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CVR Biweekly 2 > Anticoagulants > Flashcards

Anticoagulants Flashcards

(106 cards)

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1
Q

4 main steps in hemostasis

A
  1. vasoconstriction
  2. platelet aggregation (plug)
  3. coagulation (clot)
  4. thrombolysis
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2
Q

what allows for platelet aggregation

A

platelets cross-linked by fibrinogen binding to GPIIb/IIIa

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3
Q

platelet activation happens when bound to what

A

collagen

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4
Q

only molecule of coagulation cascade made by EC

A

vWF

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5
Q

clotting factors of coagulation cascade besides vWF made by what

A

liver hepatocytes

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6
Q

direct binding of platelet to collagen by what

A

GPVI

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7
Q

indirect binding of platelet to collagen

A

vWF: GPIIb/GPIIIa

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8
Q

cytokines inhibit antithrombotic factor and promote thrombotic factors

A

septic shock thrombosis pathogenesis

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9
Q

heparan sulfate
PGI2
NO
Adenosine
t-PA
thrombomodulin

A

anti-thrombotic factors produced from EC

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10
Q

vWF
PAI1 (Ang IV receptor)
tissue factor (factor III)

A

thrombotic factors produced from EC

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11
Q

thrombin receptor that activates protein C and turns thrombin into anti-coagulant

A

thrombomodulin

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12
Q

found in blood that will be used in platelet aggregation

A

fibrinogen

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13
Q

what happens for platelets to degranulate

A

they bind with GPIIb/GPIIIa and GPVI to vWF on subendothelium

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14
Q

how platelet is activated by TXA2 and 5-HT (serotonin)

A

TXA2 and 5-HT bind Gq receptor on platelet and cause increase in Ca2+

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15
Q

increased Ca2+ from TXA2 and 5-HT binding to Gq on platelet allows for what

A

activation of GPIIb/IIIa to bind to fibrinogen

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16
Q

how ADP activates platelet

A

binds P2Y12 (Gi) and decreases cAMP and activates GpIIb/IIIa

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17
Q

crosslinking by fibrinogen via GPIIb/IIIa

A

platelet aggregation

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18
Q

tissue factor (factor III) so powerful it does what when bound to platelet

A

directly activates GPIIb/GPIIIa

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19
Q

how thrombin activates platelet

A

thrombin binds PAR1 (Gq) and leads to degranulation

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20
Q

when platelets are activated what happens

A

degranulation and ready to bind fibrinogen (step 1 achieved)

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21
Q

lack of vWF (EC problem); mucosal bleeds (nose); most common bleeding disorder; AD

