Hematology Week 2: Pharmacology of Hemostasis Flashcards Preview

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Flashcards in Hematology Week 2: Pharmacology of Hemostasis Deck (105)
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1
Q

Know these drugs

A
2
Q

Question 1

A

D Thromboxane A2 levels

3
Q

Question 2

A

Severe hypocalcemia can occur during transfusion or a liver transplant which can decrease the ability to form a clot

4
Q

Thromboxane A2 pathway

10 steps

A
5
Q

Aspirin MOA

A
6
Q

Aspirin Clinical Use

2 listed

A
7
Q

Aspirin Adverse Effects

2 listed

A
8
Q

Abciximab MOA

2 listed

A
  • blocks fibrinogen receptor (GPIIb/IIIa, noncompetitively) on activated platelets
  • Blocks platelet aggregation
9
Q

Abciximab Clinical Use

2 listed

A
10
Q

Abciximab Adverse Effects

2 listed

A
11
Q

Abciximab Pathway

A
12
Q

Question 3

A

A Reduce the maximum level of platelet aggregation produced by the GPIIb-IIIa agonist (fibrinogen) but not alter the EC50 for fibrinogen

13
Q

Competitive antagonist

A
14
Q

Platelet ADP receptor pathway

A
15
Q

Ticagrelor MOA

A
  • Blocks ADP (PSY12) receptors
  • Prevents expression of GIIb/IIIa on platelet surface
16
Q

Clopidogrel MOA

A
  • Blocks ADP (PSY12) receptors
  • Prevents expression of GIIb/IIIa on platelet surface
17
Q

Prasugrel MOA

A
  • Blocks ADP (PSY12) receptors
  • Prevents expression of GIIb/IIIa on platelet surface
18
Q

Ticagrelor Clinical Use

2 listed

A
  • Acute coronary syndrome
  • Coronary stenting, decrease recurrence of thrombotic stroke
19
Q

Clopidogrel Clinical Use

2 Listed

A
  • Acute coronary syndrome
  • Coronary stenting, decrease recurrence of thrombotic stroke
20
Q

Prasugrel Clinical Use

2 Listed

A
  • Acute coronary syndrome
  • Coronary stenting, decrease recurrence of thrombotic stroke
21
Q

Ticagrelor Adverse Effects

2 Listed

A
  • Bleeding
  • Thrombocytopenia (rare)
22
Q

Clopidogrel Adverse Effects

2 Listed

A
  • Bleeding
  • Thrombocytopenia (rare)
23
Q

Prasugrel Adverse Effects

2 Listed

A
  • Bleeding
  • Thrombocytopenia (rare)
24
Q

Cilostazol MOA

A
  • PDE (type 3) inhibitor = increase cAMP
  • Prevents platelet aggregation
  • vasodilation
25
Q

Dipyridamole MOA

A
  • PDE (type 3) inhibitor = increase cAMP
  • Prevents platelet aggregation
  • vasodilation
26
Q

Cilostazol Clinical Use

3 listed

A
  • Intermittent claudication
  • Coronary vasodilation
  • thrombotic stroke prevention or TIA (aspirin combo)
27
Q

Dipyridamole Clinical Use

3 listed

A
  • Intermittent claudication
  • Coronary vasodilation
  • thrombotic stroke prevention or TIA (aspirin combo)
28
Q

Cilostazol Adverse Effects

3 listed

A
  • Bleeding
  • Nausea, headache
  • hypotension, abdominal pain
29
Q

Dipyridamole Adverse Effects

3 listed

A
  • Bleeding
  • Nausea, headache
  • hypotension, abdominal pain
30
Q

PDE 3 type 3 inhibitor pathway

A
31
Q

PDE Type 3 inhibitors

A

Cilostazol and Dipyridamole

32
Q

Question 4

A

C Decrease Aggregation

33
Q

Vorapaxar MOA

2 listed

A
34
Q

Vorapaxar Clinical Use

3 listed

A
35
Q

Vorapaxar is contraindicated in?

A

patients who have an intracerebral hemorrhage or stroke and TIA

36
Q

Vorapaxar Adverse Effects

2 listed

A
37
Q

With platelets Decreased PKA leads to?

