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CVS II Pharmacology > Anticoagulants, Antiplatelets, and Fibrinolytic Drugs > Flashcards

Anticoagulants, Antiplatelets, and Fibrinolytic Drugs Flashcards

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1
Q

what is the MOA of clopidogrel

A

ADP/P2Y12 inhibitors (antiplatelets)

inactivation of p2y12 receptors increases cAMP

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2
Q

what is the MOA of prasugrel

A

ADP/P2Y12 inhibitors (antiplatelet)

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3
Q

what is the MOA of ticagrelor

A

ADP/P2Y12 inhibitor

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4
Q

what is the MOA of abciximab

A

GP IIb/IIIa inhibitor (antiplatelet)

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5
Q

what is the MOA of eptifibatide

A

GP IIb/IIIa inhibitor (antiplatelet)

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6
Q

what is the MOA of tirofiban

A

GP IIb/IIIa inhibitor (antiplatelet)

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7
Q

what is the MOA of dipyridamole

A

phosphodiesterase inhibitor (PDE3)

when PDE3 is inhibited, the breakdown of cAMP is reduced

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8
Q

what is the MOA of Cilostazol

A

PDE3 inhibitor

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9
Q

what is the MOA of vorapaxar

A

protease-activated receptor-1 inhibitor (antiplatelet)

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10
Q

what is the MOA of Aspirin

A

Thromboxane A2 inhibitor via irreversible acetylation of COX1 receptors in platelets (antiplatelet)

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11
Q

what are the clinical uses of aspirin

A

prophylaxis in MI and stroke

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12
Q

what are the adverse effects of aspirin

A

GI upset and bleeding

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13
Q

which P2Y12 inhibitor is not used in the states due to life-threatening aplastic anemia

A

ticlopidine

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14
Q

does the inactivation of P2Y12 increase or decrease cAMP levels

A

increase, causing inhibition of platelet aggregation

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15
Q

what are the clinical uses of ADP/P2Y12 inhibitors

A

Treatment of ACS, prevention of stroke, DAPT (dual antiplatelet therapy) for drug eluted stent (usually combined with aspirin)

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16
Q

how does glycoprotein IIb/IIIa inhibition contribute to antiplatelet formation

A

it inhibits fibrinogen from binding to IIb/IIIa receptors

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17
Q

what is the MOA of Dipyridamole

A

inhibition of phosphodiesterase

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18
Q

what is the MOA of cilostazol

A

inhibition of PDE3 (phosphodiesterase 3)

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19
Q

what are the clinical uses of dipyridamole

A

thromboembolism prophylaxis, cardiac stress test for patients who can’t use the treadmill

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20
Q

what is the clinical use of cilostazol

A

treatment of intermittent claudication (PVD)

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21
Q

what is the clinical use of vorapaxar

A

thrombotic event prevention

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22
Q

what are some adverse effects of vorapaxar besides bleeding

A

depression and rash

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23
Q

what is the MOA of warfarin

A

Vit K antagonist (inhibits hepatic synthesis of vit k factors II, VII, IX, and X)

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24
Q

what are the adverse effects of warfarin besides bleeding

Study These Flashcards
A

skin necrosis, purple toe syndrome, teratogenic (bone defects)

25
what is the anticoagulant that is teratogenic
warfarin
26
why is warfarin an ambulatory anticoagulant
bc it takes 2-3 days to work)
27
what is the MOA of skin necrosis with warfarin therapy
since protein c depends on gamma carboxylation and that's the MOA of warfarin, it can cause a protein C deficiency ultimately leading to hypercoagulability
28
what is the MOA of unfractionated heparin
potentiator of antithrombin: activates the plasma antithrombin III by enhancing the serine protease activity. In turn, the antithrombin III will inactivate factors IIa, IXa, Xa, XIa, and XIIa
29
what is an adverse effect of heparin
heparin induced thrombocytopenia, osteoporosis
30
why is heparin safe during pregnancy
it doesn't cross the placenta, unlike warfarin
31
What is the MOA of LMWHs: enoxaparin and dalteparin
potentiator of antithrombin via activity against factor X
32
what is the MOA of synthetic heparinoid, fondaparinux
selective antithrombin III Xa inhibition
33
why is enoxaparin contraindicated in prosthetic valves
high risk of thromboembolism
34
of the LMWH, which one is safer in heparin induced thrombocytopenia
fonaparinux
35
what is the MOA of the hirudin family of drugs
direct thrombin inhibitor
36
what are the clinical uses of lepirudin and bivlirudin (direct thrombin inhibitors)
prevention of thrombosis in pts with unstable angina and acute MI
37
what is the MOA of argatroban
synthetic direct thrombin inhibitor
38
what is the clinical use of argatroban
treatment of thrombosis in pts with HIT
39
what is the MOA of dabigatran (pradaxa)
(oral) direct thrombin inhibitor
40
what are the clinical uses of dabigatran
reduce the risk of stroke in prs with afib; prevent thrombotic complications of hip and knee replacement surgery
41
what is a unique side effect of dabigatran
gastritis like symptoms
42
why is dabigatran contraindicated with Pgp inducers (rifampin) and pgp inhibitors (verapamil, amiodarone and clarithromycin)
because its a substrate for P-glycoprotein (Pgp)
43
what is the MOA of apixaban (eliquis)
oral direct factor Xa inhibitor
44
what are the clinical uses of apixaban
Afib to reduce risk of stroke, prevention and treatment of venous thromboembolism
45
what is the MOA of rivaroxaban (xarelto)
oral direct factor Xa inhibitor
46
what are the clinical uses of rivaroxaban (xarelto)
DVT, blood clots and pulmonary embolism after knee replacement
47
what are the overarching clinical uses of anticoagulants
1. thromboembolic disorders: DVT, PE, and Afib 2. Unstable angina undergoing PCI
48
what is the antidote for heparin
protamine sulfate
49
what is the antidote for warfarin
Vit K1 (phytonadione)
50
Heparin affects PT/PTT while warfarin affects PT/PTT?
heparin: PTT (intrinsic pathway) warfarin: PT (extrinsic pathway)
51
what test do you need to run every 2 weeks for patients on warfarin
INR (normal is 1.0 and warfarin patients should be around 2.0)
52
what is the normal PTT that you would expect to see in pts on heparin
normal is 21-35 sec, heparin pts expect 50-55
53
what are the overarching clinical uses of fibrinolytics (thrombolytics)
Acute MI, Acute PE, DVT, Thromboembolic stroke
54
what is the MOA of fibrinolytics
activate the conversion of plasminogen to plasmin --> causes lysis fibrin clot
55
what is the antidote or alteplase/fibrinolytics
aminocaproic acid
56
what are the most common 3 tPA drugs
alteplase, reteplase and tenecteplase
57
what antifibrinolytic drug is used to treat heavy menstrual bleeding
tranexamic acid
58
what are the adverse effects of tranexamic acid
thrombotic events (increased in pregnant women and obese pts)

CVS II Pharmacology (9 decks)

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