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Anti Coagulant Flashcards

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1
Q

Haemostasis

A

The arrest of blood loss from a damaged vessel.

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2
Q

Localized vasoconstriction

A

A process involved in haemostasis.

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3
Q

Platelet adhesion and activation

A

A step in the process of haemostasis.

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4
Q

Blood coagulation

A

A crucial step in haemostasis that stops bleeding.

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5
Q

Arterial thrombosis

A

This condition can cause ischemic necrosis of the tissue supplied by the artery.

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6
Q

Myocardial infarction

A

An example of arterial thrombosis due to occlusion of the coronary arteries.

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7
Q

Venous thrombosis

A

Can lead to the edema and inflammation of tissue drained by the affected vein.

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8
Q

Antiplatelets

A

Drugs that interfere with the haemostatic system by preventing platelet aggregation.

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9
Q

Anticoagulants

A

Drugs that prevent blood coagulation by affecting various components of the coagulation cascade.

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10
Q

Thrombolytics

A

Drugs that dissolve blood clots and are beneficial in managing pathological thrombus formation.

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11
Q

Extrinsic pathway of coagulation

A

Begins with damaged tissue and involves tissue factor (TF) and factor VII.

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12
Q

Intrinsic pathway of coagulation

A

Involves multiple factors beginning with factor XII and leading to factor X activation.

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13
Q

Common pathway of coagulation

A

The final stage where prothrombin is converted into thrombin.

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14
Q

Factor X

A

Activated to factor Xa, which converts prothrombin into thrombin.

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15
Q

Fibrinogen conversion

A

Thrombin converts fibrinogen into fibrin as the final step of coagulation.

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16
Q

Heparin

A

A rapidly-acting anticoagulant that can exist as unfractionated or low molecular weight heparins.

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17
Q

Unfractionated heparin (UFH)

A

Has a molecular weight of 15000 - 20000 and is used for rapid anticoagulation.

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18
Q

Low Molecular Weight Heparin (LMWH)

A

A type of heparin with a molecular weight range of 2000 - 6000, offering greater bioavailability.

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19
Q

Antithrombin III (AT-III)

A

A protein that heparin enhances the activity of, inhibiting various clotting enzymes.

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20
Q

Activated Partial Thromboplastin Time (aPTT)

A

A test used to monitor the anticoagulant effect of heparin.

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21
Q

Normal aPTT range

A

25 - 40 seconds.

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22
Q

Therapeutic aPTT range

A

55 - 70 seconds.

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23
Q

Bleeding complications of heparin

A

Includes hemorrhage, which can be controlled using protamine sulfate.

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24
Q

Protamine sulfate

A

A basic substance that neutralizes the anticoagulant effect of heparin.

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25
Argatroban
A direct thrombin inhibitor that requires heparin binding to AT-III for action.
26
Dabigatran
An orally administered direct thrombin inhibitor.
27
Warfarin
A vitamin K antagonist that inhibits the synthesis of several coagulation factors.
28
Mechanism of action of Warfarin
Inhibits Vitamin K-dependent coagulation factors II, VII, IX, and X.
29
INR (International Normalized Ratio)
A value calculated to monitor the effects of warfarin treatment.
30
Warfarin therapeutic INR range for DVT
2 - 3.
31
Warfarin therapeutic INR range for artificial cardiac valves
3 - 3.5.
32
Complications of Warfarin management
Bleeding, dermal vascular necrosis, teratogenic effects, alopecia.
33
Aspirin mechanism of action
Irreversibly inhibits COX, reducing thromboxane A2 synthesis.
34
ADP receptor antagonists
Drugs like Clopidogrel that inhibit ADP-mediated platelet aggregation.
35
Ticlopidine
Inhibits ADP-dependent platelet aggregation but has a higher risk of neutropenia.
36
Abciximab
A GP IIb/IIIa antagonist that inhibits final platelet aggregation pathways.
37
Dipyridamole mechanism of action
Inhibits phosphodiesterase and increases cAMP, decreasing thromboxane A2 synthesis.
38
Thrombolytic drugs
Used in the treatment of conditions like acute myocardial infarction and pulmonary embolism.
39
Ischemic stroke treatment
Thrombolytic agents can be used but provide little benefit.
40
Streptokinase
A thrombolytic drug that activates plasminogen, not fibrin-selective.
41
Alteplase
A recombinant tissue plasminogen activator that is fibrin-selective.
42
Rivaroxaban and apixaban
Oral anticoagulants that inhibit factor Xa.
43
LMWH monitoring
Does not usually require laboratory monitoring like UFH.
44
Adverse effect of thrombolytics
Includes bleeding, hypotension, and arrhythmias.
45
Patient profile for thrombolytics
Consideration of history, medications, and presenting symptoms essential for treatment.
46
Thrombocytopenia in heparin use
A rare but serious side effect that may necessitate replacement with argatroban.
47
Bioavailability of LMWH
Greater than unfractionated heparin, allowing less frequent dosing.
48
Heparin administration methods
Can be given as continuous infusion or deep subcutaneous injections.
49
Fibrin-selective thrombolytics
Less likely to cause bleeding due to localized action.
50
Cilostazol
A PDE III inhibitor that reduces symptoms of intermittent claudication.
51
Secondary prevention with aspirin
Beneficial in patients following stroke to prevent thromboembolic events.
52
Major drawback of aspirin therapy
Risk of gastrointestinal bleeding and allergic reactions.
53
DVT treatments
Include anticoagulants like heparin or oral agents such as warfarin.
54
Management of stroke with warfarin
Requires monitoring INR to ensure safe anticoagulation levels.
55
Long-term effects of heparin
Can include osteoporosis with prolonged use.
56
Emergency signs of a stroke
Sudden weakness and slurred speech; critical for thrombolytic intervention.
57
Final step of coagulation cascade
Conversion of fibrinogen into fibrin by thrombin.
58
Role of vitamin K in coagulation
Essential for the synthesis of active clotting factors II, VII, IX, and X.
59
Importance of anticoagulation monitoring
Essential to prevent adverse effects and ensure therapeutic ranges are met.
60
Heparin's effect on lipoproteins
Heparin releases lipoprotein lipase, accelerating clearing of lipoproteins from plasma.
61
Indicators for thrombolytic therapy
Acute myocardial infarction, pulmonary embolism, and deep venous thrombosis.

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