Drugs For Coagulation Disorders

Question 1

ADP: Platelet________

Answer 1

Aggregation

Question 2

TXA2: Platelet _______ and ___________

Answer 2

Activation and vasoconstriction

Question 3

Serotonin: Platelet __________ and ___________

Answer 3

Aggregation and vasoconstriction

Question 4

Anticoagulants

Answer 4

Heparin
Warfarin
Direct Thrombin Inhibitors

Question 5

Thrombolytics

Answer 5

T-PA derivatives

Streptokinase

Question 6

Antiplatelet drugs

Answer 6

Aspirin
Glycoprotein IIb/IIIa inhibitors
Clopidogrel
PDE/Adenosine uptake inhibitors

Question 7

Drugs that facilitate clotting

Answer 7

Vit K
Antiplasmin drugs
Replacement factors

Question 8

Nonselective irreversible cox 1 and 2 inhibitor
Inhibits platelet aggregation
Drug for ARTERIAL THROMBI (increased platelets vs. venous thrombi)

Drug?

Answer 8

Aspirin

LAHAT NG MAY -SAL- at -ATE

Question 9

Toxic dose and lethal dose of Aspirin

Answer 9

Toxic 150mg/kg

Lethal 500 mg/kg

Question 10

Drug associated with Reye Syndrome in children

Answer 10

Aspirin

Question 11

Triad of Aspirin Hypersensitivity?

Answer 11

SAMTER TRIAD
Asthma
Aspirin sensitivity
Nasal polyps

Question 12

Expected acid base abnormality in salicylate poisoning

Answer 12

Respiratory alkalosis with HAGMA

Question 13

Presentation of aspirin toxicity in adults vs. children?

Answer 13

Adults: Respiratory Alkalosis + HAGMA
Children: Pure HAGMA

Question 14

Inhibits platelet aggregation by interfering with GpIIB/IIIA binding
Drug used during PCI, adjunct to thrombolysis, ACS
Prevents vessel restenosis, reinfarction and death

Drug, class?

Answer 14

Abciximab, Antiplatelet

Eprifibatide, Tirofiban

Question 15

Drug that irreversibly inhibits binding of ADP to platelet receptors reducing platelet aggregation
For prevention and treatment of ARTERIAL thrombosis
SE: bleeding
Additive effects with ASA

Answer 15

Clopidogrel

Ticlopidine, Prasugrel

Question 16

Inhibits Phosphodiesterase III, inhibits platelet aggregation and causes vasodilation
Drug for intermitent claudication, prevention of thromboembolic complications of cardiac valve replacement, and secondary prevention of ischemic stroke (with aspirin)

Drug, class?

Answer 16

Dipyridamole, Anti-platelet
(Cilostazol)

Dipyridamole has little or no benefit by itself
Cilostazol is contraindicated in HF

Question 17

Anticoagulants: Indirect Thrombin Inhibitors

Answer 17

heparin, enoxaparin (LMWH), lepirudin

Question 18

Anticoagulants: Direct Thrombin Inhibitors

Answer 18

Coumarin derivatives (Warfarin)

Question 19

route of administration:
Heparin:________
Warfarin:________

Answer 19

Heparin: IV
Warfarin: Oral

Question 20

Can this be given in Pregnancy?
Heparin:________
Warfarin:________

Answer 20

Heparin: Yes
Warfarin: No

Question 21

Activates Antithrombin III
Drug for DVT, Pulmo Embo, MI
SE: Drug-induced Thrombocytopenia
Monitor PTT (Normal is 1.5-2.5)

Drug, Class

Answer 21

Heparin, Anticoagulant

Question 22

Antidote for Heparin Toxicity

Answer 22

Protamine Sulfate

Question 23

Potentiates effect of antithrombin III on Factor Xa (more selective), less effect on Thrombin
Drug for DVT, Pulmo Embo, MI
SE: less risk of thrombocytopenia
Does not require PTT monitoring

Drug, Class

Answer 23

Enoxaparin, Anticoagulant
(Fondaparinux, Tinzaparin, Danaparoid, Dalteparin)

Protamine is only partially effective in reversal of effects

Question 24

Binds to Thrombin’s active site and inhibits its enzymatic action
Drug for PErcutaneous Coronary Angiography (with ASA), HEparin-Induced Thrombocytopenia
Monitor with PTT
No reversal agents exist, use with caution in pxs with renal insufficiency

Drug, Class

Answer 24

Lepirudin, Anticoagulant

Desirudin, Bivalirudin, Argatroban

Question 25

Inhibits Vit K epoxide reductase (Factor 2,7,9,10,ProteinC/S)
Drug for chronic anticoagulation, except in pregnancy
SE: bleeding, drug-induced skin necrosis (for pxs with protein c&s deficiencies)
Monitor PT

Drug, Class

Answer 25

Warfarin, Anticoagulant

Dicumarol

Question 26

Antidote for Warfarin toxicity

Answer 26

Vitamin K (slow)
FFP (fast)
Discontinue drug

Question 27

Anticoagulant with narrow therapeutic window

Active ingredient in most rat poisons

Answer 27

Warfarin

Question 28

Why is an overlap of warfarin and heparin necessary?

Answer 28

Warfarin is initially prothrombotic and requires elimination of preformed clotting factors (8-60h)

Question 29

Drug that partially reverses effects of LMWHs

Answer 29

Protamine Sulfate

Chemical antagonist of heparin

Question 30

tPA analog converting plasminogen to plasmin, degrading fibrin and fibrinogen, causing thrombolysis
Drug for acute MI, Ischemic stroke, pulmonary embolism
SE: cerebral hemorrhage

Drug, Class

Answer 30

Alteplase, Thrombolytic
(STREPTOKINASE)

LAHAT NG MAY -PLASE/-KINASE

Question 31

Speed of Onset:
Heparin:________
Warfarin:________

Answer 31

Heparin: rapid (mins)
Warfarin: slow (days)

Question 32

Loss of effectiveness on 2nd use and allergic reactions may be observed with this thrombolytic

Drug?

Answer 32

Streptokinase

Question 33

Completely inhibits plasminogen activation
Drug for prevention of acute bleeding
Contraindicated in DIC and genitourinary bleeding
Antidote for Streptokinase Toxicity

Drug, Class

Answer 33

Aminocaproic Acid, Antiplasmin

Tranexamic Acid

Question 34

Increases supply of reduced vitK
Drug for VitK deficiency, Warfarin antidote, prevents bleeding in newborns
SE: infusion reaction

Drug, Class

Answer 34

Vit K1 Phytonadione
Vit K2 Menaquinone
Vit K3 Menadione (never use in therapeutics, ineffective)

Endogenous vitamin

Question 35

Vasopressin V2 agonist
Drug for Hemophilia A, vWD, Central DI
SE: Headaches, flushing, hyponatremia, seizures
Increases factor VIII activity of pxs with mild Hemophilia A or vWD

Drug?

Answer 35

Desmopressin

Question 36

Potent endothelium derived vasoconstrictor

Answer 36

Endothelin