CV Drugs 4

Question 1

what are the vitamin k-dependent factors?

Answer 1

coagulation factors II, VII, X, IX

Question 2

crap! bear just ate rodenticide! what do i do?!

Answer 2

give phytonadione (vitamin K1) = antidote

Question 3

what is the drug of choice for treatment of bleeding disorders associated w/ vitamin K1 deficiency?

Answer 3

phytonadione (vitamin K1)

Question 4

what can happen if you give phytonadione (vitamin K1) IV?

Answer 4

risk of anaphylaxis!

Question 5

what is the drug of choice for treatment of hemorrhage secondary to heparin over dosage?

Answer 5

protamine sulfate

Question 6

what are the possible consequences of giving an IV injection of protamine sulfate rapidly?

Answer 6

• hypotension
• bradycardia
• pulmonary hypertension
• dyspnea
• possible hypersensitivity rxn

Question 7

what is the MOA of protamine sulfate?

Answer 7

strong basic compound complexes w/ heparin to form inactive stable salt (neutralizes it!)

Question 8

what is aminocaproic acid used to treat for?

Answer 8

conditions associated w/ increased bleeding due to hyperfibrinolysis (inhibits fibrinolysis)

Question 9

what drug is used prophylactically to prevent post-operative bleeding in greyhounds?

Answer 9

aminocaproic acid

Question 10

of the hemostatic agents which drug is an antifibrinolytic?

Answer 10

aminocaproic acid

Question 11

of the hemostatic agents which drug is a hormonal agent?

Answer 11

desmopressin acetate

Question 12

ugh bears at it again. he got into the aspirin and has aspirin toxicity! what hemostatic agent can i use to treat?

Answer 12

desmopressin acetate

Question 13

what is the MOA of desmopressin acetate?

Answer 13

dose-dependent increase in plasma factor VIII and plasminogen factor

Question 14

what is the drug of choice for treatment of bleeding due to vonWillebrand’s disease in dobermans?

Answer 14

desmopressin acetate

Question 15

what is the drug of choice for treatment of central diabetes insipidus?

Answer 15

desmopressin acetate

Question 16

what is the MOA of unfractioned heparin?

Answer 16

binds to antithrombin III > prevents the conversion of prothrombin to thrombin

Question 17

T/F: low-molecular weight heparins have more of an impact on thrombin and clotting times than unfractionated heparin

Answer 17

FALSE, opposite

Question 18

name two low-molecular weight heparins

Answer 18

dalteparin and enoxaparin

Question 19

what anticoagulant must you monitor with aPTT coag times?

Answer 19

unfractionated heparin

Question 20

what is the big difference between unfractionated heparin compared to low-molecular weight heparins?

Answer 20

low-molecular weight heparins preferentially inhibit factor Xa and have less impact on thrombin and clotting times

Question 21

what drugs can you use to treat deep vein thrombosis, thromboembolic diseases and pulmonary embolisms?

Answer 21

low-molecular weight heparins; dalteparin and enoxaparin

Question 22

T/F: dalteparin and enoxaparin must be given IV slowly

Answer 22

FALSE, must be given SQ > may require frequent dosing in dogs/cats

Question 23

what drug is an indirect anticoagulant?

Answer 23

warfarin sodium -1st generation

Question 24

what is the MOA of warfarin sodium -1st generation?

Answer 24

inhibits the enzyme VITAMIN K EPOXIDE REDUCTASE > interferes w/ ability to synthesize coagulation factors

Question 25

which antithrombotic is contraindicated with GI ulceration and active GI bleeding?

Answer 25

aspirin! NSAID and clopidogrel bisulfate (platelet aggregation inhibitor)

Question 26

what is the MOA of aspirin?

Answer 26

reduces platelet aggregation through inhibiting synthesis of thromboxane A2

Question 27

what drug is used for prophylaxis or treatment of thrombotic disease?

Answer 27

aspirin and clopidogrel bisulfate (antithrombotics)

Question 28

T/F: aspirin has a VERY short half-life in cats

Answer 28

FALSE, very LONG

Question 29

what drug is used for feline aortic thromboembolism (FAT CAT trial)

Answer 29

clopidogrel bisulfate

Question 30

name three thrombolytics

Answer 30

streptokinase, urokinase, and t-PA

Question 31

what is the MOA of thrombolytics?

Answer 31

activate plasminogen to breakdown existing clots > thrombolysis

Question 32

what does streptokinase, urokinase, and t-PA treat?

Answer 32

existing thrombus or thromboembolism

Question 33

whats the major difference between streptokinase, urokinase, and t-PA?

Answer 33

t-PA is fibrin clot specific, must be there

Question 34

what do we worry about when it comes to using antithrombolytics?

Answer 34

life-threatening hemorrhage possible!

Question 35

which of the following drugs act by inhibiting fibrinolysis? a. vitamin K1 b. protamine sulfate c. aminocaproic acid d. clopidogrel

Answer 35

c. aminocaproic acid

Question 36

which of the following is the specific antidote for anticoagulant rodenticide toxicity? a. vitamin K1 b. protamine sulfate c. aminocaproic acid d. clopidogrel

Answer 36

a. vitamin K1

Question 37

what is the MOA of clopidogrel? a. anti-platelet aggregation through thromboxane A2 inhibition b. anti-platelet aggregation through ADP inhibition c. anticoagulation through factor Xa inhibition d. antifibrinolysis

Answer 37

b. anti-platelet aggregation through ADP inhibition

Question 38

which of the following is best described as a fibrin clot-specific thrombolytic? a. streptokinase b. urokinase c. dalteparin d. t-PA

Answer 38

d. t-PA