Pharm #2 - Anti-Platelet Drugs / Anti-Thrombolytic Drugs Flashcards Preview

PHARM/MHD - Exam #4 > Pharm #2 - Anti-Platelet Drugs / Anti-Thrombolytic Drugs > Flashcards

Flashcards in Pharm #2 - Anti-Platelet Drugs / Anti-Thrombolytic Drugs Deck (40):
1

State the following for Streptokinase:

1. MOA
2. Route
3. Indications
4. Side effects

1. Fibrinolytic
- converts plasminogen to plasmin to aid in degradation of fibrin & thrombin

2. IV

3. thrombolysis, stroke, MI, PE

4. BLEEDING

2

What are the indications of Streptokinase?

What other drug has similar indications?

thrombolysis, stroke, MI, PE

Urokinase

3

State the following for Urokinase:

1. MOA
2. Route
3. Indications
4. Side effects

1. Fibrinolytic
- converts plasminogen to plasmin to aid in degradation of fibrin & thrombin

2. IV

3. thrombolysis, stroke, MI, PE

4. BLEEDING

4

State the following for tPA (tissue Plasminogen activator):

1. MOA
2. Route
3. Indications
4. Side effects

1. Fibrinolytic
- converts plasminogen to plasmin to aid in degradation of fibrin & thrombin

2. IV

3. thrombolysis, stroke, MI, NO PE!!! (unlike Urokinase & streptokinase)

4. BLEEDING

5

State the following for Epsilon Amino Caproic Acid - EACA (AMICAR)

1. MOA
2. Route
3. Indication
4. Side effect

1. MOA:

ANTI - Fibrinolytic (inhibits conversion of plasminogen to plasmin)

- Iv

- Reversal of bleeding!

- Hypotension is a side effect of AMICAR
(when you sit in my car your BP falls)

6

State the following for Aprotonin (Trasylol)

1. MOA
2. Route
3. Indication
4. Side effect*

- Anti-fibrolytic (antagonist for thrombolytic agents)

- IV

- reversal of bleeding

- GRAFT THROMBOSIS!!

7

What are the 3 thrombolytic antagonists?

1. EACA
Epsilon Amino Caproic Acid

2. Tranexemic Acid

3. Aprotonin (trasylol)

8

What is the side effect of Aprotonin

GRAFT THROMBOSIS!!

9

State the following for Ancrod (snake venom)

1. MOA
2. Route
3. Indication *
4. Side effect *

1. FIBRINOLYTIC! (converts plasminogen to plasmin)

2. IV

3. STROKE

4. Allergic reaction

10

Which drug is indicated for stroke but is likely to cause an allergic reaction?

Ancrod

11

State the following for Tranexamic Acid (AMCHA)

1. MOA
2. Route
3. Indication
4. Side effect *

1. Anti - fibrinolytic

2. IV

3. Reversal of bleeding

4. RETINOPATHY

12

What is the adverse effect of tranexamic acid?

RETINOPATHY

13

What are the 3 eiconasoid drugs?

1. Monteleukast
2. Zafirleukast
3. Zileuton

14

What are the fibrinolytic drugs? (4)

1. Streptokinase
2. Urokinase
3. tPA
4. Ancrod

15

What is the MOA of moteleukast & zafirleukast

Leukotriene receptor inhibitor

16

What is the MOA of Zieuton

lipooxygenase inhibitor

17

What is the common route of administration of the 3 eiconasoid drugs:

1. Monteleukast
2. Zafirleukast
3. Zieuton

What is their main SIDE EFFECT?

ORAL

- Hypotension!!

( Monteleukast also has behavioral changes)

18

Indication for monteleukast?

Allergic reaction

19

Indication for zafirleukast & ZIEUTON

MOA? (review)

asthma

- leukotriene receptor inhibitor = zafirleukast

- lipooxygenase inhibitor zileuton

20

What 3 drugs can be used for the treatment of asthma?

Which is specifically for seasonal allergies?

