Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
27 Cards in this Set
- Front
- Back
|
What dose of asprin do you use post MI?
|
small dose
there is no added benefit using high doses (greater than 160-325) |
|
|
Clopidogrel vs Abciximab
Use? |
Clopidogrel: similar to aspirin
Abciximab: PCI, UA, or NSTEMI |
|
|
-plase drugs =
|
recombinant t-PA
tissue type plasminogen activator |
|
|
What is t-PA?
|
tissue type plasminogen activator
|
|
|
biggest side effect of thrombin inhibitors?
|
BLEEDING
|
|
|
2 side effects of Lepirudin
|
Bleeding
Allergic reactions including analphylaxis remember this is a Recombinant derivative of hirudin (leech) |
|
|
MOA of warfarin in her words:
|
Vitamin K1 obtained from food sources is reduced to vitamin KH2 by a warfarin-resistant vitamin K reductase.
Vitamin KH2 is then oxidized to vitamin K epoxide (Vit KO) in a reaction that is coupled to carboxylation of glutamic acid residues on coagulation factors. This carboxylation step renders Factors II, VII, IX, and X, and Protein C and Protein S activatable. Vit KO is then reduced to Vit KH2 by vitamin KO reductase. Warfarin inhibits vitamin KO reductase, thereby blocking the formation of vitamin vitamin KH2. This prevents the carboxylation (and hence production) of vitamin K dependent coagulation factors. |
|
|
What happens if vitamin K stays in the oxidized form?
|
it can't work as a co-factor for coag
|
|
|
How long does it take to get a peak effect of Warfarin?
|
72-96 hours (aka it is slow)
|
|
|
Why is the effect of warfarin so long? (2-5 days)
|
you have to synthesize new clotting factors
|
|
|
what do you have to do when you give someone warfarin?
|
have to monitor the effect of warfarin because it has a narrow therapeutic index
|
|
|
if a person comes in with atrial fib with a high risk of stroke what should you give them? 2
|
Heparin for short term
warfarin for long term |
|
|
How would you use heparin and warfarin to anticoagulate a person who develops a DVT?
|
Begin treatment with both heparin and warfarin. UFH is used in the hospital. LMWH can be used at home.
Stop heparin treatment when INR is in the correct range (about 5 days) |
|
|
What is Protein C?
|
endogenous anti-coagulant
(factors 5 and 8) |
|
|
what anti-coag do you use during pregnancy?
|
Heparin
|
|
|
what do you use in a woman who is pregnant with a mechanical heart valve considering the following
Must be anticoagulated with a mechanical heart valve Warfarin is teratogenic Reports of heparin failure in pregnant women with mechanical heart valves resulting in serious maternal consequences so which do you pick? |
no correct answer, have to weigh risk and benefit
NOT ON TEST |
|
|
contraindications of warfarin? 4
|
Same as with Heparin
Hepatic disease Chronic alcoholism Pregnancy |
|
|
What is the DOC for a person with HIT who needs to be anticoagulated?
|
one of the rudins (direct thrombin inhibitor)
|
|
|
There are more drug interactions reported for____ that any other drug
|
warfarin
|
|
|
antidote for warfarin?
|
Vitamin K (phytonadione)
or if really bad Fresh frozen plasma or prothrombin complex concentrate |
|
|
what receptor allows for 2 platelets to bind?
|
GP IIb/IIIa
(also known as fibrinogen receptor) |
|
|
TxA2 and PGI2 come from what? and that comes from?
|
Prostaglandins
(prostaglandins come from Cyclooxygenase) |
|
|
What is the job of TxA2 (thromboxane)?2
|
Vasoconstrictor
Promotes platelet aggregation |
|
|
Do you want to inhibit the production of PGI2 or TxA2?
|
TxA2
because this would normally be a Vasoconstrictor that Promotes platelet aggregation |
|
|
What gives you TxA2 from prostaglandin H2?
|
Cox1
|
|
|
what does ibuprofen do?
|
reversibly inhibits COX1 and COX2
|
|
|
big benefit of COX 2 inhibitor
|
doesn't have GI effects because it doesn't affect prostaglandins
|
