Antithrombic pharm for ischemic HD Flashcards Preview

Cardiovascular > Antithrombic pharm for ischemic HD > Flashcards

Flashcards in Antithrombic pharm for ischemic HD Deck (37):
1

indications bivalirudin

UA pt ungergoin percutaneous coronary intervention

2

lifespan of platelet

7-10 days

3

indications aspirin

UA acute MI, hx of MI

decreases futur MI and mortality

3

pharmacokinetics clopidogrel, ticlopidine, prasugrel

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

 

clopidrogrel metabolized by CYPC19

3

side effects ticlopidine

life threathening AE - neutropenia, thrombotic thrombocytopenic purpura

4

conversion of extrinsic and intrinsic pathway

Xa

4

warfarin inhibits ___ synthesis

prothrombin, VII IX, X, 

5

general treatment for NSTEMI and UA

antiplatelet/antithrombotic

statin

aspirin

B block

nitrates

6

antithrombotic agens 

unfractionated heparin

low MW heparin

direct thrombin inhibitors

7

general reperfusion therapy+therapy for STEMI

Mechanical or thromboyltic reperfusion

and

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

7

Alteplase mechanism

activates plasminogen into active protease to lyse fibrin clots

8

mechanism of thienpyridines (ticlopidine, prasugrel, ticagrelor)

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

10

mediates fibrinogen to fibrin

thrombin

11

pharmacokinetics Abciximab and Eptifibatide

Abciximab is IV admin and non-competitive

Eptifibatide is IV admin, competiive, renal clearance

12

Glycoprotein IIb/IIIa inhibitors

Abciximab

Epitifabatide

13

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)

dabigitran

rivaroxaban

14

prothrombin factor

(II)

14

aspirin impact on endothelial

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

15

Cox inhibitor

Aspirin

16

digest fibrin, other plasma proteins

Plasmin

17

patients do not benefit from fibrinolytic therapy

UA or STEMI

18

factors inactivated by heparin

XII

XI

IX

X

VII

Thrombin

19

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

STEMI

20

activates plasminogen

t-PA

21

heparin inactivates

only circulating thrombin (not bound)

22

factors dependent of vitK for synth

II IX X VII

24

recombinant tissue type plasminogen activators for fibrinolytic therapy

Alteplase

26

LMWH and fondaparinux advantage over UFH

more predictable bioavail 

longer half life

27

reversible thienopyridine

ticagrelor

28

adverse effects alteplase

bleeding

systemic lytic state 

29

indications abciximab

PCI (angioplasty,stent)

combo with aspirin or heparin/LMWH

with alteplase for thrombolysis

30

ADP receptor inhibtors

Clopidogrel

Prasugrel

Ticagrelor

31

mechanism Abciximab and eptifibatide

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

32

birect thrombin inhibitor

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

33

indications epitifibatide

PCI (angioplasty or stent)

UA and MI, often along with LMWH

35

UFH and LMW heparins pharomacokinetics

parentally admin (not absorbed from GI)

36

mechanism, indication Dipyridamole

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

 

little therapeutic use alone, Pts with aspriin intollerance