Antithrombotic Agents Flashcards Preview

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Flashcards in Antithrombotic Agents Deck (38)
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1
Q

Venous thrombi are composed mainly of _____ and _______ with relatively few ______.

A

fibrin; trapped red blood cells; platelets

2
Q

______ are composed mainly of fibrin and trapped red blood cells with relatively few platelets.

A

Venous thrombi

3
Q

Arterial thrombi are composed mainly of _____ held together by small amounts of _____.

A

platelet aggregates; fibrin

4
Q

______ are composed mainly of platelet aggregates held together by small amounts of fibrin.

A

Arterial thrombi

5
Q

How is UA/NSTEMI treated?

A

Aspirin

± clopidogrel or prasugrel or ticagrelor

± UFH or LMWH or fondaparinux

± GPIIb/IIIa inhibitor

6
Q

How is an Acute MI (STEMI) treated?

A

Aspirin

+ clopidogrel or prasugrel or ticagrelor

+ UFH or LMWH or fondaparinux

± GPIIb/IIIa inhibitor

7
Q

What medications are given before PCI?

A

Aspirin

+ clopidogrel or prasugrel or ticagrelor

+ UFH or LMWH or bivalirudin

± GPIIb/IIIa inhibitor

8
Q

How is A-fib treated?

A

Warfarin or dabigatran or rivaroxaban or apixaban

9
Q

What does the CHA2DS2-VASc acronym stand for?

A

Congestive HF-Hypertension-Age ≥ 75-

Diabetes-Stroke-Vascular disease-Age 65-74-Sex (female)

10
Q

How does Warfarin work?

A

Inhibit synthesis of Vit K-dependent clotting factors II, VII, IX, and X

11
Q

How does Heparin work?

A

Combines with antithrombin III (ATIII) to inactivate active clotting factors (IIa, IXa, Xa, XIa, XIIa)

12
Q

How do LMWHs/Fondaparinux work?

A

they combine with antithrombin III (ATIII) to inactivate Xa

13
Q

How do Hirudin, Dabigatran work?

A

they directly inactivate IIa (thrombin)

14
Q

Which drug directly inactivates IIa (thrombin)?

A

Hirudin

Dabigatran

15
Q

How does Rivaroxaban work?

A

Directly inactivates Xa

16
Q

Which drug directly inactivates Xa?

A

Rivaroxaban

17
Q

Which drug combines with antithrombin III (ATIII) to inactivate Xa?

A

LMWHs

Fondaparinux

18
Q

Which drug combines with antithrombin III (ATIII) to inactivate active clotting factors (IIa, IXa, Xa, XIa, XIIa)?

A

heparin

19
Q

Which drug inhibits synthesis of Vit K-dependent clotting factors II, VII, IX, and X?

A

warfarin

20
Q

What test is used to monitor heparin therapy?

A

aPTT

21
Q

What is a normal aPTT value?

A

26-33 sec

22
Q

Prolonged clotting time in the aPTT indicates a defect in?

A

the intrinsic pathway

23
Q

What test is used to monitor warfarin therapy?

A

PT

24
Q

The aPTT test is used to monitor ____ therapy.

A

heparin

25
Q

The PT test is used to monitor ____ therapy.

A

warfarin

26
Q

What is a normal PT time?

A

12-14 sec (but now reported using INR)

27
Q

What does ECT stand for?

A

Ecarin Clotting Time

28
Q

What is Ecarin Clotting Time (ECT) used for?

A

to monitor anticoagulant therapy with direct thrombin (IIa) inhibitors (hirudin and dabigatran)

29
Q

Which test is used to monitor anticoagulant therapy with direct thrombin (IIa) inhibitors (hirudin and dabigatran)?

A

Ecarin Clotting Time (ECT)

30
Q

Name 2 LMWHs.

A

Enoxapirin (Lovenox)

Dalteparin (Fragmin)

31
Q

What are Enoxapirin (Lovenox) and Dalteparin (Fragmin)?

A

LMWHs

32
Q

______ (side effect) is more likely with heparin than LMWH but NOT with fondaparinux.

A

Thrombocytopenia

33
Q

Thrombocytopenia is more likely with heparin than LMWH but NOT with ______.

A

fondaparinux

34
Q

Thrombocytopenia is more likely with _____ than _____ but NOT with fondaparinux.

A

heparin; LMWH

35
Q

What is the heparin antidote?

A

protamine

36
Q

Can heparin be given in pregnancy? Can warfarin?

A

heparin = yes

warfarin = no

37
Q

What kind of drug is Dabigatran (Pradaxa)?

A

a newer oral anticoagulant (NOAC)

non-vitamin K antagonist

*** inhibits factor IIa (thrombin)

38
Q

What kind of drugs are Rivaroxaban (Xarelto), Apixaban (Eliquis), and Edoxaban (Savaysa)?

A

newer oral anticoagulants (NOACs)

non-vitamin K antagonist

*** inhibit factor Xa