Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm > Hematological Agents > Flashcards

Hematological Agents Flashcards

1
Q

What does serotonin do in the blood vessels?

A

vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the stimulus to secrete endothelin-1?

A

thrombin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Upon activation, the platelets secrete what three coagulation mediators?

A

ADP

Serotonin

TXA2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the two receptors for ADP on platelets?

A

P2Y1 and P2Y12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

P2Y12 activation increases the concentration of what intracellular ion? Decreases the concentraion of what intracellular signaling molecule?

A

calcium

cAMP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the function of factor XIII?

A

stabilize fibrin clots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What two molecules does thrombomodulin bind?

A

thrombin and Protein C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What protein binds to and activates Activated Protein C?

A

Protein S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The association of which two coagulation factors are inhibited by TFPI?

A

three and seven

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What clotting factors are inhibited by Antithrombin III? Which two coagulation factors promarily?

A

two, seven, nine, ten, eleven, twelve

two and ten

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What molecule inhibits tPA?

A

Plasminogen Activator Inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does α2 anti-plasmin inhibit?

A

plasmin not yet bound to fibrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the broad definition of acute coronary syndrome?

A

any disease process that limits blood flow through the coronary arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does Dipyridamole do to cAMP levels? What does increased cAMP do to calcium levels?

A

increase

decrease Ca2+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Would dipyradimole be a vasoconstrictor or vasodilator?

A

vasodilator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What receptor do Clopidogrel antagonize?

A

P2Y12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What specific CYP enzyme activates Dipyradimole?

A

CYP 2C19

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the MOA of Prasugrel?

A

irreversibly inhibits P2Y12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Is the activity of Prasugrel affected by CYP2C19 polymorphisms?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the MOA of Ticagrelor?

A

reversibly inhibits P2Y12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which P2Y12 inhibitor is not a prodrug?

A

Ticagrelor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the MOA of Cangrelor?

A

reversible inhibitor of P2Y12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the MOA of Abciximab?

A

GPIIb/IIIa inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the MOA of Eptifibatide?

A

peptide that prevents fibrinogen from binding GPIIb/IIIa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the MOA of Tirofiban?

A

non-peptide inhibitor of GPIIb/IIIa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the inhibitor of the Protease Activated Receptor (PAR)?

A

Vorapaxar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What type of severe hemorrhage can too much anti-coagulation medication produce?

A

Cerebral hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

In what cell type of heparin normally found?

A

mast cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the inhibitor of heparin?

A

Protamine sulfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the name for LMW Heparin?

A

Enoxaparin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What clotting factor does LMWH heparin inhibit the most?

A

factor X

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which has better bioavailability after a subQ injection, LMWH or Heparin?

A

LMWH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Which has better half-life after a subQ injection, LMWH or Heparin?

A

LMWH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What binds to plasma proteins and endothelial cells less, LMWH or Heparin? What does this mean?

A

LWMH

more predictable response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is notable about the clearance of LMWH?

A

clearance = dose dependent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Would a patient with low renal function be put on LWMH or heparin? Why?

A

unfractioned

LWMH heparin is cleared almost exclusively by the kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the effect of protamine sulfate on LMWH?

A

partial reversal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What drug does Fondaparinux funtion similarly to?

A

LMWH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What clotting factor does fondaparinux primarily inhibit?

A

Factor ten

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are the effects of protamine sulfate on Fondaparinux?

A

no effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is the MOA of hirudin?

A

direct thrombin inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the MOA of lepirudin?

A

direct thrombin inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the MOA of bivalirudin?

A
  1. inhibits thrombin

2. blocks thrombin binding site of fibrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the MOA of argatroban?

A

direct thrombin inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the MOA of dabigatran?

A

direct thrombin inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

How long does it take for the full anti-coagulant effects of warfarin to be reached?

A

3-5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Which cytochrome metabolizes warfarin?

A

CYP 2C9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is another family of drugs that are metabolized by CYP2C9? What does this do to warfarin clearance?

A

statins

decrease

49
Q

What OTC drug can increase warfarin clearance? How?

A

aspirin

competing for plasma proteins

50
Q

What protein is though to be responsible for Warfarin Induced Necrosis?

A

protein C

51
Q

What is the MOA of rivaroxaban?

A

direct factor Xa inhibitor

52
Q

What is the MOA of apixoban?

A

direct Xa inhibitor

53
Q

What are two fibrinolytic antagonsists?

A

aminocaproic acid

Tranexamic acid

54
Q

Which CYP enzyme activates Clopidogrel?

A

CYP2C9

55
Q

What are the four P2Y12 receptor antagonists?

A

clopidogrel

Prasugrel

Ticagrelor

Cangrelor

56
Q

Which drug is more efficiently metabolized, clopidogrel or prasugrel?

A

Prasugrel

57
Q

Is Ticagrelor reversible or irreversible?

A

reversible

58
Q

What is the most notable side effect of vorapaxar?

A

life-threatening intracranial bleeding

59
Q

What are the two mechanisms of heparin clearance?

A
  1. liver/kidneys

2. absorbed by endothelial cells

60
Q

What is a side-effect of long-term heparin use?

A

osteoporosis

61
Q

Why cant LMWH inhibit thrombin?

A

molecule is not long enough to bring thrombin to ATIII

62
Q

What two partners does LMWH bind to less than unfractionated heparin? What does this mean?

A

plasma proteins/endothelial cells

more predictable dose

63
Q

What type of drug is fondaparinux?

A

synthetic factor ten inhibitor

64
Q

What drug is lepirudin designed to replace? When?

A

Heparin

HIT

65
Q

What are the five DTIs?

