Flashcards in Pharm 13-Direct/Indirect Thrombin Inhibitors Deck (96)
How are anticoagulants classified?
Direct or indirect thrombin inhibitors
What drugs are indirect thrombin inhibitors? (Anticoagulants)
Unfractionated Heparin/LMWH (Lovenox)
What drugs are direct thrombin inhibitors? (Anticoagulants)
Argatroban (No brand name)
How do anticoagulants work?
Inhibit one or more steps in the clotting cascade that lead to fibrin formation; they do not dissolve clots
What is the single most important drug you will use as a perfusionist?
What is heparin made out of?
Mix of straight-chain polymers consisting of extremely anionic repeating dissacharide units
Why is heparin so acidic?
So many carboxyl and sulfate groups attached
Which critters produce heparin?
virtually all critters, even ones lacking traditional blood so its an ancient molecule on the evolutionary tree
What are circulating mast cells?
Where does heparin "live"?
What do mast cells produce?
What is the kind of heparin that is used the most?
How big is unfractionated heparin?
How many daltons is water?
What is a Dalton?
a unit used in expressing the molecular weight of proteins, equivalent to atomic mass unit.
What is heparin measured in?
What is 1 unit of heparin?
The quantity of heparin required to keep 1 mL of cat's blood fluid for 24 hours at 0 degrees C
0.002 mg of heparin/ unit
What are the two main sources of heparin?
1. Porcine intestinal-derived heparin
2. Bovine lung
Which source of heparin may be better in preventing some complications (such as HIT)?
Porcine intestinal-derived heparin
How is heparin administered?
High molecular weight heparin (HMWH)
5,000- 30,000 Daltons
Low molecular weight heparin (LMWH)
Which type of heparin is much more uniform, contains less contaminants and inactive forms of heparin?
What does heparin do?
Isn't an anticoagulant by itself
Acts on AT-III
Heparin + ATIII is how many more x active than ATIII by itself?
IV Half Life: Heparin vs. LMWH
Heparin: 2 hours
LMWH: 4 hours
Anticoagulant Response: Heparin vs LMWH
Bioavailability: Heparin vs LMWH
Heparin 20 %
Major adverse effect: Heparin vs. LMWH
Heparin: Frequent bleeding
LMWH: Less frequent bleeding