Haematology Flashcards Preview

2a Pharmacology > Haematology > Flashcards

Flashcards in Haematology Deck (34):
1

PO Aspirin
MofA

Irreversibly inhibits COX --> so decreased thromboxane --> so decreased platelet aggregation

2

PO Aspirin
Uses

- Long term prevention of cardiovascular, cerebrovascular and peripheral vascular disease
- 2nd line for emboli/ thrombus in AF (when warfarin=CI)
- ACS treatment --> rapid inhibition of aggregation can prevent or limit arterial thrombosis

- Stroke treatment

3

PO Aspirin
Side effects

- GI irritation (NSAID) or haemorrhage if severe
- Tinnitus
- Overdose

4

PO Aspirin
Contraindications

- Children under 16yrs --> Reye's syndrome
- 3rd trimester of pregnancy --> early ductus arteriosus closure
- Peptic ulceration
- Gout

5

PO Aspirin
Interactions

- Acts synergistically with other anti platelet agents (working together to produce enhanced result)
- Caution if used with anti-coagulants, e.g. if blood thinning disorder
- Lasts for lifetime of platelet (7-10 days) so discontinue 10 days before surgery

6

PO Clopidogrel
MofA

- Binds to ADP receptors (P2Y12) on platelets surface, so inhibits aggregation

7

PO Clopidogrel
Uses

- Long term prevention of cardiovascular, cerebrovascular and peripheral vascular disease
- 2nd line for emboli/ thrombus in AF (when warfarin=CI)
- ACS treatment --> rapid inhibition of aggregation can prevent or limit arterial thrombosis

- Prevents occlusion of coronary artery stents

8

PO Clopidogrel
Side effects

- Bleeding
- Thrombocytopenia
- GI upset

9

PO Clopidogrel
Contraindications

- Significant active bleeding
- Stop 7 days before elective surgery

10

PO Clopidogrel
Interactions

- Effects reduced by cytochrome p450 inhibitors (omeprazole, ciprofloxacin, erthryomycin, SSRI's) since it is a prodrug.

11

PO Dipyridamole
MofA

- Increases cAMP to inhibit platelet aggregation
- Prolongs the effect of adenosine on blood vessels --> vasodilaton

12

PO Dipyridamole
Uses

- 1st line therapy following TIA
- 2nd line therapy for ischaemic stroke - when clopidogrel is CI

13

PO Dipyridamole
Side effects

- Headache
- Flushing
- Dizziness
- GI upset
(All above from vasodilation)
- Bleeding

14

PO Dipyridamole
Contraindications

- Causes vasodilation and tachycardia, so use with caution in HF, IHD, aortic stenosis

15

PO Dipyridamole
Interactions

- Inhibits cellular uptake of adenosine so prolongs the effect on heart - reduce dose!

16

SC Heparin
Types

- Unfractioned
- Low molecular weight, e.g. Dalteparin
- Fondaparinux

17

SC Heparin
Uses

- Venous thromboembolism prophylaxis
- DVT and PE treatment
- ACS treatment

18

SC Heparin
Side effects

- Bleeding

19

SC Heparin
Contraindications

- Clotting disorders
- Uncontrolled hypertension
- Recent surgery
- Renal impairment - LMWH or fondaparinux may accumulate so use lower dose or unfractioned

20

SC Heparin
Interactions

- Combining anti-thrombotic drugs increases the risk of bleeding
- Special reasons for combined therapy - use of LMWH when initiating warfarin or in ACS
- Reversal = Protamine

21

Unfractioned Heparin
MofA

Activates antithrombin, which inactivates factor Xa and thrombin

22

LMW Heparin
MofA

Preferentially factor Xa inhibition

23

Fondaparinux
MofA

Factor Xa only

24

PO Warfarin
MofA

Inhibits production of Vitamin K-dependent coagulation factors (inhibits Vit-K epoxide reductase)

25

PO Warfarin
Uses

- Prevents clot extension and reocurrence in DVT and PE
- Prevents embolic complications in AF/ heart valve
replacement

26

PO Warfarin
Side effects

- Bleeding
- Epistaxis or retroperitoneal haemorrhage if XL

27

PO Warfarin
Contraindications

- Trauma/surgery
- Liver disease --> less metabolism
- 1st trimester of pregnancy --> abnormalities, and maternal haem towards term

28

PO Warfarin
Interactions

- Cytochrome p450 inhibitors decreases metabolism so increase bleeding risk
- Vice versa for p450 inducers --> clots!
- Reversal = Vitamin K

29

Examples of anti-platelets (3)

- Aspirin (NSAIDs)
- Clopidogrel
- Dipyridamole

30

Examples of anti-coagulants (2)

- Heparin
- Warfarin

31

What does DOAC stand for?

Direct Acting Anti-Coagulant

32

Examples of DOACS?

- Rivaroxiban
- Apixaban

33

DOAC
MofA

Inhibit factor Xa in the clotting cascade

34

DOAC
Benefit

Do not need to monitor (INR) when on this