Know these drugs
Question 1
D Thromboxane A2 levels
Question 2
Severe hypocalcemia can occur during transfusion or a liver transplant which can decrease the ability to form a clot
Thromboxane A2 pathway
10 steps
Aspirin MOA
Aspirin Clinical Use
2 listed
Aspirin Adverse Effects
2 listed
Abciximab MOA
2 listed
- blocks fibrinogen receptor (GPIIb/IIIa, noncompetitively) on activated platelets
- Blocks platelet aggregation
Abciximab Clinical Use
2 listed
Abciximab Adverse Effects
2 listed
Abciximab Pathway
Question 3
A Reduce the maximum level of platelet aggregation produced by the GPIIb-IIIa agonist (fibrinogen) but not alter the EC50 for fibrinogen
Competitive antagonist
Platelet ADP receptor pathway
Ticagrelor MOA
- Blocks ADP (PSY12) receptors
- Prevents expression of GIIb/IIIa on platelet surface
Clopidogrel MOA
- Blocks ADP (PSY12) receptors
- Prevents expression of GIIb/IIIa on platelet surface
Prasugrel MOA
- Blocks ADP (PSY12) receptors
- Prevents expression of GIIb/IIIa on platelet surface
Ticagrelor Clinical Use
2 listed
- Acute coronary syndrome
- Coronary stenting, decrease recurrence of thrombotic stroke
Clopidogrel Clinical Use
2 Listed
- Acute coronary syndrome
- Coronary stenting, decrease recurrence of thrombotic stroke
Prasugrel Clinical Use
2 Listed
- Acute coronary syndrome
- Coronary stenting, decrease recurrence of thrombotic stroke
Ticagrelor Adverse Effects
2 Listed
- Bleeding
- Thrombocytopenia (rare)
Clopidogrel Adverse Effects
2 Listed
- Bleeding
- Thrombocytopenia (rare)
Prasugrel Adverse Effects
2 Listed
- Bleeding
- Thrombocytopenia (rare)
Cilostazol MOA
- PDE (type 3) inhibitor = increase cAMP
- Prevents platelet aggregation
- vasodilation
Dipyridamole MOA
- PDE (type 3) inhibitor = increase cAMP
- Prevents platelet aggregation
- vasodilation
Cilostazol Clinical Use
3 listed
- Intermittent claudication
- Coronary vasodilation
- thrombotic stroke prevention or TIA (aspirin combo)
Dipyridamole Clinical Use
3 listed
- Intermittent claudication
- Coronary vasodilation
- thrombotic stroke prevention or TIA (aspirin combo)
Cilostazol Adverse Effects
3 listed
- Bleeding
- Nausea, headache
- hypotension, abdominal pain
Dipyridamole Adverse Effects
3 listed
- Bleeding
- Nausea, headache
- hypotension, abdominal pain
PDE 3 type 3 inhibitor pathway
PDE Type 3 inhibitors
Cilostazol and Dipyridamole
Question 4
C Decrease Aggregation
Vorapaxar MOA
2 listed
Vorapaxar Clinical Use
3 listed
Vorapaxar is contraindicated in?
patients who have an intracerebral hemorrhage or stroke and TIA
Vorapaxar Adverse Effects
2 listed
With platelets Decreased PKA leads to?
Platelet activation
Platelet inhibitors
Summary of platelet activation mechanisms
Warfarin MOA
2 listed
Warfarin Clinical Use
2 listed
Warfarin Adverse Effects
4 listed
Vitamin K epoxide reductase gene polymorphisms
change how Warfarin works
Warfarin w/ heparin or dorect thrombin inhibitors in patients with low protein C or S
can cause skin necrosis
Question 5
B Increased
Vitamin K Cycle & mechanism of Warfarin
Warfarin Timeline
not for rapid anticoagulation
Question 6
C Administer 4 Factor prothrombin complex concentrate
can also administer Vitamin K but this would be slow
Heparin MOA
3 listed
What is this?
Heparin Clinical Use
Heparin Adverse Effects
4 listed
Low Molecular Weight heparins mainly inhibits
Factors 2a and 10a
Warfarin is given how?
oral
Heparin is given how
IV
Warfarin and Heparin can have this side effect
Bleeding
Osteoporosis
Heparin Pathway
binds to anti-thrombin III and increases its enzymatic activity by 1000x by holding it in a stable conformation
Problems with Heparin
poor availability because of natural heparinases and a risk for heparin-induced thrombocytopenia
MOA for LMWH
Low Molecular Weight Heparin
Question 7
E Thrombocytopenia
Heparin vs Warfarin
Heparin-induced Thrombocytopenia
Management of Heparin-induced Thrombocytopenia
4 listed
Hirudin MOA
Hirudin Clinical Use
Hirudin Adverse Effects
Bivalirudin MOA
2 listed
Bivalirudin Clinical Use
3 listed
Bivalirudin Adverse Effects
2 listed
Argatroban MOA
2 Listed
Argatroban Clinical Use
3 Listed
Argatroban Adverse Effects
2 Listed
Dabigatran MOA
2 Listed
Dabigatran Clinical Use
2 Listed
Dabigatran Adverse Effects
2 Listed
Hirudins
4 listed
- Hirudin
- Bivalirudin
- Argatroban
- Dabigatran
Hirudin Bleeding Antidotes
3 listed
- Idarucizumab
- PCC
- antifibrinolytic (tranexamic acid)
Apixaban, Rivaroxaban and Edoxaban do what?
Inhibit Factor Xa
Dabigatran does what?
Inhibits Factor IIa
Fondaparinux MOA
2 listed
Rivaroxiban MOA
2 listed
Apixaban MOA
2 listed
Fondaparinux Clinical Use
3 listed
Rivaroxiban Clinical Use
3 listed
Apixaban Clinical Use
3 listed
Fondaparinux Adverse Effects
2 listed
Rivaroxiban Adverse Effects
2 listed
Apixaban Adverse Effects
2 listed
Question 8
Anticoagulant Reversal Agents for life-threatening bleeding
Alteplase (tPA) MOA
3 listed
Alteplase (tPA) Clinical Use
2 listed
Alteplase (tPA) Adverse Effects
2 listed
Reteplase (rTPA) MOA
3 listed
Reteplase (rTPA) Clinical Use
2 listed
Reteplase (rTPA) Adverse Effects
2 listed
Tenecteplase (TNK-tPA) MOA
3 listed
Tenecteplase (TNK-tPA) Clinical Use
2 listed
Tenecteplase (TNK-tPA) Adverse Effects
2 listed
The Fibrinolytic pathway
Question 9
Fibrinolytic inhibitors
Tranexamic Acid
Aminocaproic Acid
Fibrinolytic Inhibitors AKA
Antiplasmin Drugs
Question 10
heparin antidote
Protamine Sulfate