Pharm: Thrombolytic agents Flashcards Preview

MHD/Pharm Block 4 > Pharm: Thrombolytic agents > Flashcards

Flashcards in Pharm: Thrombolytic agents Deck (19):
1

What is the function of plasmin?

Plasmin is the major fibrinolytic enzyme. Breaks down fibrinogen and fibrin.

2

What are the activators of plasmin?

t-PA, urokinase, streptokinase
Factor XIIa

3

What are the inhibitors of plasmin?

Aminocaproic acid
PAI-1, TAFI, alpha2 antiplasmin, alpha2 macroglobulin

4

What fragments are formed by plasmin degradation of stabilized fibrin?

Fragments X, Y, D and E
These products form D-dimers, hallmarks of DVT and DIC

5

What are the main factors that promote fibrinolysis?

Plasminogen content of clot
t-PA content/activity in and around clot
Protection of bound plasmin from antiplasmin

6

What are the factors that limit fibrinolysis?

Fibrin crosslinking by factor XIIIa
Antiplasmin content in and around fibrin clot

7

What are the main effects of thrombolytic therapy?

-Reduce thrombus size
-Reduce fibrinogen levels
-Increase fibrinogen and fibrin degradation products
-Antiplatelet activators

8

What are the 3 main categories of thrombolytic agents?

Urokinase
Streptokinase
Recombinant tissue plasminogen activators

9

What are the major recombinant tissue plasminogen activator drugs?

Alteplase, reteplase, and tenecteplase

10

How is thrombolytic therapy useful for MI patients?

Many MI patients have thrombi formed in the coronary vessels. Thrombolytic therapy is used to try to get rid of the fibrin-rich occlusion

11

How does time affect success of thrombolytic therapy?

Older clots are less susceptible to the lytic action of thrombolytic agents

12

Which thrombolytic agents are used for pulmonary embolism?

Streptokinase and urokinase

13

What complications are associated with thrombolytic therapy?

Bleeding, re-occlusion, stroke

14

What are the absolute contraindications of thrombolytic therapy?

Intracranial bleeding
Massive hemmorhage

15

What are the drug interactions with thrombolytic agents?

Antiplatelet drugs, heparins and dextrans

16

What drugs are used to counteract the effects of thrombolytic agents?

Epsilon amino caproic acid (EACA)
Tranexemic acid
Aprotonin

17

Where are defibrinogenating agents found in nature?

Snake venom

18

What is the route of administration for all thrombolytic agents?

IV

19

What is the indication for ancrod?

fibrinolytic agent used to treat strokes