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Coagulation Disorders Flashcards

1
Q

In hemostasis, vasoconstriction are due to ____

A
  1. Nervous reflexes
  2. Local myogenic spasm
  3. Local autacoid factors - TXA2 and endothelin
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2
Q

In hemostasis, primary hemostasis is triggered by ___

A

exposure of subendothelial collagen

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3
Q

In hemostasis, what mediates platelet adhesion?

A

vWF by GpIb in the platelet surface

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4
Q

What are the essential factors in the intrinsic pathway?

A

Factors 5, 8, 9, 10, 11,12, prothrombin, fibrinogen

PTT = PiTT

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5
Q

What are the essential factors in the extrinsic pathway?

A

Factos 5, 7, 10, prothrombin, fibrinogen

PeT

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6
Q

Drug that is both an antiplatelt and anti-inflammatory

A

Aspirin

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7
Q

Dose of aspirin for antiplatelet use

A

<160mg

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8
Q

Dose of aspirin for antipyretic, analgesic

A

160 to 1200mg

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9
Q

Dose of aspirin as anti-inflammatory

A

> 1200mg

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10
Q

How many grams of aspirin is enough for antiplatelet activity to prevent TIA and MI

A

80mg

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11
Q

What is the triad of aspirin toxicity?

A

Samter Triad

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12
Q

[Diagnose]

Asthma
Aspirin sensitivity
Nasal polyp

A

Samter Triad; aspirin hypersensitivity

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13
Q

What is the expected acid-base abnormality in salicylate poisoning?

A

respiratory alkalosis with HAGMA

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14
Q

A pure acid-base disorder due to aspirin intoxication is seen in which population?

A

children

Adults present with mixed-base disorder

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15
Q

Drug that inhibits GPIIa/IIIa

A
  1. Abciximab
  2. Eptifibatide
  3. Tirofiban
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16
Q

What is the drug of choice used during PCI to prevent thrombosis since it prevent vessel restenosis, reinfarction, and death

A

Abciximab

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17
Q

Cite examples of antiplatelet drugs that inhibit ADP

A
  1. Clopidogrel
  2. Prasugel
  3. Ticagrelor
  4. Ticlodipine
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18
Q

This drug specifically inhibits ADP subtype P2Y

A

Ticagrelor

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19
Q

Antiplatelet drug and also a PDE III inhibitor causing vasodilation

A
  1. Cilostazol

2. Dipyridamole

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20
Q

Drug used to prevent thromboembolic complications of cardiac valve replacement; prosthetic heart valves

A
  1. Cilostazol

2. Dipyridamole

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21
Q

Drugs used to treat refractory intermittent claudication for patients with PAD

A

cilostazol

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22
Q

Antiplatelet that also inhibit adenosine uptake by endothelial cells and RBC leading to inhibition of platelet aggregation

A
  1. Cilostazol

2. Dipyridamole

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23
Q

Cite examples of indirect thrombin inhibitors

A
  1. Heparin
  2. Enoxaparin
  3. LMWH
  4. Warfarin
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24
Q

Cite examples of direct thrombin inhibitors

A
  1. Argatroban
  2. Bivalirudin
  3. Dabigatran
  4. Desirudin
  5. Lepirudin
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25
[Heparin/Warfarin] Large, acidic polysaccharide Rapid onset
Heparin
26
[Heparin/Warfarin] small, lipid-soluble molecule Slow onset
Warfarin
27
What is the MOA of heparin?
Activates antithrombin III
28
What is the MOA of warfarin?
Inhibit Factors 9 10 7 2
29
Heparin is monitored via?
PTT Remember: HTTP
30
Warfarin is monitored by?
PT
31
What is the antidote of heparin?
Protamine
32
What is the antidote for warfarin
Vitamin K, FFP
33
[Heparin/Warfarin] Can be used during pregnancy
heparin
34
During angioplasty and stent placement, heparin and this drug is given concomittantly
GPIIb/IIIa inhibitors
35
___ is a heparinoid consisting of 80% heparing and 20% dermatan sulfate
Sulodexide
36
___ is an indirect thrombin inhibitor that binds and potentiates effect of antithrombin III on Factor Xa; has less effect on thrombin
Enoxaparin
37
Among the indirect thrombin inhibitor, this drug is given SC once a day
Fondaparinux
38
Cite examples of indirect thrombin inhibitor
1. EnoXAparin 2. Dalteparin 3. Tinzaparin 4. Danaparoid 5. Fondaparinux 6. Nadroparin
39
___ binds to thrombin's active site and inhibits its enzymatic action
Lepirudin
40
Used to treat heparin-induced thrombocytopenia
Lepirudin
41
During percutaneous coronary angioplasty, lepirudin is paired with this drug
aspirin
42
What is the antidote for Dabigatran?
Idarucizumab
43
Examples of oral direct factor Xa inhibitor
1. rivaroxaban | 2. apixaban
44
Drugs used as anticoagulants after hip or knee surgery
Rivaroxaban | Apixaban
45
___ inhibits vitamin K epoxide reductase (for gamma carboxylation of the vitamin K-dependent clotting)
Warfarin Dicumarol Anisindione
46
Complication of warfarin treatment in patients with protein C and S deficiencies
warfarin-induced skin necrosis
47
Antidote of warfarin that is fast acting
FFP
48
what enzyme is needed to convert vitamin K to activated vitamin K?
epoxide reductase
49
Cite examples of Cyt P450 inducers
``` Ethanol Barbiturates Phenytoin Rifampicin Griseofulvin Carbamazepine St. Johns Wort Smoking ```
50
Cite examples of Cyt P450 inhibitors
``` Isoniazid Sulfonamides Cimetidine Ketoconazole Erythromycin Grapefruit juice Ritonavir Amiodarone Quinidine Valproic Acid ```
51
This thrombolytic agent forms a complex with endogenous plasminogen, thus catalyzing the conversion of plasminogen to plasmin
Streptokinase
52
what is the antidote of alteplase?
aminocaproic acid
53
tPA is selective for what ___-
fibrin-bound plasminogen
54
What are the contraindications to thrombolysis?
1. History of CV hemorrhage 2. Non-hemorrhagic stroke or other CV event within the past year 3. >180/110 4. suspicion of aortic dissection 5. active internal bleeding excluding sepsis
55
This antiplasmin drug is contraindicated in DIC
Tranexamic acid
56
Among the type of vitamin K, which should never be used as therapeutics
Vitamin K3 (menadione)
57
__ an ADH agonist that increases factor VIII activity in patients with hemiphilia A
desmopressin
58
Drug of choice for vWF disease
desmopressin
59
A serine protease inhbitor, antiplasmin drig that is used for post-op or intraop bleeding; has increased risk of renal failure
Aprotinin this was removed from the market due to mortality
60
___ is a hormone used to treat intestinal and pancreatic fistula
somatostatin

Pharmacology (35 decks)

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