A

Hirudin

Lepirudin

Bivalirudin

Argatroban

Dabigatran

66
Q

What two drugs is a bivalent inhibitor of thrombin? How did it get this name?

A

Lepirudin and Bivalirudin

binds active site of thrombin and fibrin binding site of thrombin

67
Q

What is the advantage of DTIs over heparin?

A

DTIs can inhibit thrombin and thrombin bound to fibrin. h

heparins only inhibit free thrombin

68
Q

Where does argatroban and dabigotran bind?

A

fibrin binding site of thrombin

69
Q

What is the only DTI that can be administered orally?

A

Dabigotran

70
Q

How long does it take for the anticoagulant effects of warfarin to take place?

A

3-5 days

71
Q

Does warfarin have a high or low plasma protein binding ability?

A

high

72
Q

What CYP enzyme metabolizes warfarin? Inactivate or activate warfarin?

A

CYP2C9

activate

73
Q

What three drugs induce CYP2C9? What would this do to warfarin clearance?

A

rifampicin, carbamazepine, barbiturates

increase warfarin clearance

74
Q

What does liver disease do to liver clearance?

A

decrease warfarin clearance

75
Q

What does renal insufficiency do to warfarins effects? Why?

A

increased warfarin activity

loss of albumin means more warfarin is released per dose

76
Q

What anticoagulant is a teratogen?

A

warfarin

77
Q

What are the two direct factor Ten inhibitors?

A

Apixiban

Rivaroxaban

78
Q

Apixiban/Rivaroxaban have a decreased risk of what compared to warfarin?

A

decreased intracranial bleeding risk

79
Q

Where is urokinase made?

A

kidney

80
Q

What does the active site of thrombin do?

A

cleaves fibrinogen into fibrin

81
Q

What does the E1 site of thrombin do?

A

binds fibrinogen

82
Q

Does heparin/antithrombin complex inhibit fibrin bound to thrombin?

A

no

83
Q

Do elevated levels of cAMP inhibit or increase levels of intracellular Ca2+ in platelets?

A

inhibit

84
Q

What drug is Dipyramidole often used in combination with?

A

Warfarin

85
Q

Would dipyramidole by itself be a vasodilator or vasoconstrictor?

A

vasodilator

86
Q

The activation of P2Y12 by ADP will result in the increase or decrease of cAMP levels?

A

decrease

87
Q

Which P2Y12 antagonists are prodrugs?

A

Clopidogrel and Prasugrel

88
Q

Which two P2Y12 antagonists are irreversible?

A

Clopidogrel and prasugrel

89
Q

Which two P2Y12 antagonists are reversible?

A

Ticagrelor and Cangrelor

90
Q

What enzyme activates clopidogrel?

A

CYP2C19

91
Q

What drug should not be given in combination with clopidogrel? Why?

A

Omeprazole

Omeprazole inhibits CYP2C19 and would lead to inhibition of clopidogrel activation

92
Q

When compared to clopidogrel, what do prasugrel and ticagrelor carry a higher risk of?

A

intracranial bleeding

93
Q

Which drug is more affected by polymorphisms in CYP2C19, clopidogrel or prasugrel?

A

clopidogrel

94
Q

What are the two side effects of all GpIIb/IIIa antagonists?

A

bleeding and thrombocytopenia

95
Q

Of the three GpIIb/IIIa antagonists, which has the highest risk of thrombocytopenia?

A

Abciximab

96
Q

Is HIT more common in unfractionated or fractionated heparin?

A

unfractionated

97
Q

Is HIT more common in men or women?

A

women

98
Q

Does HIT more often produce venous or arterial thrombosis?

A

venous

99
Q

Which is used to monitor LMWH and fondaparinox use, PTT or Xa?

A

Xa

100
Q

What are the two DTIs that bind both the active site and fibrin binding site of thrombin?

A

Lepirudin and bivalirudin

101
Q

Which two DTIs only bind to the thrombin active site?

A

Argatroban and Dabigatran

102
Q

What is the advantage of DTIs vs. heparin/antithrombin?

A

DTIs can bind to thrombin bound to fibrin

ATIII/heparin only bind soluble heparin

103
Q

Would broad spectrum antibiotics increase or decrease INR? Why?

A

increase

destroy gut flora that synthesize vitamin K

104
Q

Would NSAIDs increase or decrease INR? Why?

A

increase

interfere with primary hemostasis

105
Q

Would SSRIs increase or decrease INR?

A

increase

106
Q

Would statins increase or decrease INR?

A

increase

107
Q

Would Rifampin increase or decrease INR? Why?

A

decrease

increase hepatic metabolism of warfarin

108
Q

Would barbiturates increase or decrease INR? Why?

A

DEcrease

increase hepatic metabolism

109
Q

Would diseases of the GI tract increase or decrease INR? Why?

A

INrease

can interfere with vitamin K absorption

110
Q

Would renal disease increase or decrease INR?

A

increase

111
Q

When is dabigatran contraindicated?

A

mechanical heart valves

112
Q

What is the route of administration for apixaban and rivaroxaban?

A

oral

113
Q

Are fibrinolytics used for non-STEMI? Why?

A

no

increased risk of intracranial bleeding

114
Q

What is the MOA of aminocaproic acid and tranexamic acid?

A

prevent plasmin binding to fibrin

115
Q

Does antithrombin have a higher affinity for thrombin or factor X?

A

ten

116
Q

What two mechanisms ca be employed to reverse the effects of DTIs?

A

factor seven

prothrombinase complex

117
Q

Alteplase must be used within how many hours of an MI?

A

12 hours

118
Q

Can DTIs induce HIT?

A

no

Pharm (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions