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Flashcards in Anticoagulant Deck (25)
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1

What is the main outcome of the intrinsic and the extrinsic pathway?

activation of prothrombin to thrombin

2

What does 5HT cause at sight of wound? TXA2? ADP?

1. vasoconstriction 2. platelet activation 3. Allows clumping

3

What does epithelial cells produce to suppress platelet aggregation?

PGI2

4

What measures the intrinsic pathway?

PTT

5

What measures the extrinsic pathway?

PT

6

What factors does Active Protein C block?

V and VIII

7

What does TFPI block? Antithrombin?

1. Factor VII 2. Thrombin and X

8

What is the INR equation? What is normal? High? Low?

(PT patient/ PT mean-normal)^ISI
[ISI= international sensitivity index issured to manufactured tissue factors]
Normal=.9-1.3
High= 4 or 5-->bleeding
Low=.5--> clotting

9

Does arterial thrombosis or venous thrombosis primarily involve platelet deposition?

Arterial does. Venous is mainly fibrin.

10

What is clopidogrel activated by? prasugrel?

1. CYP2C19 2. Hydrolysis (more effective in most people)

11

What 2 things does platelet IIb/IIIa receptor function as a receptor for?

1. FIBRINOGEN AND VITRONECTIN
2. FIBRINOGEN AND VON WILLEBRAND

12

How is glycoprotein IIb/IIIa inhibitors administered? Heparin?

Parenterally

13

What factors does Heparin inhibit? by doing what?

IIA, IXa, and Xa By activating antithombin

14

How many daltons is low molecular weight?

7000

15

Where must you never administer heparin?

Never administer intramuscularly

16

What is HIT?

heparin induced thrombocytopenia- systemic hypercoaguable state in patients treated with UFH heparin for 7 days

17

T or F--high molecular weight heparin binds to platelets with high affinity and low molecular weight binds to ATIII with low affinity?

False-- the affinities are opposite but binding is true

18

What is the saturable mechanism for heparin removal? unsaturable?

1. reticuloendothelial system
2. renal excretion

19

Does protamine reverse the effect of fondaparinux? What chem structures are added to fondaparinux?

1. No although it does in an incomplete way to other LMWHs
2. pentasacc. with added methyl groups

20

What factors is vitamin K needed for?

II, VII, IX, X, C, and S INHIBITS SYNTHESIS NOT DEGRADATION

21

What is warfarin cleared by?

cleared by liver and kidney

22

Does warfarin interact with a lot of drugs?

Yes and diets and disease states

23

is there any definitive evidence supporting the exclusive use of any fibrinolytic agent?

No--all agents induce a lytic state which may lead to bleeding

24

What takes fibrin to fibrin degradation products?

Plasmin

25

What thrombolytic has the longest half life? shortest?

1. streptokinase
2. TPA