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Pharm Midterm 1 > Reduce Clotting > Flashcards

Flashcards in Reduce Clotting Deck (72):
1

What are platelet aggregation inhibitors used for

Primary Hemostasis

2

What are anticoagulants used for

Secondary Hemostais

3

What are the Platelet Aggregation Inhibitors

Aspirin
Clopidogrel
Ticlopidine
Dipyridamole
Cilostazol
Abciximab
Eptifibatide
Eirofiban

4

What are the Anticoagulants

Heparin
Enoxaparin
Dalteparin
Tinzaparin
Fondaparinux
Leupirudin
Bivalirudin
Argatroban
Warfarin

5

What are Thrombolytics used for

Tertiary Hemostasis

6

What do Thrombolytics activate

Plasmin

7

What are the Thrombolytics

Streptokinase
Urokinase
Alteplase
Reteplase
Tenecteplase
Anistreplase

8

COX inhibitor

Aspirin

9

ADP receptor blockers

Clopidogrem
Ticlopidine

10

PDE inhibitors

Dipyridamole
Cilostazol

11

GPIIb/IIIa blockers

Abciximab
Eptifibatide
Tirofiban

12

Synthetic pentasaccharide

Fondaparinux

13

Direct thrombin inhibitors

Lepirudin
Bivalirudin
Argatroban

14

Coumarin Anti-coagulant

Warfarin

15

Made by beta-hemolytic strep

Streptokinase

16

Recombinant tPA

Alteplase

17

Purified human plasminogen with bacterial streptokinase

Anistreplase

18

Which clotting reducers are irreversible

Aspirin
Clopidogrel
Ticlopidine
Abciximab

19

What does Aspirin do

Block TXA2 - Prolong BT

20

What does TXA2 do

Increase affinity of GPIIb/IIIa for fibrinogen

21

When do you give Aspirin to stop clotting

Cerebral Ischemia
Stroke
MI

22

How long before new COX2 can be synthesized

10 days

23

How do ADP receptor blockers act

Inhibit P2Y12 receptor on platelets

24

When do you use ADP receptor blockers

Recent Stroke, MI, acute coronary syndrome

25

Why do you prefer Clopidogrel over Ticlopidine

Less AE

26

What do you NEVER give with Clopidogrel and why

Omeprazole (inactivates 2C19, 3A4)

27

ADP receptor blockers AE

Inhibit P450
Thrombocytopenic purpura

28

Which ADP receptor blockers can cause neutropenia

Ticlopidine

29

What do you coadminister PDE inhibitors with

Aspirin or warfarin

30

What do PDE inhibitors do

Increase cAMP
Coronary vasodilation

31

What are PDE inhibitors used for

Angina prophylaxis

32

Which GPIIb/IIIa blocker is an irreversible monoclonal Ab

Abciximab

33

Which GPIIb/IIIa blocker is a reversible cyclic peptide antagonist

Eptifibatide

34

Which GPIIb/IIIa blocker is a non-peptide reversible antagonist

Tirofiban

35

What are GPIIb/IIIa blocker used for

Acute coronary syndrome
Angioplasty

36

Which clotting blockers do you give for acute coronary syndrome

Clopidogrel (preferred)
Ticlopidine
Abciximab
Eptifibatide
Tirofiban

37

Which do you give IV ONLY

Heparins

38

What is a lack of GPIIb/IIIa

Glanzmann's Thrombasthemia

39

What is the DOC clotting reducer in pregnancy

Heparins

40

What is UFH

Unfractionated Heparin
Straight chain anionic GAGs

41

What is LMWH

Low Molecular Weight Heparin
Pentasaccharide (binds ATIII)
Higher therapeutic index

42

How does UFH act

Binds AT-III increasing activity
AT-III complexes with IX and X to inhibit thrombin

43

How does LMWH act

Inhibit X
Less effect on thrombin

44

What are Heparins used for

DVT
PE
MI

45

How do you treat excess Heparin

Protamine sulfate

46

What is Heparin-induced Thrombocytopenia (HIT)

IgG binds Heparin/PF4 complex
Bind to FcR on platelets
Degranulation and PF4 release
Thrombosis and thrombocytopenia

47

Tx for HIT

Discontinue Heparin
Give DTI or Fondaparinux

48

What is a selective PF-10 inhibitor

Fondaparinux

49

What does Fondaparinux bind

AT-III

50

What is Fondaparinux used for

DVT Tx and prevention

51

What binds the active site of thrombin

Direct thrombin inhibitors

52

What are direct thrombin inhibitors used for

HIT thrombosis
Coronary angioplasty

53

Which clotting reducers are given parenterally

GPIIb/IIIa inhibitors
Direct thrombin inhibitors

54

How often should Warfarin be monitored

2-4 weeks via PT
INR

55

What do you monitor with PTT

Heparins
Direct thrombin inhibitors

56

What does Warfarin do

Inhibit Vit K epoxide reductase

57

What factors does Warfarin affect

II, VII, IX, X

58

Which factor is first affected by Warfarin

VII

59

How can you reverse Warfarin action

Vit K

60

Which is Pregnancy Category X

Warfarin

61

How is Warfarin administered

Oral

62

Warfarin AE

Narrow therapeutic window
Drug interactions
Hemorrhage

63

Why can Warfarin cause cutaneous necrosis

Decreased Protein C activity
Paradoxical hypercoagulability

64

What does Streptokinase do

Catalyses PF-V and VII degradation
Activates Plasmin

65

What does Urokinase do

Plasminogen to Plasmin conversion

66

Where is Urokinase made

Kidneys

67

When is Urokinase given

Lysis of PE

68

What is tPA

Serine protease that activates Plasminogen bound to fibrin

69

When is recombinant tPA used

2nd line for acute MI and ischemic stroke

70

1st line for acute MI and ischemic stroke

Angioplasty

71

Less selective tPA

Reteplase

72

Mutant tPA

Tenecteplase