A

vWD

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22
Q

nose bleeds

A

epistaxis

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23
Q

stabilizes factor VIII and protects it from inactivation by Protein C

A

vWF

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24
Q

2 main functions of vWF

A

platelet aggregation and saving factor VIII

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25
lack of vWF will affect what stages of coagulation
increased (PTT)
26
2nd most common bleeding disorder; x-linked recessive
Hemophilia A
27
males of Royal family were affected by this bleeding disorder
Hemophilia B
28
mutation in Factor V causes it to not be inactivated by protein C; propensity to form clots (thrombosis)
Factor V Leiden
29
GpIb deficiency (platelet problem)
Bernard-Soulier
30
Gp IIb/IIIa deficiency
Glanzmann thromboasthenia
31
made by Stellate cells in the liver
ADAMTS13
32
multimeric vWF used for adhesion is degraded by what
ADAMTS13
33
Ab against ADAMTS13, causes accumulation of vWF and thrombosis (TTP)
Ticlopidine
34
abnormal function of this makes collagen (can lead to cirrhosis of liver)
Stellate cells of liver
35
endothelial cell exocytotic bodies
Weibel-Palade body
36
cAMP associated exocytosis when V2 (Gq) is bound
Weibel-Palade body exocytosis
37
what is carried in the Weibel-Palade body
vWF
38
V2 receptor agonist (increases release of vWF from EC Weibel-Palade Body)
Desmopressin
39
what to administer in patient w/ DIC that has no platelets available and clotting factors being used in the disseminated clots
Desmopressin
40
no platelets available and clotting factors being used in the disseminated clots
consumption coagulopathy
41
defective platelet aggregation due to absent fibrinogen
Afibrinogenemia
42
what test to use to tell if vWF or GpIb is deficient
Ristocetin induced platelet aggregation (RIPA)
43
plant based molecule that directly binds to vWF
Ristocetin
44
no aggregation means what if both RIPA and RCA tests were used
vWF is absent or not active
45
RIPA no aggregation, but RCA aggregation (means vWF present)
absent or inactive GpIb
46
multiple platelets joined together
platelet plug
47
antiaggregant drug that is a COX I/II irreversible inhibitor (blocks TXA2)
Aspirin
48
(-GREL)
P2Y12 inhibitors (stops activation of GpIIb)
49
PDE inhibitor (cAMP increased and GpIIb not activated)
50
ABCIXIMAB
mab that blocks fibrinogen from binding GpIIb/IIIa
51
GpIIb/IIIa inhibitors (blocks FIBrinogen from binding)
52
VORAPAXAR
PAR1 inhibitor (prevents binding of thrombin)
53
SE of Ticlopidine (P2Y12 inhibitor)
neutropenia, TTP
54
contraindication for Clopidogrel
breast feeding (can get into breast milk
55
most liked P2Y12 inhibitor now
Prasugrel
56
____ when converted to ____forms the structural meshwork that consolidates an initial platelet plug into a solid hemostatic clot
fibrinogen to fibrin
57
what is required for the clotting factors to be activated
factor IV (Ca2+)
58
protein C can deactivate which 2 factors
factor VIII and V
59
when deactivated by thrombomodulin, ____ can help protein C deactivate VIII and V
thrombin
60
what factor from extrinsic side activates factor X
VIIa
61
what factors from intrinsic side activate factor X
VIIIa and IXa
62
way to measure functionality of extrinsic arm
PT (N 11-15 s)
63
way to measure functionality of intrinsic arm
PTT (N 25-40 s)
64
TT normal length (time to convert fibrinogen to fibrin)
<2
65
INR normal length (patient PT/normal PT)
1
66
PTT increases with what
vWFD, Heparin and Hemaphilia
67
PT increases with what
Warfarin and Vitamin K deficiency
68
what to check for thrombosis in the body
D-dimer
69
vitamin K antagonist; oral anticoagulant
Warfarin
70
ingesting Vitamin K can decrease effects of what
Warfarin
71
very effective drugs that block factor Xa
Warfarin and Dicumarol
72
block Epoxide reductase (VKORC1 gene); blocks formation of Vitamin K
Warfarin and Dicumarol
73
target INR for patients on Warfarin
2.5
74
warfarin used for
Atrial fibrillation
75
WARNING for warfarin
TERATOGEN
76
SE's of warfarin
bleeding and skin necrosis
77
how microthrombosis and then skin necrosis is induced with patient on warfarin
Protein C depletes before factor II or X and before warfarin can reduce their production
78
what do you prescribe with warfarin to prevent microthrombosis
Heparin
79
antidote of warfarin serious bleeding
FFP (fresh frozen plasma) vitamin K
80
indirect inhibitor of factor IIa (thrombin) and factor Xa
heparin
81
indirect effect of heparin due to what
they amplify action of antithrombin III
82
high molecular weight heparin
Heparin
83
low molecular weight heparin
Enoxaparin
84
minimalistic heparin
Fondaparinux
85
main factors antithrombin III inhibits
IIa (thrombin) Xa
86
heparin is safe to use in patient's with what 2 things
pregnancy or renal failure
87
SE of heparin
heparin induced thrombocytopenia (HIT)
88
antibodies against platelet 4 leads to what
HIT (heparin induced thrombocytopenia)
89
antidote for heparin
protamine sulfate
90
specific heparin that inactivates factor Xa
ENOXAPARIN
91
heparins that activate antithrombin III and inhibit only Xa
Enoxaparin Fondaparinux
92
this specific type of heparin activates antithrombin III and inhibits Xa AND IIa
unfractionated heparin
93
(-RUDIN)
inactivate IIa (thrombin)
94
antidote of -RUDINs (thrombin inactivators)
IDARUCIZUMAB
95
drug from leech saliva that blocks thrombin
HIRUDIN
96
(-XABAN)
factor Xa inhibitors
97
more effective and safer than warfarin
direct factor Xa inhibitors
98
antidote for direct factor Xa inhibitors
ANDEXANET
99
major 2 fibrinolytic agents
t-PA urokinase
100
clot buster
plasmin
101
natural in our bodies and blocks plasmin
alpha2-antiplasmin
102
inhibits t-PA and urokinase
PAI-1and2
103
drug that inhibits plasmin
AMINOCAPROIC ACID
104
initial Rx of venous thromboembolism
heparins -RUDINS (direct IIa inhibitors)
105
secondary Rx for venous thromboembolism
Warfarin -XABAN (direct Xa inhibitors)
106
2 main drugs used to treat arterial thrombosis
Aspirin t-PA

CVR Biweekly 2 (15 decks)

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