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pharm sci exam 2 > Fibro > Flashcards

Fibro Flashcards

0
Q

Plasmin

A

Degrades fibrin clots, fibrinogen, factor 5 and 8

No discrimination btwn norm and pathological

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1
Q

Tissue plasminogen activator

A

Catalyzes conversion of plasminogen to plasminogen

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2
Q

When is tpa most effective?

A

When bound to fibrin mesh

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3
Q

What is tpa inhibited by?

A

Plasminogen activator inhibitor

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4
Q

Thrombin and inflammatory cytokines increase the release of what?

A

Pai

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5
Q

Alpha 2 antiplasmin

A

Inactivates circulating Plasmin

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6
Q

Thrombocytes drugs dissolve what?

A

Already formed clots by activating plasminogen forming Plasmin

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7
Q

Indications for thrombocytopenia agents

A 
Acute mi 
Stroke
Artery occlusion 
Pe 
VTE
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8
Q

MOA of thrombocytopenia agents c

A

Activating plasminogen and form Plasmin
Nonspecific
Bleeding cause circulating plasminogen
Degrade factor 5 and 8

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9
Q

How to reverse thrombocytopenia agents

A

Blood replacement

Aminocaproic acid

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10
Q

Streptokinase

A

Beta hemolytic streptococci
Allergic rxns
Bleeding activation of free Plasmin
Antithrombolytic agent

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11
Q

Alteplase

A

Anti. Thrombocytopenia agent

Recombinant human tpa

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12
Q

Reteplase

A

Antithrombolytoc agent

Derivative of rTPA

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13
Q

Tenecteplase

A

Antithrombolytoc agent
Derivative of rTPA
Resistant to PAI

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14
Q

ADR of thrombocytopenia agents

A

Bleeding
Re thrombosis can occur
Anticoags are co admin continued after thrombolytic therapy
If have trauma don’t use

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15
Q

Tenecteplase causes what?

A

Degradation of blood clots by activating plasminogen

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16
Q

Anti platelet drug is a member of class of agents that do what?

A

Block platelet activation and aggregation

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17
Q

Overdose of heparin is treated how?

A

Protamine sulfate

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18
Q

MOA of Protamine sulfate

A

Binds to heparin forming an inactive complex that’s reversible

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19
Q

Ibuprofen and low dose aspirin?

A

Ibuprofen reduces anti platelet effect of aspirin

Aspirin taken 2 h before ibuprofen

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20
Q

Syndrome where pts develop antibodies to hapten when heparin molecules bind platelets causing depletion is?

A

Hit

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21
Q

Which agent is used for continued coagulation therapy in pt with hit?

A

Argatroban

Lepirudin

22
Q

What is required for synthesis of key coag factors?

A

Vit k

23
Q

Which factors are dependent on vit k?

A

Prothrombin
Factor VII
Factor IX
Factor X

Protein C and S

24
Q

What is key to calcium binding and increase the activity of factors?

A

2nd cooh on carboxy glutamate acid

25
Q

Vitamin k reductase

A

Converts oxidized vit k to reduced vit k
Needed to do carboxylate on of coag factors
Blocked by warfarin

26
Q

Vit k quinone reductase

A

Converts intermediate to reduced form of vit k

Not affected by warfarin

27
Q

MOA warfarin

A

Racemic
Blocks VKORC1
Prevents regeneration of vit k

28
Q

Half life prothrombin

A

60 h

29
Q

Half life factor 7

A

4-6 h

30
Q

Factor 9 half life

A

24h

31
Q

Factor x half life

A

48-72

32
Q

Protein c half life

A

8 hours

33
Q

Protein s half life

A

30 h

34
Q

What do you have to wait till they decay to see onset of warfarin?

A

Half life of protein c and s

35
Q

Onset of action of warfarin

A

8-12 h

36
Q

Peak action of warfarin

A

4-5h

37
Q

Which form of warfarin is more active?

A

S

38
Q

Cyp mediated metabolism of s warfarin

A

2c9

Interacts with fenofibrate

39
Q

Cyp metabolism for r warfarin

A

1a1, 1a2, 3a4

40
Q

ADR of Warfarin

A

Bleeding
Crosses placenta
Skin necrosis

41
Q

Drug interactions with warfarin

A

Abs decreased by cholestyramine
Increase free drug, increase effect ex aspirin, sulfonamides
Inhib 1a2, 2c9, 3a4 increase effect
Inducers of 1a2, 2c9, 3a4 decrease effect
Platelet/clotting drugs increase risk bleeding
Antibiotics

42
Q

Disease state interactions with warfarin

A

Hypo/hyperthyroid
Diarrhea
Liver dysfunction

43
Q

Food interactions with warfarin

A

Vit k rich foods decrease effect

44
Q

What is expected to have the greatest effect on warfarin plasma levels?

A

2c9

45
Q

MOA of warfarin

A

Reduced syn of functional clotting factors

46
Q

You adjust warfarin based on what?

A

Inr

47
Q

Warfarin monitoring

A

Pt

Inr

48
Q

Pt

A

Activity of clotting factors

Norm is 11 to 13.5 sec

49
Q

Inr

A

Pt vs control

Accounts for variability in thromboplastin sensitivity

50
Q

Target inr for warfarin

A

2-3

51
Q

High inr

A

Risk of bleeding

52
Q

Low inr

A

Risk of clotting

pharm sci exam 2 (7 decks)

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