Anticoagulant Drugs Flashcards Preview

Pharmacology - Test #4 > Anticoagulant Drugs > Flashcards

Flashcards in Anticoagulant Drugs Deck (34):
1

Which coagulation factors are Glycoproteins used to activated Serine proteases

8, 5, 3, S
Alto -- Anti-thrombin III

2

Hemophilia A is a deficiency of...

Factor 8

3

Hemophilia B is a deficiancy of...

Factor 9

4

What is Factor V Leiden

A mutation tat gives resistance to Protein C

5

Where are clotting factors produced?

Liver (except VWF in the endothelial cells and megakaryocytes)

6

Role of factor 13

Cross links fibrin into stable clots incorporated into platelet plug

7

What are PT, aPTT, and Bleeding Time used to assess

PT -- Monitor Oral Anticoagulation therapy
aPTT -- Monitor heparin therapy
Bleeding Time -- Abnormal with defect in platelet number or fxn

8

INR =

(Patient PT/Control PT)^International sensitivity index

9

How does Warfarin work?

Inhibit the reduction of Vitamin K, which is essential for factors 2, 7, 9, 10, C, and S

10

Timeline on Warfarin efficacy

Will take 3-5 days to deplete the pool of circulating clotting factors. Takes several dys to re-synthesize factors after discontinuing therapy.

11

Warfarin is matabolized by...

Cyp 2C9

12

Important details about Warfarin Overdose...

Iatrogenic Hemorrhage
Discontinue Warfarin and Give Vitamin K or plasma

13

Features of fetal warfarin syndrome

Nasal Hypoplasia
Abnormal Bone Formation

14

Aside from reversing warfarin, when else might you dose someone with Vitmain K

Fat absorption anomalies
Newborns

15

How does Heparin work

Binds and activates antithrombin III
Then dissociated and interacts with even more

16

Antithrombin III can inactivate...

Thrombin
Factors 7, 9, and 10

17

Main adverse effect of Heparin to watch for an impt. details

Iatrogenic Hemorrhage
RFs -- Over 50, Ulcers, Severe HTN, Antiplatelet Drugs
Tx -- Stop Hep, Specific antagonist if life threatening

18

What is the Heparin's antidote?

Protamine sulfate

19

The other two important adverse effects of Heparin use to watch for

Thrombocytopenia (7-12 days post therapy, Ab against PF4-Heparin compex)
Osteoporosis (After 3-6 months of treatment)

20

Heparin's _____ groups are required for antithrombin binding

Sulfate groups

21

Perks of Low molecular weight heparin

Less frequent dosing, longer half life
No clotting monitoring needed
Less thrombocytopenia and osteo

22

Main form of low moledular weight heparin

Danaparoid
(also Enoxaparin, Tinzaparin)

23

How is the activity of LMW Heparin different from normal Hep

Binding to AT leads to preferential inhibition of Factor X, parely hits thrombin

24

Important Factor Xa inhibitors

Fondaparinux Sodium
Rivaroxaban (Xarelto)
Apixaban (Eliquix)
Edoxaban

25

Important details on Fondaparinux Sodium

Indirect inhib of Factor X by AT binding
SC once daily
used for DVT, Prophylaxis of surgical patient (abdominal and ortho surgery)
NOT REVERSIBLE BY PROTAMINE SULFATE

26

What is Rivaroxaban (Xarelto) used for?

Prevent VT, PE, and thrombus in Afib

27

What s Apixaban used for?

Prevent thrombus in A Fib

28

Problem with discontinuing Factor Xa inhibitors?

Increased risk of stroke

29

Important Edoxaban details

Treatment of VT and PE after briding anticoag
Quickly renally excreted

30

Four significant Direct thrombin Inhibitors

Hirudin
Desirudin
Bivalirudin
Argatroban
Dabigatran

31

Important details about Hirudin

Peptide from leach saliva

32

Important details about Desirudin

Recombinant Hirudin from yeast
Irreversible inhibition of thrombin
No effect on AT, aPTT values increase dose-dependently
HS rxns

33

Important details about Bivalirudin

Reversible binding, rapid onset and short duration
Given via IV in PCA
No Ab formation

34

Important details about Argatroban

Reversible binding
Monitor with aPTT
Half life of 40-50 minutes
Prophylaxis/Treatment in patients with Hep-induced thrombocytopenia