Anti-platelet/Anti-coagulant Flashcards
(55 cards)
1
Q
dabigatran category of drug
A
oral direct acting thrombin inhibitor
2
Q
drug interactions with warfarin
A
- NSAIDS - Amiodarone - Cimetidine
3
Q
UFH/LMWH MOA
A
- inhibits factors Xa and thrombin by acting on anti-thrombin
4
Q
when do we give fibrinolytic drugs?
A
- immediately to treat STEMIS
5
Q
enoxaparin is given how?
A
- subQ
6
Q
half life of factor 10a
A
- 40 hours
7
Q
warfarin/coumadin category of drugs
A
oral indirect acting vitamin K inhibitors
8
Q
P2Y12 inhibitors MOA
A
- irreversibly block ADP receptor binding for platelets - non competitive antagonists
9
Q
MOA of warfarin
A
- vitamin K reductase inhibitor
10
Q
what is an alternative to heparin in patients with HIT?
A
- argatroban
11
Q
how do we manage until warfarin kicks in?
A
- heparin bridging
12
Q
argatroban category of drug given how
A
-direct acting thrombin inhibitor - IV
13
Q
COX1/2 inhibitors used to treat
A
- unstable angina - MI - stroke
14
Q
P2Y12 inhibitors used to treat
A
- MI - stroke
15
Q
how must GPIIb/IIIa inhibitors be given?
A
- IV
16
Q
before warfarin effects begin, what must happen?
A
- affected coagulation factors must degrade
17
Q
diet and warfarin
A
- variability in diet makes warfarin dosing problematic - dependent on vitamin K intake
18
Q
half life of factor 7a
A
- 6 hours
19
Q
what proteins is vitamin K responsible for
A
- 2 - 7 - 9 - 10 - proteins C and S
20
Q
GPIIb/IIIa inhibitors MOA
A
- prevent activated platelets from sticking together
21
Q
Abciximab class of drug
A
- GPIIb/IIIa inhibitor
22
Q
what part of heparin binds to the anti-thrombin
A
- the pentasaccharide
23
Q
toxicities of COX 1/2 inhibitors
A
- gastric damage
24
Q
when do we give Streptokinase or alteplase
A
- immediately to treat pulmonary emboli
25
fondaparinux MOA
- inhibits factor Xa by acting on anti-thrombin
26
half life of factor 2a (thrombin)
- 60 hours
27
UFH toxicities
- heparin-induced thrombocytopenia
28
unfractionated heparin and enoxaparin category of drug
- indirect acting thrombin and factor Xa inhibitors
29
half life of factor 9a
- 24 hours
30
role of Alteplase and Streptokinase how must they be administered
- proteins that convert inactive plasminogen into active plasmin - IV because they are large molecules
31
fondaparinux category of drug given how
- indirect acting factor Xa inhibitor - SubQ
32
fibrinolytics should definitely not be used for
- strokes caused by cerebral hemorrhage - those patients who for blood clotting is good
33
unfractionated heparin is given how?
- IV - SubQ - too large a molecular size
34
COX1/2 inhibitors MOA
- inhibit COX synthesis of TXA2
35
Pharmacokinetics issues with wafarin
- slow onset of action - may take up to a week to reach therapeutic levels - polymorphism issues - variability in diet
36
When can we also give alteplase
- immediately to treat stroke
37
aspirin class of drug
- COX1/2 inhibitor
38
how Amiodarone and Cimetidine interact with warfarin
- decrease warfarin metabolism - increase INR
39
Tirofiban class of drug
- GPIIb/IIIa inhibitor
40
how does heparin-induced thrombocytopenia occur
- platelet coated with immune complex and heparin - platelet removed by splenic macrophages
41
Eptifibitide class of drug
- GPIIb/IIIa inhibitor
42
how NSAIDS impact warfarin
- kick warfarin off albumin - increase free warfarin - increase bleeding risk
43
clopidogrel class of drug
- P2Y12 inhibitors
44
platelet activation is what phase of hemostasis?
- primary hemostasis
45
- apixaban, rivaroxaban, edoxaban category of drug
oral direct acting factor Xa inhibitor
46
GPIIb/IIIa inhibitors used to treat
- angioplasty - stent placement
47
what is fondaparinux really?
- only the pentasaccharide portion of heparin
48
Warfarin toxicities
- birth defects - fetal warfarin syndrome - category X toxin
49
thrombin activation is what phase of hemostasis?
- secondary hemostasis
50
Pharmacokinetics issues with P2Y12 inhibitors
- given in the prodrug form first - must be activated by CYP2C19 - slow metabolizers (activators) will have reduced therapeutic effects
51
role of TXA2
- platelet activation and aggregation
52
which polymorphisms affect warfarin dosing?
- VKORC1 - CYP2C9
53
Name the 1° Hemostasis Inhibitors by Category
(1) COX1/2 Inhibs: Aspirin
(2) P2Y12 Inhibs: Prasugrel, Clopidogrel, Ticagrelor
(3) GIIb/IIIa Inhibs: Abciximab, Tirofiban, Eptifibatide
54
Name the Parenterally administered 2° Hemostasis Inhibitors by group
Parenterally Administered:
Direct Acting Thrombin Inhibs: Argatroban (IV), Bivalirudin (IV)
Direct Acting Factor Xa Inhibs: none
Indirect Acting Thrombin Inhibs: UFH (IV, SubQ)
Indirect Acting Factor Xa Inhibs: Fondaparinux (SubQ), Enoxaparin (SubQ)
55
Name the Orally administered 2° Hemostasis Inhibitors by group
Direct Acting Thrombin Inhibs: Dabigatran
Direct Acting Factor Xa Inhibs: Apixaban, Rivaroxaban
Indirect Acting Vit. K Reductase Inhibs: Warfarin/Coumadin