Asthma
- Montefleukast
- Zafirleukast
- Zileuton

21

State the following for aspirin:

MOA
Route

COX inhibitor; ORAL

(Aspirin acts as an irreversible inhibitor of COX1 by acetylating Ser530
in the active site thereby preventing access to arachidonic acid substrate)

Aspirin also acetylates COX-2, but is a less potent inhibitor,
as the COX2 active site is larger and can still partially bind arachidonic acid


22

State the following for aspirin:

Indications (3)
Adverse Effects (2)

1. ACS
2. Stroke
3. Arterial Thrombosis

1. Bleeding
2. Gastric irritation

23

State the following for Clopidogrel:

MOA
Route

1. ADP receptor inhibitor

2. ORAL

24

State the following for Clopidogrel:

Indications (3)
Adverse Effects (2)

1. ACS
2. Stroke
3. In STENT THROMBOSIS

BLEEDING
& TTP!!

25

Which drug has an adverse effect of Thrombotic Thrombocytopenic Purpura?

CLOPIDROGEL

(decreased ADAMTS13 leading to large wf multimers occluding small vessels)

26

What 3 drugs are ADP inhibitors?

1. Clopidrogel
2. Prasugrel
3. Ticagrelor

- all oral

27

State the following for Prasugrel, Ticagrelor :

MOA
Route

MOA: ADP inhibitors (same as clopidrogel)

route = ORAL

28

What are the indications for Prasugrel and Ticagrelor
(3)

Side effect?

What is this similar to?

1. ACS
2. Stroke
3. In STENT THROMBOSIS

BLEEDING

- same as clopidrogel

29

Wear drug is a reversible competitive inhibitor of COx1?

Which is irreversible non-competitive?

1. NSAID

2. Aspirin

30

NSAID:

MOA
Route
Indication
Side effect

MOA - cox inhibitor (reverisble)

Oral

Many indications - analgesic, antipyretic, anti-platelet

Side effect: BLEEDING, GI issues

31

Dipyramidole:

MOA
Route

Phosphodiesterase Inhibitor

ORAL

32

Dipyramidole:

Indications (2)
Side effect

Arterial thrombosis, stroke

BLEEDING

33

What are the 2 phosphodiesterase inhibitors?

Dypyramidole, Cilostazol

34

Cilostazol:

MOA
Route

MOA: phosphodiesterase inhibitor

Oral

35

Cilostazol:

Indication
Side effect

INTERMITTENT CLAUDICATION

Adverse = HYPOTENSION!


(phosphodiesterase inhibitor ; Oral)

36

What are the 3 pIIB/IIIa inhibitors?

How are they administered?

1. Abciximab
2. Eptifibatide
3. Tirofiban

IV!!!

37

1. Abciximab
2. Eptifibatide
3. Tirofiban

What are the 2 indications for these drugs?
Adverse effect?
How do they function

1. ACS (acute coronary syndrome)
2. Percutaneous Coronary Intervention (angioplasty)
- PCI

BLEEDING!!! (all anti-platelets cause bleeding)

MOA: GpIIb/IIIa inhibitors (no aggregation of platelets)

38

What is the absolute contraindication of thrombolytic therapy (with streptokinase/urokinase)

3

Drug interactions?

1.Intracranial bleeding
2. Massive hemorrhage
3. PREGNANCY


Drug interactions:
Antiplatelet Drugs
Heparin
Dextrans (coronary vasodilation)

39


A elderly patient was accidently overdosed with streptokinase. Which of the following agent can be used to neutralize bleeding complications?

Protamine sulfate
Vitamin K
Epsilon aminocaproic acid
Factor VIIa
Factor VIII concentrate

EACA

40

Which of the following mechanisms represents the main effect of thrombolytic agents?


Reduces the circulating levels of platelets
Converts plasminogen to plasmin
Interacts with antithrombin
Interacts with heparin cofactor II
Decreases the synthesis of fibrinogen in the liver

Converts plasminogen to plasmin