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Pharmacology > Antithrombotics extras (do last) > Flashcards

Antithrombotics extras (do last) Flashcards

1
Q

What is the BBW for antithrombotics?

A

spinal anesthesia/puncture –> hematoma –> paralysis

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2
Q

The treatment for HIT is__________.

A

Fondaparinux or argatabon.

Do NOT give warfarin.

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3
Q

Pentasaccharide increases _________ affinity for _________ (direct pathway).

A

Antithrombin

Factor Xa

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4
Q

Activation of ____________ will form a fibrinogen bridge for platelet aggregation.

A

GP IIb/IIIa

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5
Q

What inhibits Factor IIa (thrombin)?

A

Dabigatran
Fondaparinus
Warfarin

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6
Q

What are indications for use of thrombolytics?

A

ischemic stroke <4 h

MI untreatable by PCI <14 h

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7
Q

Idarucizumab (Praxbind) is the antidote for ___________.

A

Dabigatran

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8
Q

Why is it important to start heparin along with warfarin?

A

Warfarin has a slow onset of action because existing functional clotting factors have to turn over. If you do not give heparin, there may be an initial procoagulant effect due to inhibition of Protein S and C.

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9
Q

Alteplase mechanism of action

A

binds fibrin to activate plasminogen on a fresh clot

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10
Q

What drugs REVERSIBLY blocks GP IIb/IIIa from binding to fibrinogen and vWF

A

Abciximab
Tirofiban
Eptifibatide

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11
Q

What are the DIRECT Factor Xa inhibitors?

A

Ribaroxaban

Apixaban

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12
Q

What inhibits Factor Xa?

A

Warfarin
Rivaroxaban
Enoxaparen

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13
Q

Streptokinase mechanism of action

A

activates circulating plasminogen

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14
Q

The benefit of using Ribiroxaban or Dabigatran

A

there is a predictable response, do not need routine monitoring (in comparison to warfarin!)

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15
Q

What are the DIRECT factor IIa (thrombin) inhibitors?

A

Dabigatran

Others used only in invasive cardiology

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16
Q

Drugs that inhibit Pgp/CYP34A will ________ efficacy of Rivaroxaban.

A

increase efficacy

17
Q

Long polysaccharide chains bridge ___________ and __________.

A

Antithrombin

Factor IIa

18
Q

What inhibits factor VIIa?

A

Warfarin

19
Q

Why does heparin require IV or SQ administration?

A

it is very acidic so always negatively charged, highly sulfated, does not cross GI/placenta/brain barrier

20
Q

Do not give Aspirin to people < age ______ because it may cause _____ syndrome in the setting of a viral infection/vaccine.

A

19

Reye

21
Q

The goal/target of anticoagulation is to diminish activity of Factors _______ and/or _______.

A

Xa

IIa

22
Q

Inhibition of COX-2 results in____

A

Decrease in pro inflammatory prostaglandins and an increase in anti-inflammatory lipoxins

23
Q

Clopidogrel and Prasugrel irreversibly block ____________.

A

P2Y12, the ADP purine receptor on platelet

24
Q

What is the antidote for heparin?

A

Protamine Sulfate

inactivates heparin by ionic binding to polysaccharide chains

25
Q

Aspirin is metabolized in the liver to _________.

A

salicylic acid

26
Q

Half life is inversely proportional to _________ of the heparins.

A

chain length

27
Q

HIT develops when _______ binds to heparin and the body forms antibodies to the complex.

A

PF4, released from platelet granules

28
Q

LMW Heparin (Enoxaparin) and Fondaprinux are eliminated by the ________.

A

kidney

29
Q

What irreversibly blocks COX-1?

A

Aspirin

30
Q

Warfarin is metabolized by __________ in the liver. People who are poor metabolizers are at increased risk of ____________.

A

CYP2C9

MI, stroke

31
Q

What does gamma carboxyglutamate (Gla) do?

A

Chelates calcium to enable factors VII, IX, and Xa as well as Protein C and Protein S to the platelet membrane

32
Q

What does antithrombin do?

A

neutralizes coagulation proteases

33
Q

Drugs that induce Pg will __________ efficacy of Dabigtran.

A

Decrease

34
Q

Inhibition of COX-1 decreases platelet recruitment/activation by what mechanism?

A

Decreases arachidonic acid conversion to thromboxane (TXA2), which is needed for fibrinogen bridging

35
Q

________(antithrombin catalyst) can be used in pregnant women as long as there are no preservatives in it.

A

Heparin

36
Q

Contraindications for Aspirin

A

NSAID hypersensitivity

asthma/rhinitis/nasal polyps

37
Q

Aspirin is excreted by the _______.

A

Kidney

38
Q

Overdose of Aspirin results in ______

A

uncoupling of oxidative phosphorylation

metabolic acidosis, seizures, coma

Pharmacology (6 decks)

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