Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CV 2 > Anticoagulants, antithrombotics, and thrombolytics > Flashcards

Anticoagulants, antithrombotics, and thrombolytics Flashcards

(53 cards)

Start Studying
1
Q

What is the purpose of anticoagulant drugs?

A

Slow clotting time and stop coagualtion cascade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which anticoagulants are used for rapid termination of clot propagation? How are these administered?

A

Heparin, LMWH, and fondaparinux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which anticoagulants would be used for a slow and prolonged effect?

A

Warfarin (Coumadin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What would antiplatelet drugs be used for?

A

Inhibition of platelet activation and aggregation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does aspririn do?

A

Inhibits produciton of thromboxane inhibiting platelet activation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are clopidogrel, ticlodipine, prasugrel?

A

Inhibits the ADP receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is cilostazol?

A

Inhibits platelet aggregation and stimulates vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are abciximan, eptifibatide, and tirofiban?

A

Blockers of the GpIIb-IIIa complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Whare are fibrinolytic drugs? What are two examples?

A

these are given to cause thrombolysis

t-PA and urokinase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where is heparin isolated from?

A

Procine intestinal mucosa or bovine lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the effects of heparin?

A

Heparin serves as a template for the binding of ATIII to thrombin

Also inhibits IXa, Xa, XIa, XIIa, and kalikrein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the effects of heparin on clotting times?

A

Prolongs aPTT and TT

Only high concentrations will prolong PT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How can heparin be administered and why?

A

Heparin is a large molecule which will be digested in the GI tract. It must be administered parenterally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does the onset of action of heparin determine administration?

A

Heparin’s onset is directly related to the rate at which it appears in the blood. When rapid onset is required, an IV bolus with continuous IV perfusion is administered. When slower onset is sufficient, a subcutaneous injection is administered.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the process of a continuous heparin infusion?

A

Continuous infusion is initiated and then the bolus is given. Rate of infusion is adjusted base on aPTT. Although this allows rapid onset, hypervolemia may occur.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why is intermittent intravenous heparin not recommended??

A

Can result in fluctuations of blood concentrations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is normal aPTT time for heparin thearapy?

A

1.5-2.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the two major manifestations of heparin toxicity?

A

Hemorrhage or HIT-1 and HIT-2

HIT-1 is a transient thrombocytopenia which normally resolves

HIT-2 is the formation of autoantibodies to the platelet factor-4 heparin complex. this causes thrombocytopenia, but immune complex damage of the endothelium will cause a prothrombotic state.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are five indications for heparin use?

A

AMI, unstable angina, PE, DVT, or DIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do you treat heparin toxicity?

A

Immediate withdrawal of heparin and IV administration of protamine sulfate

Note: cannot reverse the effects of warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is protamine sulfate?

A

Protamine sulfate is a strongly negative protein which complexes and inactivates the strongly positive heparin protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are potential side effects (3) of protamine sulfate?

Study These Flashcards
A

transient hypotension, thrombotic state, or anaphylaxis

23
Q

What is the prototype of LMWH and its suffic

Study These Flashcards
A

Enoxoparin

suffix = parin

24
Q

What is the effect of LMWH?

