Anti-platelet, anti-coagulant and thrombolytic drugs Flashcards Preview

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Flashcards in Anti-platelet, anti-coagulant and thrombolytic drugs Deck (43)
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1

Which clotting factor is factor 2?

Thrombin

2

What kind of thrombus is a white thrombus? (Arterial/venous)

Arterial

3

What kind of thrombus is a red thrombus? (Arterial/venous)

Venous

4

Which organs do white thromboemboli generally tend to occlude the blood supply to?

Brain
Heart
Kidney

5

Where do red thromboemboli tend to lodge?

Pulmonary artery

6

What is the definition of thrombosis?

Pathological haemostasis

7

What kind of precursors are clotting factors 2, 7, 9 and 10?

Glycoprotein

8

What do the active factors 2a, 7a, 9a and 10a act as?

Serine proteases

9

What need to occur to allow transformation of precursors to clotting factors? E.g. prothrombin to thrombin.

Gamma carboxylation (of glutamate residues)

10

What process does Vitamin K allow to occur and what does this facilitate?

Gamma carboxylation, facilitating the conversion of precursors to active clotting factors e.g. prothrombin to thrombin

11

Which form of Vitamin K is required to allow gamma carboxylation to occur? (Oxidised/reduced)

Reduced form - a hydroquinone

12

Which enzyme converts vitamin K from it's oxidised form to it's reduced form?

Vitamin K reductase

13

Which enzyme does the drug warfarin target?

Vitamin K reductase

14

What can be used to counteract Warfarin when dose is too high?

Vitamin K

15

What drug may be added to dose of warfarin to produce rapid anticoagulant effect?

Heparin

16

What scale is used to ensure that the correct dose of warfarin has been given?

International normalised ratio

17

Why is haemorrhage more likely with warfarin in a patient with existing liver disease?

The liver produces clotting factors

18

Which molecule in the body acts to stop the coagulation cascade naturally?

Antithrombin 3

19

How does antithrombin 3 act to stop the coagulation cascade?

It binds directly to the active site of active thrombin and inhibits it

20

How does heparin work?

Heparin binds to antithrombin III, increasing its affinity for serine protease clotting factors (particularly Xa and IIa (thombin) to greatly increase their rate of their inactivation

21

To inactivate factor 2a, what must heparin bind to?

Both antithrombin 3 and thrombin

22

To inactivate factor 10, what must heparin bind to?

Antithrombin 3

23

What clotting factor does low molecular weight heparin inhibit?

Factor Xa

24

Where does excretion of LMWH occur?

Kidneys

25

Which drug - heparin or LMWH - shows zero order kinetics?

Heparin

26

Which drug - heparin or LMWH - shows first order kinetics?

LMWH

27

Which drug - heparin or LMWH - is preferred in renal failure and why?

Heparin - LMWH excreted via renal system

28

How does rivaroxiban work?

Directly inhibitis Xa

29

When is rivaroxiban used in treatment?

After hip and knee surgeries to prevent formation of venous clot

30

How do platelets adhere to surfaces with endothelial damage? Where does von Willebrand factor (vWF) come into this?

Endothelial damage exposes subendothelial molecules to which platelets adhere via surface glycoproteins (GPIb receptors)
Von Willebrand factor acts as a bridge