Pharm: Anti Coag Anti Platelet Flashcards Preview

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Flashcards in Pharm: Anti Coag Anti Platelet Deck (62)
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1

When do we use antithrombotic therapy?

prevent thrombosis in pts w/acute or symptomatic venous thromboembolism

2

3 subgroups of antithrombotic agents

anticoagulants
antiplatelet agents
fibrinolytic agents

3

Venous thrombosis thrombi?

Red thrombi, RBCs enmeshed in thrombi

4

Arterial thrombosis thrombi?

White thrombi, platelets with little fibrin or red cells

5

Venous thrombosis risk factors?

immobility, surgery, cancer, pregnancy, estrogen use

6

Arterial thrombosis risk factors?

smoking, HTN, DM, obesity, hyperlipidemia

7

Gain of function mutations associated with venous thrombosis?

G20210A
factor V leiden

8

What causes primary hemostasis?

formation of a platelet monolayer over the subendothelial matrix
platelets are held in place by vWF

9

What receptor is necessary for platelet aggregation?

GPIIb/IIIa

10

What do platelets synthesize from arachidonic acid?

TXA2

11

What causes secondary hemostasis?

coagulation cascase (conversion of soluble fibrinogen to insoluble fibrin)
clot formation

12

How to platelets activate the coagulation cascade?

surface phospholipids provide support on which the complexes of coag cascade are formed, allowing for calcium binding

13

Heparin mechanism

no intrinsic anticoag activity
binds antithrombin and thrombin simultaneously
accelerates rate of interaction of antithrombin w/Xa

14

Heparin admin

parenteral, immediate onset of action

15

What are the LMWHs?

exoxaparin
dalteparin

16

LMWH mechanism

potentiate factor Xa inhibition by antithrombin
(not as good at inhibiting thrombin)

17

LMWH admin

parenteral, can accumulate in pts w/renal disease

18

Heparin SEs

thrombocytopenia
bleeding

19

LMWH SEs

bleeding
lower risk of thrombocytopenia

20

What are the direct thrombin inhibitors?

lepirudin
bivalirudin

21

Lepirudin mechanism?

binds tightly to catalytic site and extended substrate recognition site of thrombin

22

Bivalirudin mechanism?

occupies catalytic site of thrombin

23

Direct thrombin inhibitors admin?

parenteral
excreted by kidneys

24

What is the direct factor Xa inhibitor?

Fondaparinux

25

Fondaparinux mechanism?

causes antithrombin mediated selective inhibition of Xa

26

Fondaparinux admin?

subcut
Do NOT use in pts w/renal failure

27

Direct thrombin inhibitor SEs?

bleeding if they accumulate

28

Fondaparinux SEs

bleeding
much less likely to cause thrombocytopenia

29

Warfarin mechanism?

inhibits vitamin K epoxide, which recycles vit K back to it's active form

30

What requires Vit K?

facotrs 2,7,9,10, protein C, protein S