Anticoagulants

Question 1

How does hemostasis happen?

Answer 1

1. plt aggregation

2. coagulation

Question 2

what needs to happen to platelets before they aggregate and form plug?

Answer 2

platelet activation before aggregation

Question 3

what receptors are used to form bridges?

Answer 3

GPII/III receptor

undergo activation, aka undergo a configurational change that allows them to bind with fibrinogen

Question 4

now it (platelet plug) has to be reinforced, how does that happen?

Answer 4

plug is unstable and must be reinforced with fibrin if protection is to last

coagulation cascade

Question 5

2 pathways converge at factor

Answer 5

Xa

Question 6

warfarin’s mechanism of action

Answer 6

vitamin K antagonist

name misleading. it is antagonism of vitamin k activation

Question 7

what clotting factors is vitamin k necessary for

Answer 7

clotting factors 2, 7, 9, 10

Question 8

can we use warfarin in situation where anticoagulation is needed urgerntly

Answer 8

no bc it does not get rid of already active clotting

Question 9

what lab value do we monitor with warfarin

Answer 9

inr

Question 10

mechanism of action with heparin

Answer 10

block clotting factor action

activation of antithrombin which inactivates factor xa and thrombin

Question 11

heparin is preferred drug in pregnancy bc

Answer 11

it cannot cross placenta

polar molecule

Question 12

example of direct thrombin inhibitor and how it works

Answer 12

dabigatron

inhibits thrombin

Question 13

thrombin inhibition prevents conversion of blank to blank

Answer 13

fibrinogen to fibrin

so overall effect is less fibrin meshwork to support platelet plug

Question 14

side effect of all anticoagulants

Answer 14

bleeding

Question 15

how do factor xa inhibitors work

Answer 15

selective inhibition of factor xa

inhibits production of thrombin

Question 16

prevent conversion of prothrombin to thrombin which ultimately decreases ___ production

Answer 16

fibrin

Question 17

end result of all anticoagulants is less what

Answer 17

fibrin

accomplished in different ways

Question 18

mechanism of action for aspirin

Answer 18

irreversaible inhibition of cyclooxygenase which blocks syntheis of TXA

Question 19

Cox inhibits cycloxygenase but how does that prevent platelet aggregation?

Answer 19

aspirin inhibits

COX is necessary for conversion of arichidonic acid to thrombaxane A2 (which plays role in platelet aggregation/activation)

Question 20

irreversible inhibition

Answer 20

effects last for life of platelet

Question 21

How does clopogrel differ in mechanism of action?

Answer 21

block P2Y ADP receptor

It works to prevent platelet aggregation…just using different method