Lecture 6: Drugs for Thromboembolic Disorders Flashcards Preview

CPR II Exam 2 > Lecture 6: Drugs for Thromboembolic Disorders > Flashcards

Flashcards in Lecture 6: Drugs for Thromboembolic Disorders Deck (87)
Loading flashcards...
1

White (platelet-rich) thrombi form in arteries under what type of pressure?

High-pressure arteries

2

What are 2 pathologic conditions of coronoary arteries associated w/ white thrombi?

- MI

- Unstable angina

3

Red (fibrin-rich) thrombi form in vessels under what type of pressure and in which location?

Low-pressure veins and in the heart

4

Anticoagulants are primarily used to prevent clots form forming where?

Which specific type of thrombi?

- Venous system and heart

- Red (fibrin) thrombi

5

Antiplatelet drugs are primarily used to preven clots from forming in which vessels?

What specific type of thrombi?

- Arteries

- White thrombi

6

What are the 3 classes and drugs in each of parenteral anticoagulants which act as indirect thrombin and factor Xa (FXa) inhibitors?

- Unfractionated (HMW) heparin = Heparin sodium

- LMW heparins = Enoxaparin, Tinzaparin, and Dalteparin

- Synthetic pentasaccharide = Fondaparinux

7

Which 3 drugs belong to the direct thrombin inhibitor class and are used as parenteral anticoagulants?

- Lepirudin

- Argatroban

- Bivalirudin

8

The indirect thrombin and factor Xa (FXa) inhibitors bind to what in the plasma?

Serine protease inhibitor antithrombin III

9

Unfractionated (HMW) heparin inhibits the activity of?

Thrombin and factor Xa

10

LMW heparins inhibit what?

Factor Xa w/ little effect on thrombin

11

Which 2 drugs in the parenteral direct thrombin inhibitor class are bivalent and bind at both the active site and substrate recognition site of thrombin?

- Lepirudin

- Bivalirudin

12

Which parenteral class of heparin has increased bioavailability from the SC injection site and allows for less frequent injections and more predictable dosing?

LMW Heparin (-aparin's)

13

Heparins are used during surgery or in hospitalized patients to reduce the risk of what?

Reduces risk of emboli

14

Heparin is administered to patients with what disorders?

- DVT

- Atrial arrhythmias

15

Why must heparins be given via IV or SC routes?

Very hydrophilic

16

What are 2 AE's associated with Heparin?

- Bleeding

- Heparin-induced thrombocytopenia (HIT)

17

What are heparin locks used for?

Prevents clots from forming in catheters

18

What 2 lab studies are used to monitor patients on Heparin?

- Activated partial thromboplastin time (aPTT)

- Anti-Xa assay

19

Heprain-induced thrombocytopenia (HIT) is due to what underlying mechanism?

Immunogenicitiy of the complex of heparin with platelet factor 4 (PF4)

20

What 2 things should you be looking for in a patient on Heparin?

- Thrombocytopenia

- Thrombosis

21

Treatment for hepain-induced thrombocytopenia?

Discontinue heparin and administer DTI

22

What are 4 contraindications for using Heparin?

- Severe HTN

- Active TB

- Ulcers of GI tract

- Patients w/ recent surgeries

23

What is used clinically for reversal (antidote) of heparin action?

Protamine sulfate

24

The synthetic pentasaccharide, Fondaparinux, used as an anticoagulant binds to and inhibits what?

Acts as antithrombin III catalyst --> indirectly inhibit factor Xa (NO effect on thrombin)

25

In what 3 ways does the anticoagulant, Fondaparinux, differ from heparins?

- Does not inhibit thrombin acitivity

- Rarely induces HIT (thrombocytopenia)

- Action is not reversed by Protamine sulfate

26

What are 3 clinical indications for the use of Fondaparinux?

- Prevention of DVT's

- Tx of acute DVT (in conjunction w/ Warfarin)

- Tx of pulmonary embolism

27

Which parenteral direct thrombin inhibitor binds only at the thrombin active site?

Argatroban

28

Which parenteral direct thrombin inhibitor is an irreversible inhibitor of thrombin?

Lepirudin

29

Which parenteral direct thrombin inhibitor is a reversible inhibitor of thombin and also inhibits platelet aggregation?

Bivalirudin

*Think Bi = 2 mechanisms!

30

Which parenteral direct thrombin inhibitor is short acting and used IV?

Argatroban