Thrombolytics, Anticoagulants, Antiplatelet Drugs--Regal Flashcards Preview

IHO Wk 6 > Thrombolytics, Anticoagulants, Antiplatelet Drugs--Regal > Flashcards

Flashcards in Thrombolytics, Anticoagulants, Antiplatelet Drugs--Regal Deck (21)
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1
Q

Acetylsalecylate

A

MOA: irreversibly binds COX 1/2

  • platelets only express COX 1
  • COX 2 absent on platelets

TU: anticoag (low dose), anti-inflammatory, anti-pyretic (high dose)

Adverse: bleeding, GI, tinnitus

2
Q

Clopidogren

A

MOA: ADP receptor antagonist

PK: irreversible, CYP2C19 activation, ADP receptors always present

Adverse: bleeding, severe leukopenia

3
Q

Prasugrel

A

MOA: ADP receptor antagonist

PK: irreversible, ADP receptors always present

Adverse: bleeding, severe leukopenia

4
Q

Ticlopidine

A

MOA: ADP receptor antagonist

PK: irreversible, ADP receptors always present

Adverse: TTP, bleeding, severe leukopenia

5
Q

Abciximab

A

MOA: antibody agianst GPIIb/IIIa

PK: IV

Adverse: bleeding, thrombocytopenia

6
Q

Eptifibatine

A

MOA: fibrinogen acitvator (GPIIb/IIIa receptor inhibitor)

PK: IV

Adverse: bleeding, thrombocytopenia

7
Q

Tirofiban

A

MOA: non-peptide competative inhibitor (GPIIb/IIIa receptor inhibitor)

PK: IV

Adverse: bleeding, thrombocytopenia

8
Q

Dipyrimadole

A

MOA: increases [cAMP] –> inhibitits platelet activation

phosphodiesterase 3 inhibitor

inhibits platelet uptake of adenosine

TU: combinatin w/ warfarin or aspirin

Adverse: headache, vasodilation

9
Q

Unfactionated Heparin

A

MOA: bind ATIII (anti-thrombin III) –> exposes active site –> increases efficacy of ATIII –> inactivates thrombin and Xa

PK: t1/2 = 1 hr (close monitoring)

Adverse: bleeding, heprin-induced thrombocytopenia (IgG against Factor IV-platelet factor complex)

10
Q

Low MW Heparin

A

MOA: bind ATIII (anti-thrombin III) –> exposes active site –> increases efficacy of ATIII –> inactivates Xa and (some) thrombin

PK: t1/2 = 4 hr (less monitoring)

Adverse: bleeding, heparin-induced thrombocytopenia (IgG against Factor IV-platelet factor complex)

11
Q

Fondaparinux

A

MOA: bind ATIII (anti-thrombin III) –> exposes active site –> increases efficacy of ATIII –> inactivates Xa (not thrombin)

PK: t1/2 = 17 hr. (less monitoring, harder to reverse)

Adverse: bleeding, heparin-induced thrombocytopenia (IgG against Factor IV-platelet factor complex)

**pentasaccharide, small synthetic molecule**

12
Q

Bivalirudin

A

MOA: inhibit thrombin

PK: IV

13
Q

Argatroban

A

MOA: inhibit thrombin

PK: IV

14
Q

Dibigatran etexylate

A

MOA: inhibit thrombin

PK: PO** (unique)

15
Q

Warfarin

A

MOA: binds vitamin K (epoxide) reductase

  • blocks (oxidized) vit. K epoxide –> (reduced) vit. K hydroquinone reaction
  • Factors II, VII, IX, X, protein C* sythesis affected

PK: slow onset (days)–b/c affects synthesis

  • INR monitors
  • heparin used as bridge b/c protein C synthesis affected first (normally antithrombotic) –> hypercoagulable state
  • VKORC1 polymorphisms = 30% of pt-pt variability
  • 20-70% patient-patient variability

Adverse: bleeding

_**Vit. K is anecdote**_

16
Q

Apixaban

A

MOA: inhibits Xa

PK: no monitoring, rapid onset and short t1/2

_**no antidote available**_

17
Q

Rivaroxaban

A

MOA: inhibits Xa

PK: no monitoring, short t1/2

_**no antidote available**_

18
Q

Exodaban

A

MOA: inhibit Xa

PK: no monitoring

_**no antidote available**_

19
Q

Streptokinase

A

MOA: complexes w/ plasminogen –> plasmin

Adverse: bleeding, cost

20
Q

Urokinase

A

MOA: directly converts plasminogen –> plasmin

Adverse: bleeding, cost

21
Q

tPAs

(alteplase, reteplase, tenecteplase)

A

MOA: preferentially activates plasminogen bound to fibrin–preferentially active at site of clot

Adverse: bleeding, cost

**only thrombolytic approved to treat ischemic stroke