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Blood > final lecture 5 > Flashcards

final lecture 5 Flashcards

1
Q

anticoagulant effect of UFH is mediated through

A

pentasaccharide sequence

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2
Q

minimum length of UFH saccharide chain required to bind to thrombin:

A

18 units

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3
Q

UFH has high protein binding to

A

PF4

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4
Q

UFH antidote

A

protamine sulfate

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5
Q

two types of thrombocytopenia

A

heparin-associated (HAT) &heparin-induced (HIT)

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6
Q

HAT

A

mild; reversible

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7
Q

HIT

A

a serious drug rxn

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8
Q

main difference between LMWH & UFH

A

their relative ability to inhibit Xa and thrombin

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9
Q

LMWH action

A

limited anti-thrombin activity but greater anti-factor Xa

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10
Q

LMWH advantages over UFH

A

more predictable dose response, dose-independent clearance (renal), longer T1/2. lower risk of HIT or osteoporosis, reduced lab monitoring

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11
Q

LMWH antidote

A

protamine sulfate

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12
Q

fondaparinux has ___ effect on thrombin activity

A

no direct effect

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13
Q

fondoparinux antidote

A

none

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14
Q

fondaparinux CI in

A

pts <50kg

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15
Q

anti Xa

A

fondparinux and idraparinux

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16
Q

DIRECT anti-factor Xa inhibitors

A 
rivaroxaban & apixban
ORAL
do not require antithrombin
no antidotes
CYP interaction
17
Q

DTIs over UFH, LMWH

A

do not require cofactor (antithrombin), inhibit BOTH circulating and clot bound thrombin, treatment of HIT

18
Q

DTIs are derived from

A

hirudin salivary gland of a leach

19
Q

lepirudin

A

DTI
parenteral
binds irreversibly to thrombin
renal excretion

20
Q

desirudin

A

DTI
a little long T`1/2
irreversibly binds
renal excretion

21
Q

bivalirudin

A

DTI
reversibly binds- lower risk of bleeding
short T1/2
hepative metabolism

22
Q

argatroban

A

DTI
IV
binds reversibly only to active site of thrombin
metabolized in liver- can use in renal impairment

23
Q

dabigatran

A

DTI
PO
renal clearance
used for DVT prophylaxis for orthopedic surgery

Blood (10 decks)

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