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13 Cards in this Set
- Front
- Back
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indirect thrombin inhibitors
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HEF
heparin (UFH) enoxaparin (SC)- low molecular wt heparins fondaparinux (SC)-long half life synthetic pentasaccharide analog of heparin |
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Unfractionated heparin vs low molecular wt heparin
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UFH-accelerates interaction w/ both thrombin and factor Xa
LMWH-accelerates interaction w/ factor Xa only |
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ITI side effects
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hemorrhage
osteoporosis heparin-induced thrombocytopenia (HIT)-monitor platelet count; discontinue heparin and use direct thrombin inhibitor |
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Direct thrombin inhibitors
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LBAD
lepirudin (IV)-derivative of hirudin bivalirudin (IV)-synthetic 20aa analog of lepirudin argatroban (IV)-derivative of L-arginine dabigatran (oral)-synthetic non-peptide analog |
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DTI MOA
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prevent thrombosis-inhibit thrombin and prolong aPPT
therapy monitored by aPTT blood tests not required for dabigatran because its given orally |
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DTI side effects
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hemorrhage-doesn't cause thrombocytopenia
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oral anticoagulants
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warfarin-inhibits Vit K epoxide reductase-->inhibits synthesis of Vit K dependent clotting factors II, VII, IX and X
site of genetic resistance |
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Rx interactions
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antagonize coumarin action-barbituates
potentiate coumarin action action-cimetidine, grapefruit juice displacement from protein-binding sites-sulfonamides |
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aspirin
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antiplatelet agent
decreases TXA2 (accelerates platelet clotting) and PGL2 (maintains fluidity of blood in contact w/ endothelium side effects-GI discomfort, bleeding |
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ADP inhibitors
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1. clopidogrel
2. prasugrel MOA-irreversibly ihibits ADP binding to platelet on receptor-->decreases platelet aggregation and increases bleeding time lifetime effect alternative to ASA to prevent MI or stroke |
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GP IIb/IIIa receptor blockers
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1. Abciximab
2. Eptifibatide MOA-inhibit ligand binding to IIb/IIIa receptor, decreasing platelet aggregation |
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thrombolytic (fibrinolytic) drugs
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tissue-type plasminogen activator (alteplase)-recombinant form of thrombolytic enzyme
reteplase-derivative of tissue plasminogen activator streptokinase-obtained from beta-hemolytic streptococci |
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thrombolytic drugs MOA
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converts plasminogen to plasmin-->degrades fibrin and fibrinogen and increases clot dissolution
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