Hematological agents I Flashcards Preview

Year 2 Pharmacology > Hematological agents I > Flashcards

Flashcards in Hematological agents I Deck (20):
1

what allows fibrin to remain at the site of injury?

when bound to thrombin it cannot be inhibited by antithrombin / heparin

2

what are features of venous thrombi?

1. platelet poor - "red thrombi"
2. often occur at valves
3. antiplatelet therapy not usually useful

3

what are features of arterial thrombi?

1. platelet rich - "white thrombi"
2. occur atop plaque ruptures

4

what is the MOA of aspirin?

1. irreversible inhibition of COX-1 in platelets
2. reduces TXA2 production - reduction in platelet activation and aggregation

5

what class of drug is dipyridamole? what is the MOA?

1. antiplatelet
2. inhibits phosphodiesterase
3. more cAMP, less calcium (in platelets), less activation

6

what is the role of P2Y12?

1. ADP receptor
2. binding leads to platelet activation

7

what class of drug are clopridogrel and prasugrel? what is the MOA?

1. antiplatelet
2. irreversible P2Y12 inhibitors - decrease GpIIb/IIIa
3. must be activated by liver

8

what class of drug are ticagrelor and cangrelor? what is the MOA?

1. antiplatelet
2. irreversible P2Y12 inhibitors - decrease GpIIb/IIIa
3. does NOT need to be metabolized by liver

9

prasugrel and ticagrelor are not recommended in patients with what history?

intracranial bleeding

10

what are the GpIIb/IIIa antagonists? what is the MOA?

1. abciximab
2. eptifibatide
3. tirofiban

11

what is the MOA of abciximab?

1. fragment of monoclonal against GpIIb/IIIa
2. prevents fibrinogen cross bridges between platelets

12

what class of drug is vorapaxar? what is the MOA?

1. protease activated receptor (PAR) antagonist
2. blocks thrombin - does not allow to bind to GPCR

13

what are the indirect thrombin inhibitors (bind to antithrombin)?

1. heparin
2. enoxaparin
3. fondaparinux

14

what are the direct thrombin inhibitors?

1. lepirudin
2. bivalirudin
3. argatroban
4. dabigatran

15

what are the direct Xa inhibitors?

1. rivaroxaban
2. apixaban

16

how does heparin work?

binds antithrombin at endothelial surface, increases inhibition of factor Xa thrombin

17

how is unfractionated heparin different from regular heparin?

unfractionated heparin is shorter and cannot keep thrombin in close proximity - can only activate antithrombin and have effects on Xa inactivation

18

what are the two mechanisms of heparin clearance?

1. rapid but saturable by endothelial cells
2. non-saturable via kidney and liver

19

what is the main test for heparin monitoring?

activated partial thromboplastin time (aPTT)

20

in instances of severe bleeding, what agent can be used to inactivate heparin?

protamine

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