Study These Flashcards
A

LMWH has a greater affinity for Xa specifically over all others

25
What are the benefits of LMWH affinity?
It allows less frequent dosing reducing the risk of side effects
26
What are the indications (5) for LMWH?
Used to prevent DVT and thromboembolic events in abdominal surgery, hip replacement, knee replacement, and severe immobility
27
How does LMWH home therapy work?
pre-filled syringes are provided to the patient
28
What is Fondaparinux?
This is a synthetic analog of heparin, which inhibits Xa and not thrombin or platelet activity
29
What is the route of administration and benefits (3) of fondaparinux?
Administered subcutaneously No HIT does not prolong aPTT, PT, or bleeding time Doesn't affect platelet function
30
What are the indications for fondaparinux?
DVT, knee replacement, hip replacement, abdominal surgery, and immobility
31
What is hirudin and lepirudin? What are the uses? How is lepirudin administered?
Hirudin and lipirudin are irreversible thrombin inhibitors Hirudin is produced by medicinal leeches and lipirudin is the recombinant form. used to treat thrombosis in HIT Administered by IV
32
What is argatrobin?
It is a reversible thrombin inhibitor used for HIT patients
33
What is warfarin?
It is an oral anticoagulant which interferes with the vitamin K-dependent coagulation factors. Inhibits II, VII, IX, X, PrS, PrC, and PrZ
34
What is the onset, absorption, bioavailability, duration of action, and termination of warfarin?
Onset is 36 to 72 hours. Completely absorbed through the GI mucosa and 99% bound to albumin. The duration of action is long because the termination half-life is 40 hours.
35
What are the toxic manifestations (4) and contraindication of warfarin?
Toxicity - hemorrhage, anorexia, nausea, vomiting, and diarrhea Contraindication - pregnancy
36
What is warfarin used for?
Prophylaxis in any condition increasing thromboemboli
37
How is warfarin therapy monitored?
Monitored by INR with PT time. Normal INR is 2-3
38
How do you treat warfarin toxicity?
Withdrawal of warfarin, administration of vitamin K, and possibly frozen plasma rich in II, VII, X
39
What is dabigatran etexilate?
This is an orally administered thrombin innhibitor which also reduces the thrombin activation of platelet aggregation. It is rapidly absorbed as a prodrug and converted in the blood by esterases. Note: has a less variably effect compared to warfarin and doesn't require INR monitoring.
40
What is rivaroxaban?
An orally administered factor Xa inhibitor which seems more effective than LMWH
41
How does aspirin act as an antiplatelet agent?
aspirin is an irreversible COX-1 inhibitor which blocks the production of thromboxane-2.
42
What are the indications for aspirin in CVD?
primary prevention of MI and secodary prevention of MI
43
What is clopidogrel?
This is an orally administered drug which irreversibly inhibits the ADP receptor on platelets and subsequently the ADP-dependent activation of the gpIIb-gpIIIa complex. Administered as a prodrug.
44
What are the indications (4) of clopidogrel?
prophylaxis of stroke, MI, PAD, and ACS
45
What is the mechanism of action, indication, and adverse effects (2) of ticlodipine?
Irreversible blocks the binding of ADP and fibrinogen to platelets. Used to prevent stroke and TIA. Can cause TTP and aplastic anemia.
46
What is cilostazol? what is the mechanism of action? What is the indication? what is the contraindication?
Cilostazol is an inhibitor of cAMP PDE-III. Increases the concentration of cAMP in blood vessels causing vasodilation and inhibition of platelet aggregation. Used for intermittent claudication. contraindicated in CHF
47
What is dipyridamole? What are its three indications?
It is a PDE inhibitor which raises cAMP levels. Used for secondary prevention of AMI in prosthetic valve patients. Prevention of stroke in TIA. Maintenance of valve patency in coronary bypass graft.
48
What is abciximab? Its mechanism of action? Indications (2)?
Abciximab is a monoclonal antibody which inhibits gpIIb-IIIa inhibiting platelet aggregation. Used for high risk angioplasty and ACS.
49
What is pentoxyifylline?
This drug increases the flexibility of erythrocytes and decreased blood viscosity. Used for intermittent claudication.
50
Name three thrombolytics?
t-PA (alteplase, reteplase, and tenecteplase), streptokinase, urokinase
51
What are the 4 indications for thrombolytics?
AMI, PE, DVT, and stroke
52
What is significant about the blood interactions of streptokinase?
Many patients have developed antibodies, so a loading dose must be given to saturate these sites.
53
What are the uses of aPTT (4)?
monitor intrinsic pathway, hemophilias A and B (factor VIII and IX deficiency), and unfractionated heparin therapy.

CV 2 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions