Session 8 - Anti-platelets, Thrombolysis and IHD Flashcards Preview

Semester 5 - Farmocology > Session 8 - Anti-platelets, Thrombolysis and IHD > Flashcards

Flashcards in Session 8 - Anti-platelets, Thrombolysis and IHD Deck (33)
1

What are the two main indications for aspirin?

 Prevention and treatment of MI / Ischaemic stroke
 Analgesic & Anti-inflammatory agent

2

Give five main contraindications for aspirin?

 Children under 12 years who are at risk of Reye’s Syndrome
 Breastfeeding, Haemophilia, peptic ulcers, known hypersensitivity

3

How is aspirin an anti-platelet?

 Prevents the formation of Thromboxane A2 from Arachidonic Acid in platelets. Thromboxane A2 stimulates phospholipase C, increasing calcium levels and causing platelet aggregation

4

Give two aspirin ADRs

 Bronchospasm, GI haemorrhage

5

Give two ways in which aspirin interacts with a particular drug?

 Displaces Warfarin from plasma proteins (PKs)
 Increases Anti-Coagulant effect of Warfarin at a different site (PDs)

6

Give two anti-platelets other than aspirin

Dipyridamole
Copidogrel

7

What is the indication for dipyridamole?

Used in conjunction with warfarin in prophylaxis against thrombosis due to prosthetic mechanical heart valves

8

What is the mech of action of dipyridamole?

 Inhibits Phosphodiesterase enzyme
 Phosphodiesterase increases cAMP, which increases Ca2+, which causes platelet aggregation

9

Give three adverse drug reactions to dipyridamole?

 Hypotension, nausea, diarrhoea, headache

10

What is the main use of clopidogrel?

Can be used if patient allergic to aspirin

11

HOw does clopidogrel work?

 ADP Antagonists
 Inhibits ADP-ADP receptor interaction, which aids platelet aggregation

12

What is glycoprotein IIb and IIIa used for?

 Prevention of ischaemic cardiac complications in patients undergoing Percutaneous Coronary Intervention (PCI)
 Short term prevention of MI in unstable angina patients

13

What is the mech of action of glycoprotein IIb?

 Monoclonal Antibody to Glycoprotein IIb/IIIa Receptors
 Prevents platelet aggregation

14

What is the normal clearance method of fibrin?

Plasmin cleaves fibrin, fibrinogen and other coag factors

15

What is plasmin formed from?

Plasminogen

16

Give two types of fibrinolytic drugs

Ones that generate plasmin themselves (tPA)
Ones that bind to and activate endogenous plasminogen (Streptokinase)

17

Give two fibrinolytics

Streptokinase
Tissue plasminogen activator

18

What is the indication for streptokinase?

 Life-threatening venous thrombosis, pulmonary embolism, arterial thromboembolism, acute myocardial infarction

19

What are the contraindications for streptokinase?

 Recent haemorrhage, trauma, surgery, aortic dissection, coma, history of cerebrovascular disease

20

What does streptokinase do?

Forms a complex with and activates plasminogen -> Plasmin

21

Give three adverse drug reaction of streptokinase

Nausea, vomiting, bleeding/haemorrhage

22

What is streptokiunase often used with?

Anti-platelet and anti-coagulants

23

Why can't streptokinase be used more than once?

 Streptokinase is derived from haemolytic streptococci, and is therefore antigenic. Repeated administration of streptokinase could therefore result in anaphylaxis.

24

What should streptokinase be replaced by if patient allergic?

Tissue plasminogen activator

25

Give an example of tpaA

 Alteplase
 Reteplase

26

Give two indications for t-PAs

 Myocardial infarction, pulmonary embolism

27

Give some contraindications for tpas

 Recent haemorrhage, trauma, surgery, aortic dissection, coma, history of cerebrovascular disease

28

What do tas do?

 t-PAs are tissue-type plasminogen activators, Plasminogen  Plasmin

29

Give three ADRs for Tpas

 Nausea, vomiting, bleeding/haemorrhage

30

What is acute MI fibrinolysis treatment guideline?

Fibrinolysis should be offered to people with an acute STEMI within 12 hours of onset of symptoms if Percutaneous Coronary Intervention (PCI) cannot be delivered within 120 minutes of the time when fibrinolysis could have been given.

31

How does the window for venous thrombo-embolism compare?

Longer, but only three hours for ischaemic stroke

32

Give three major ADRs of thrombolytic therapy

Bleeding
Anaphylaxis
Hypotension

33

Give 6 major contraindications for fibrinolytic therapy

o Peptic Ulcer (or other potential bleeding source)
o Recent trauma or surgery
o History of cerebral haemorrhage or stroke of uncertain aetiology
o Uncontrolled hypertension
o Coagulation defect
o Previous Streptokinase therapy