A

Platelet activation

38
Q

Platelet inhibitors

A
39
Q

Summary of platelet activation mechanisms

A
40
Q

Warfarin MOA

2 listed

A
41
Q

Warfarin Clinical Use

2 listed

A
42
Q

Warfarin Adverse Effects

4 listed

A
43
Q

Vitamin K epoxide reductase gene polymorphisms

A

change how Warfarin works

44
Q

Warfarin w/ heparin or dorect thrombin inhibitors in patients with low protein C or S

A

can cause skin necrosis

45
Q

Question 5

A

B Increased

46
Q

Vitamin K Cycle & mechanism of Warfarin

A
47
Q

Warfarin Timeline

A

not for rapid anticoagulation

48
Q

Question 6

A

C Administer 4 Factor prothrombin complex concentrate

can also administer Vitamin K but this would be slow

49
Q

Heparin MOA

3 listed

A
50
Q

What is this?

A
51
Q

Heparin Clinical Use

A
52
Q

Heparin Adverse Effects

4 listed

A
53
Q

Low Molecular Weight heparins mainly inhibits

A

Factors 2a and 10a

54
Q

Warfarin is given how?

A

oral

55
Q

Heparin is given how

A

IV

56
Q

Warfarin and Heparin can have this side effect

A

Bleeding

Osteoporosis

57
Q

Heparin Pathway

A

binds to anti-thrombin III and increases its enzymatic activity by 1000x by holding it in a stable conformation

58
Q

Problems with Heparin

A

poor availability because of natural heparinases and a risk for heparin-induced thrombocytopenia

59
Q

MOA for LMWH

A

Low Molecular Weight Heparin

60
Q

Question 7

A

E Thrombocytopenia

61
Q

Heparin vs Warfarin

A
62
Q

Heparin-induced Thrombocytopenia

A
63
Q

Management of Heparin-induced Thrombocytopenia

4 listed

A
64
Q

Hirudin MOA

A
65
Q

Hirudin Clinical Use

A
66
Q

Hirudin Adverse Effects

A
67
Q

Bivalirudin MOA

2 listed

A
68
Q

Bivalirudin Clinical Use

3 listed

A
69
Q

Bivalirudin Adverse Effects

2 listed

A
70
Q

Argatroban MOA​

2 Listed

A
71
Q

Argatroban Clinical Use​

3 Listed

A
72
Q

Argatroban Adverse Effects

2 Listed

A
73
Q

Dabigatran MOA

2 Listed

A
74
Q

Dabigatran Clinical Use

2 Listed

A
75
Q

Dabigatran Adverse Effects

2 Listed

A
76
Q

Hirudins

4 listed

A
  • Hirudin
  • Bivalirudin
  • Argatroban
  • Dabigatran
77
Q

Hirudin Bleeding Antidotes

3 listed

A
  • Idarucizumab
  • PCC
  • antifibrinolytic (tranexamic acid)
78
Q

Apixaban, Rivaroxaban and Edoxaban do what?

A

Inhibit Factor Xa

79
Q

Dabigatran does what?

A

Inhibits Factor IIa

80
Q

Fondaparinux MOA

2 listed

A
81
Q

Rivaroxiban MOA

2 listed

A
82
Q

Apixaban MOA

2 listed

A
83
Q

Fondaparinux Clinical Use

3 listed

A
84
Q

Rivaroxiban Clinical Use

3 listed

A
85
Q

Apixaban Clinical Use

3 listed

A
86
Q

Fondaparinux Adverse Effects

2 listed

A
87
Q

Rivaroxiban Adverse Effects

2 listed

A
88
Q

Apixaban Adverse Effects

2 listed

A
89
Q

Question 8

A
90
Q

Anticoagulant Reversal Agents for life-threatening bleeding

A
91
Q

Alteplase (tPA) MOA

3 listed

A
92
Q

Alteplase (tPA) Clinical Use

2 listed

A
93
Q

Alteplase (tPA) Adverse Effects

2 listed

A
94
Q

Reteplase (rTPA) MOA

3 listed

A
95
Q

Reteplase (rTPA) Clinical Use

2 listed

A
96
Q

Reteplase (rTPA) Adverse Effects

2 listed

A
97
Q

Tenecteplase (TNK-tPA) MOA

3 listed

A
98
Q

Tenecteplase (TNK-tPA) Clinical Use

2 listed

A
99
Q

Tenecteplase (TNK-tPA) Adverse Effects

2 listed

A
100
Q

The Fibrinolytic pathway

A
101
Q

Question 9

A
102
Q

Fibrinolytic inhibitors

A

Tranexamic Acid

Aminocaproic Acid

103
Q

Fibrinolytic Inhibitors AKA

A

Antiplasmin Drugs

104
Q

Question 10

A
105
Q

heparin antidote

A

Protamine Sulfate