the class for Eptifibatide (Integrilin)

Antiplatelet

What is the mechanism for Eptifibatide (Integrilin)

Fibrinogen analog which competes with endogenous fibrinogen for IIb/IIIa

What are the important side effects for Eptifibatide (Integrilin)

Bleeding; ACS; PCI

What are the other side effects for Eptifibatide (Integrilin)

Thrombocytopenia

What are the miscellaneous for Eptifibatide (Integrilin)

Given parenterally

What is the class for Tirofiban (Aggrastat)

Antiplatelet

What is the mechanism for Tirofiban (Aggrastat)

Fibrinogen analog which competes with endogenous fibrinogen and vWF for IIb/IIIa

What are the important side effects for Tirofiban (Aggrastat)

Bleeding; NSTE-ACS

What are the miscellaneous for Tirofiban (Aggrastat)

Given parenterally; immediate effect

9) Thrombosis Flashcards

(91 cards)