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Cardiovascular > Antithrombic pharm for ischemic HD > Flashcards

Antithrombic pharm for ischemic HD Flashcards

1
Q

indications bivalirudin

A

UA pt ungergoin percutaneous coronary intervention

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2
Q

lifespan of platelet

A

7-10 days

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3
Q

indications aspirin

A

UA acute MI, hx of MI

decreases futur MI and mortality

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3
Q

pharmacokinetics clopidogrel, ticlopidine, prasugrel

A

clopidrogrel, ticlopidine and prasugrel metabolized to active metabolite (prasugrel more readily metab, stronger)

clopidrogrel metabolized by CYPC19

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3
Q

side effects ticlopidine

A

life threathening AE - neutropenia, thrombotic thrombocytopenic purpura

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4
Q

conversion of extrinsic and intrinsic pathway

A

Xa

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4
Q

warfarin inhibits ___ synthesis

A

prothrombin, VII IX, X,

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5
Q

general treatment for NSTEMI and UA

A

antiplatelet/antithrombotic

statin

aspirin

B block

nitrates

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6
Q

antithrombotic agens

A

unfractionated heparin

low MW heparin

direct thrombin inhibitors

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7
Q

general reperfusion therapy+therapy for STEMI

A

Mechanical or thromboyltic reperfusion

and

antiplatelet/antithrombotic, statin, aspin, beta blockers, nitrates

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7
Q

Alteplase mechanism

A

activates plasminogen into active protease to lyse fibrin clots

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8
Q

mechanism of thienpyridines (ticlopidine, prasugrel, ticagrelor)

A

inhibit ADP meidated activaion of platelets (at PY12 receptor to block decrease in cAMP and subsequnet increase in calcium)

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10
Q

mediates fibrinogen to fibrin

A

thrombin

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11
Q

pharmacokinetics Abciximab and Eptifibatide

A

Abciximab is IV admin and non-competitive

Eptifibatide is IV admin, competiive, renal clearance

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12
Q

Glycoprotein IIb/IIIa inhibitors

A

Abciximab

Epitifabatide

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13
Q

new oral anticoagulants,

reduce risk of stroke and Syst. embolism in pt with nonvalvular Afib,

reduce risk of recurrent ischemia after ACS event (thrombin remains elevated following ACS event)

A

dabigitran

rivaroxaban

14
Q

prothrombin factor

A

(II)

14
Q

aspirin impact on endothelial

A

inhibits COX1, but endothelial have nucleus and can regenerate and can produce prostacyclin to work against platelet aggregation (against thromboxane and clotting)

15
Q

Cox inhibitor

A

Aspirin

16
Q

digest fibrin, other plasma proteins

A

Plasmin

17
Q

patients do not benefit from fibrinolytic therapy

A

UA or STEMI

18
Q

factors inactivated by heparin

A

XII

XI

IX

X

VII

Thrombin

19
Q

exception to antirombotic/antiplatelet treatment rule: ___ may also be treated with thrombolytic

A

STEMI

20
Q

activates plasminogen

A

t-PA

21
Q

heparin inactivates

A

only circulating thrombin (not bound)

22
Q

factors dependent of vitK for synth

A

II IX X VII

24
Q

recombinant tissue type plasminogen activators for fibrinolytic therapy

A

Alteplase

26
Q

LMWH and fondaparinux advantage over UFH

A

more predictable bioavail

longer half life

27
Q

reversible thienopyridine

A

ticagrelor

28
Q

adverse effects alteplase

A

bleeding

systemic lytic state

29
Q

indications abciximab

A

PCI (angioplasty,stent)

combo with aspirin or heparin/LMWH

with alteplase for thrombolysis

30
Q

ADP receptor inhibtors

A

Clopidogrel

Prasugrel

Ticagrelor

31
Q

mechanism Abciximab and eptifibatide

A

inhibit common pathway of platelet aggregation (binding GPIIb/IIIa receptors to fibrinogen and vWF)

32
Q

birect thrombin inhibitor

A

bivalirudin (independent of anatithrombin) (clotted and free thrombin)

33
Q

indications epitifibatide

A

PCI (angioplasty or stent)

UA and MI, often along with LMWH

35
Q

UFH and LMW heparins pharomacokinetics

A

parentally admin (not absorbed from GI)

36
Q

mechanism, indication Dipyridamole

A

inclrease platelet cAMP blocking phosphodiesterase and blocking cell uptake+destruction of adenosine

little therapeutic use alone, Pts with aspriin intollerance

Cardiovascular (39 decks)

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