Anti-coagulant (week 7) Drugs Flashcards
(18 cards)
1
Q
Aspirin
A
anti-platelet: COX inhibitor irreversibly acetylates COX1--/ PG, TXA2 prevent TXA platelet aggreg (PK) oral upper GI effect ~10 day effect (X) 1o prevention - reduce MI mortality (X) 2o prevention - hx of MI, angina, stroke- reduce MI, stroke, death (-1) bleeding (-2) GI irritation (ulcer)
2
Q
Clopidogrel
A
anti-platelet: ADP:P2Y12 Inhibitor inhibit ADP from binding to P2Y12R (platelet) (PK) cyP2C19 (O) proton pump inhib (-1) bleeding (-2) severe neutropenia
3
Q
Prasugrel
A
anti-platelet: ADP:P2Y12 inhibit ADP from binding to P2Y12R (platelet) (PK) cyP2C19 (O) proton pump inhib (-1) bleeding (-2) severe neutropenia
4
Q
Ticlopidine
A
anti-platelet: ADP:P2Y12 inhib inhibit ADP from binding to P2Y12R (platelet) (PK) cyP2C19 (O) proton pump inhib (-1) bleeding (-2) severe neutropenia
5
Q
Ticagrelor*
A
anti-platelet: ADP:P2Y12 inhib REVERSIBLE inhibit ADP from binding to P2Y12R (platelet) (PK) cyP2C19 (O) proton pump inhib (-1) bleeding (-2) severe neutropenia
6
Q
Abcximab
A
anti-platelet: GpIIb/IIIa inhibitor Non-competitive Fab chimeric human-murine monoAb bind (platelet) GPIIb/IIIa-R --/ fibrinogen cross-link (PK) IV , bi-phasic t 1/2 (X) PCI (-1) bleeding (-2) thrombocytopenia (-3) hyp-O- tension (-4) bradycardia
7
Q
Eptifibatide
A
anti-platelet: GpIIb/IIIa inhibitor Competitive, reversible prevent fibrinogen cross-link of platelets Lys-Gly-Asp (KGD) seq= ^ specificity for R (PK) IV, renal clearance (X) 2o prevention (X) unstable angina (X) NSTEMI (O) renal dysfunction (-1) bleeding
8
Q
Heparin
A
anti-thrombotic: parenteral bind antithrombin --/ thrombin + F Xa (PK) parenteral NOT abs in GI (^ size and charge) , immediate onset (X) Coronary Artery Disease (X) prevention of death, AMI, refract angina, (X) PCI (-1) bleeding (-2) heparin-induced thrombocytopenia
9
Q
Enoxaparin
A
anti-thrombotic: parenteral LMWH ^ inhib of FXa (less thrombin) (PK) parenteral (NOT abs in GI) longer t 1/2> heparin (X) 1st line subQ for UA or AMI (X) IV for STEMI or PCI (O) renal impairment (-1) bleeding (-2) LMWH-induced thrombocytopenia (less than< heparin)
10
Q
Dalteparin
A
anti-thrombotic: parenteral LMWH ^ inhib of FXa (less thrombin) (PK) parenteral (NOT abs in GI) longer t 1/2> heparin (X) 1st line subQ for UA or AMI (X) IV for STEMI or PCI (O) renal impairment (-1) bleeding (-2) LMWH-induced thrombocytopenia (less than< heparin)
11
Q
Bivalirudin
A
anti-thrombotic: parenteral direct thrombin inhib
Phe-Pro-Arg-Pro
bind/occupy catalytic site of thrombin
(PK) t 1/2 = 25 min
IV, kidney excr
(X) 2nd line (to heparin) angioplasty, CABG
(O) renal failure
(-1) bleeding
12
Q
Lepirudin
A
anti-thrombotic: parenteral direct thrombin inhib
bind/occupy exosite 1 and catalytic site of thrombin
(PK) t 1/2 = 1.3hr
IV, kidney excr
(X) 2nd line (to heparin) angioplasty, CABG
(O) renal failure
(-1) bleeding
13
Q
Fondaparinux
A
anti-thrombotic: direct FXa inhibitor anti-thrombin-mediated --/FXa (PK) subQ , renal excr, t 1/2 = 17hr (X) ACS (UA, NSTEMI, STEMI) (O) renal failure (-1) heparin-induced thrombocytppenia (-2) catheter-related thrombosis
14
Q
Warfarin
A
(oral)anti-thrombotic: oral anti-vit K
inhib epoxide reductase –/ F II, VII, IX, X
(X) 2o prevention after STEMI
(X) AF mechan/ prosthetic heart valve
15
Q
Dabigatran
A
(oral)anti-thrombotic: oral thrombin
direct thrombin inhibitor
free + fibrin-bound
16
Q
Rivaroxiban
A
(oral)anti-thrombotic: oral anti FXa
17
Q
Dipyridamole
A
(oral) anti-thrombotic: oral –/PDE
^^cAMP–/platelet aggreg + vasoDILATE
(X) use + clopidogrel or Aspirin
18
Q
Alteplase
A
thrombolytic (tPA) activate plasminogen bind fibrin (clot)- activate plasminogen> plasmin*--> clot dissolve (PK) (1) bolus dose 1 min (2) infusion (X) AMI (STEMI or L bundle block) within 3 HOURS! (-1) bleeding= intracranial hemorrhage
