Blood And Lymphatics I

Front 1

What is the difference between venous and arterial thromboembolisms?

Back 1

arterial thromboembolisms are formed by white or arterial thrombus, venous- red or venous thrombus 2)arterial- composed of fibrin and platelets, venous- fibrin and RBC's 3)arterial- in areas of rapid blood flow, venous-slow blood flow 4)arterial-grows and occludes blood flow venous-grows long tail and detatches to form embolizm of pulmonary artery

Front 2

heparin, enoxaprin, and fondaparinux are what?

Back 2

anticoagulants

(Kathryn heparin and Jane Fonda anti-coagulate on the lunar equinox)

Front 3

Lepirudin, Bivalirudin are what?

Back 3

Direct thrombin inhibitors- anticoagulants

(They are rudenough to interupt thrombin)

Front 4

Warfarin (Coudamin) does what?

Back 4

Smart enough to engage in oral war fare, warfarin is an oral anticoagulant

Front 5

Aspirin, Clopidogrel, Abciximab, and Eptifibate do what?

Back 5

they anticoagulate by being antiplatelet agents

Front 6

How do Abciximab and Eptifibatide act as antiplatelet agents?

Back 6

they block the platelet GP IIb/IIIa receptors

(as easy as ABC to use EPT)

Front 7

What do alteplase, reteplase, and streptokinase have in common?

Back 7

they are all throbolytic drugs that activate tissue plasminogen

Front 8

What do vitamin K and aminocaproic acid do?

Back 8

They are hemostatic agents

Front 9

How does Heparin act as an anticoagulant?

Back 9

It binds antithrombin and increases the rate of inhibition of CF by 1000 times

Front 10

What is the difference between heparin and fondaparinux, and enoxaprin (low molecular weight heparin)?

Back 10

Heparin has the strongest action, it binds antithrombin, thrombin, and clotting factors and increases the rate of clotting factor inhibition by 1000%, fondaparinux- is a sythetic analog of heparin, but has a longer half life ENOXMPRIM (LMWH)- inhibits clotting factor 10 and antithrombin, but can not inhibit thrombin (causes less hemoraging)

Front 11

What are the advantages of LMWH?

Back 11

LMW heparin- longer half life, can be used on out patient basis, less hemoragging,

Front 12

Side effects of these anticoagulants?

Back 12

1)hemorrhage 20%, 2)thrombocytopenia (increased platlet)- 3)IgG antibodies aainst complexes of heparin to platelet factor 4>platelet aggregation and thrombisis 4)osteoporosis and fractures

Front 13

What does Protamin sulphate?

Back 13

chemical antagonist to Heparin, it is the anti-drug

Front 14

What do the direct thrombin inhibitors do?

Back 14

Synthetic version of active ingrediant in leeches, prevents trhobosis by blocking thrombin and prolonging aPPT

Front 15

When would we use Lepirudin over Heparin?

Back 15

If (HIT) Heparin-induced throbocytopenia has occured against Heparin, used during coronary angioplasty

Front 16

What acts in the liver to inhibits the synthesis of Vit K dependend Clotting Factor II, VII, IX, X?

Back 16

Warfarin, Kumadin

Front 17

What does Warfarin inhibit?

Back 17

Vitamin K epoxide reductase

Front 18

Will vitamin K deficiency, liver disease and hypermetabolic states increase or decrease the action of warfarin?

Back 18

Increases the activity of Warfarin

Front 19

What causes decreased activity of Warfarin?

Back 19

hereditary resistance, hypothyroidism, and pregnancy

Front 20

What is the treatment for an overdose of Warfarin?
What is a side effect in warfarin not seen in other anticoagulants?

Back 20

vitamin K (competative antagonism) or plasma or prothrombin complex

contraindicated with pregnancy

Front 21

what will drugs that increase catabolism do to warfarin

Back 21

these drugs will inducing enzymes that will break it down

Front 22

what will vitamin K do to warfarin

Back 22

it will increase clotting factor synthesis and make it so you need more (it is the anti-drug)

Front 23

What will sulfonamides do to Warfarin?

Back 23

it displaces protien binding sites, unclear how this effects it?

Front 24

What is the mechanism of action of aspirin?

Back 24

it inhibits cyclo-oxygenase which inhibits thromboxane A2 and prostacyclin which are anti-platelet and anti-clotting

Front 25

What might be the advantage of taking very low doses of Aspirin regularly?

Back 25

my offer advantage of not inhibiting synthesis of both prostacyclin and thromboxane, just thromboxane which is a platlet agregator and vasoconstictor- but prostacyclin is a vasodilator and an antiplatelet effector so it is working for the mechanism of aspirin that we want here, so in this case a half a pill is actually more potent

Front 26

What is the mechanism of action for Ticlopidine and Clopidogrel bisulfate?

Back 26

inhibits ADP-R on platelets preventing platelet aggregation

Front 27

If you couldn't use aspirin as a prophalactic for a post-MI patient, what would you use?

Back 27

Clopidogrel bisulfate (Plavix)

Front 28

What would you use for a patient who had just had angioplasy and stent placement?

Back 28

Clopidogrel (plavix)

Front 29

What drugs inhibit platelet activation by inhibiting the ligand binding to the IIb and IIIa receptor via the R-blockade

Back 29

Abciximab and Eptifibatide

Front 30

What do the IIb/IIIa complex do?

Back 30

They act as a receptor mainly for fibrinogen and vitronectin

Front 31

What are the clinical uses for Abciximab and Eptifibatide?

Back 31

prevents throbotic complications in acute coronary syndrome-IV, and for percutaneous coronary intervention

Front 32

What do plasminogen activators do?

Back 32

they cause lysis of formed clots in arteries and viens

Front 33

What are they useful for?

Back 33

to use soon after an infarction and in concurrent long term use with heparin followed by warfarin, and aspirin to work against the reinfarction and reocclusion

Front 34

what are the two plasminogen activators?

Back 34

alteplase and streptokinase
better against newly formed clots

Front 35

What do they do to plasminogen?

Back 35

convert plasminogen to plasmin and plasmin can break up the clot

Front 36

What is the difference between K1 and K2?

Back 36

K2 is made in the human tissues and K1 is found in the diet-primarily in leafy green vegetables

Front 37

What are the clinical uses for Vitamin K?

Back 37

given to all newborns to prevent hemorrhagic disease (esp common in premies)

used to reverse bleeding episodes caused by oral anticoagulants

Front 38

What is Aminocaproic Acid used for- what is it opposite to?

What are the side effects?

Back 38

reverses the actions of alteplase and streptokinase by inhibiting plasminogen activation and preventing fibrinolysis- also used to treat hemophilia and post surgical bleeding

side effects are thrombosis, hypotension, myopathy and diarrhea