Thrombosis

Question 1

What is the mechanism of action for unfractionated heparin?

Answer 1

Bind antithrombin–potentiating formation of antithrombin-coagulation factor complex (Xa, IIa)

Question 2

What indirect thrombin inhibitor is used for the treatment and prevention of venous thromboembolism?

Answer 2

Unfractionated heparin

Question 3

What are the major side effects of unfractionated heparin?

Answer 3

HIT
Bleeding
Osteoporosis-with long term use

Question 4

How is dosing of unfractionated heparin monitored?

Answer 4

PTT

Question 5

What is given to reverse the effects of unfractionated heparin?

Answer 5

Protamine

Question 6

What is the mechanism of action for Dalteparin and Enoxaparin?

Answer 6

LMWH that inhibits thrombin less effectively than Xa

Question 7

What class is Dalteparin in?

Answer 7

Indirect thrombin inhibitor

Question 8

Name the 4 indirect thrombin inhibitors…

Answer 8

Unfractionated heparin
Dalteparin
Enoxaparin
Fondaparinux

Question 9

What indirect thrombin inhibitor is the drug of choice in pregnancy and is used to treat and prevent venous thromboembolism?

Answer 9

Enoxaparin

Question 10

How is Dalteparin and enoxaparin monitored?

Answer 10

Heparin assay–anti-factor Xa

Question 11

How are the actions of dalteparin and enoxaparin reversed?

Answer 11

Protamine

Question 12

A synthetic polysaccharide that binds active site of antithrombin-inhibiting Xa?

Answer 12

Fondaparinux

Question 13

What is the use for fondaparinux, an indirect thrombin inhibitor?

Answer 13

Given for HIT

Question 14

Can the actions of fondaparinux be reversed?

Answer 14

No

Question 15

What is the mechanism of action for warfarin?

Answer 15

Blocks vitamin K-dependent gamma carboxylation of factors–2, 7, 9, 10, protein C and S

Question 16

What is warfarin used for?

Answer 16

Long-term anticoagulation

Question 17

What is the major side effect of warfarin?

Answer 17

Thrombosis–beginning of therapy Protein C depression

Question 18

How is warfarin monitored?

Answer 18

PT/INR

Question 19

How is the action of warfarin reversed?

Answer 19

Vitamin K and factor concentrates

Question 20

What are the 3 direct thrombin inhibitors?

Answer 20

Bivalirudin
Argatroban
Dabigatran

Question 21

What is the mechanism of action of the direct thrombin inhibitors (Bicalirudin, Argatroban, Dabigatran)?

Answer 21

Inactivate fibrinogen-bound and unbound thrombin

Question 22

Which of the 3 direct thrombin inhibitors binds irreversibly?

Answer 22

Bivalirudin

Question 23

Which of the 3 direct thrombin inhibitors binds reversibly?

Answer 23

Dabigatran – competitive

Question 24

Direct thrombin inhibitor used for the treatment/prevention of DVT/PE, Afib?

Answer 24

Dabigatran

Question 25

Direct thrombin inhibitor used for the treatment/prevention of percutaneous coronary intervention and HIT?

Answer 25

Argatroban

Question 26

Direct Thrombin inhibitor used for the treatment/prevention of percutaneous coronary intervention?

Answer 26

Bivalirudin

Question 27

How are the direct thrombin inhibitors monitored?

Answer 27

PTT

Question 28

What are the 2 Direct Xa inhibitors?

Answer 28

Rivaroxaban | Apixaban

Question 29

What is the mechanism of action for the direct Xa inhibitors, rivaroxaban and apixaban?

Answer 29

reversibly bind active site of Xa

Question 30

What are the direct Xa inhibitors, rivaroxaban and apixaban used for?

Answer 30

DVT/PE prophylaxis

Question 31

Name the 3 fibrinolytic drugs used to lyse already formed clots by activating plasminogen...

Answer 31

Alteplase Reteplase Tenecteplase

Question 32

What do the fibrinolytic drugs activate in order to lyse already formed clots?

Answer 32

Plasminogen

Question 33

What are the fibrinolytic drugs used for? (alteplase, Reteplase, Tenecteplase)

Answer 33

STEMI Alteplase--also acute stroke and PE

Question 34

An anti platelet drug the irreversibly inhibits platelets by preventing thromboxane A2 formation?

Answer 34

Aspirin

Question 35

PDE inhibitors that are anti platelet drugs used to increase platelet cAMP

Answer 35

Dipyridamole | Cilostazol

Question 36

Anti platelet drugs that inhibit platelet ADP receptors and prevent/treat ACS, stroke, peripheral vascular disease, angina, stent?

Answer 36

Clopidogrel Prasugrel Ticagrelor

Question 37

How are the anti platelet, inhibitors of platelet ADP receptors, reversed?

Answer 37

Platelet transfusion

Question 38

An anti platelet drug that is a monoclonal antibody against GP IIb/IIIA?

Answer 38

Abciximab

Question 39

An anti platelet drug that is a fibrinogen analog that competes with endogenous fibrinogen for IIb/IIIa?

Answer 39

Eptifibatide

Question 40

An anti platelet drug that is a fibrinogen analog that competes with endogenous fibrinogen and vWF for IIb/IIIa?

Answer 40

Tirofiban