hemeonc

Question 1

lowers the activity of thrombin and factor Xa

Answer 1

heparin (short half life)

Question 2

use of heparin:

Answer 2

immediate anticoagulation for pulm embolism, acute coronary syndrome, MI, DVT

Question 3

heparin or warfarin in pregnancy

Answer 3

heparin (does not cross placenta)

Question 4

this drug prolongs PTT

Answer 4

heparin

Question 5

SE of heparin

Answer 5

bleeding, thrombocytopenia (HIT), osteoporosis, drug-drug interactions

Question 6

rapid reversal of heaprin use:

Answer 6

protamine sulfate (pos charged molecule to bind neg charged heparan)

Question 7

heparin induced thrombocytopenia (HIT)

Answer 7

development of IgG ab against heparin bound platelet factor 4 (PF4).

Question 8

antibody heparin PF4 complex activates platelts

Answer 8

HIT (thrombosis and thrombocytopenia)

Question 9

LMW heparins

Answer 9

enoxaparin, dalteparin)

Question 10

which heparins act predominantly on factor Xa

Answer 10

enoxaparin, dalteparin

Question 11

fondaparinux acts only on

Answer 11

factor Xa

Question 12

which has better bioaviality and a 2-4x longer half life. lmw heparin or unfractionated hparin

Answer 12

low molecular weight hpearin

Question 13

direct thrombin inhibitors inlcude

Answer 13

bivalirudin, argatroban, dabigatran

Question 14

the only oral in the direct thrombin inhibitor class is

Answer 14

dabigatrin

Question 15

Use of direct thrombin inhibitors

Answer 15

Venous thromboembolism
atrial fibrilatiion
HIT

Question 16

how do you reverse dabigatran

Answer 16

idarucizumab

Question 17

if no reversal agent avaible for dabigatran, use

Answer 17

PCC, and/or antifibrinolytics (eg tranexamic acid)

Question 18

serious side effect of direct thrombin inhibitor

Answer 18

bleeding

Question 19

how does enoxparin function

Answer 19

binds ATIII via pentasaccharide sequence. once activated, ATIII binds to facotr Xa and strips factor Xa from converting protrhombin to thrombin

Question 20

more molecules than LMWH

Answer 20

unfractionated heparin: allows it to bind factor Xa and thrombin; more effective than LMWH in activaitng thrombi

Question 21

gene for vitamin K epoxide reductase complex

Answer 21

VKORC1

Question 22

warfarin crosses placenta

Answer 22

true

Question 23

adverse effects of warfarin

Answer 23

bleeding, teratogenic, skin/tissue necrosis, drug drug Iinteractsion

Question 24

rapid reversal of warfarin

Answer 24

FFP or PCC

Question 25

does fresh frozen plasma (FFP) contain all coagulation factors

Answer 25

yes

Question 26

for reversal of warfarin,

Answer 26

give vitamin K

Question 27

Why is ffp ineffective in heparin overdose

Answer 27

it contains ATIII; which enhances hparin affect

Question 28

longer duration of action warfarin or hpearin

Answer 28

warfarin (days)

Question 29

site of action in liver: heparan or warfarin

Answer 29

warfarin

Question 30

heparin is in the blood and is parenteral

Answer 30

true

Question 31

warfarin is oral

Answer 31

true

Question 32

direct factor Xa inhibitors

Answer 32

apiXaban, rivaroXaban

Question 33

direct factor xa inhibiotr use

Answer 33

treatment and prophylaxis for dvt and pe; stroke prophylaxis in pt's with atriabl fibrillation.

Question 34

thrombolytics drugsa

Answer 34

alteplase (tPA), reteplase (rPA), streptokinase, tenecteplase (TNK-tPA)

Question 35

thrombolytics increase

Answer 35

PT , PTT, no change in platelet count

Question 36

directly or indirectly aid conversion of plasminogen to plasmin, which cleaves thrombin and fibrin clots

Answer 36

thrombolytics

Question 37

use of thrombolytics

Answer 37

early MI, early ischemic stroke, direct thrombolysis of severe PE

Question 38

clopidogrel, prasugrel, ticagrelor, ticlopidine

Answer 38

ADP receptor inhibtors

Question 39

ADP receptor inhibitors mechanism

Answer 39

inhibit platelet aggregation by irreversibly blocking ADP (P2Y12) receptor. prevents expression of glycoproteins IIb/IIIa on platelet surface

Question 40

use of adp receptor inhibitors

Answer 40

acute coronary syndrome; coronary stenting. decrease incidence or recurrrence of thrombotic storke

Question 41

SE of ticlopidine

Answer 41

neutropenia

Question 42

ADP receptor inhibots se

Answer 42

TTP

Question 43

cilostazol, dipyridamole

Answer 43

PDE inhibitors; increase cAMP in platelts, resulting in inhibiton of platelt aggregation; vasodilators

Question 44

use of cilostazol, dipyradimaloe

Answer 44

intermittent claudication, coronary vasodilation, prevention of stroke or TIAs (combined with aspirin)

Question 45

se of cilostazol, dipyridamole

Answer 45

nausea, headache, facial flushing, hypotension, abdominal pain

Question 46

GPIIb/IIIa inhibitors

Answer 46

abciximab, eptifibatide, tirofiban

Question 47

GP IIB/IIa inhibitors

Answer 47

binds to GP IIb/IIIa on activated platelets, preventign aggregation

Question 48

use of GpIIb/IIIa inhibitors

Answer 48

unstable angina, PCI

Question 49

SE of gp2b/3a inhibitors

Answer 49

bleeding thrombocytopenia