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38 Cards in this Set

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  • Back
What is the difference between venous and arterial thromboembolisms?
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
heparin, enoxaprin, and fondaparinux are what?

(Kathryn heparin and Jane Fonda anti-coagulate on the lunar equinox)
Lepirudin, Bivalirudin are what?
Direct thrombin inhibitors- anticoagulants

(They are rudenough to interupt thrombin)
Warfarin (Coudamin) does what?
Smart enough to engage in oral war fare, warfarin is an oral anticoagulant
Aspirin, Clopidogrel, Abciximab, and Eptifibate do what?
they anticoagulate by being antiplatelet agents
How do Abciximab and Eptifibatide act as antiplatelet agents?
they block the platelet GP IIb/IIIa receptors

(as easy as ABC to use EPT)
What do alteplase, reteplase, and streptokinase have in common?
they are all throbolytic drugs that activate tissue plasminogen
What do vitamin K and aminocaproic acid do?
They are hemostatic agents
How does Heparin act as an anticoagulant?
It binds antithrombin and increases the rate of inhibition of CF by 1000 times
What is the difference between heparin and fondaparinux, and enoxaprin (low molecular weight heparin)?
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)
What are the advantages of LMWH?
LMW heparin- longer half life, can be used on out patient basis, less hemoragging,
Side effects of these anticoagulants?
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
What does Protamin sulphate?
chemical antagonist to Heparin, it is the anti-drug
What do the direct thrombin inhibitors do?
Synthetic version of active ingrediant in leeches, prevents trhobosis by blocking thrombin and prolonging aPPT
When would we use Lepirudin over Heparin?
If (HIT) Heparin-induced throbocytopenia has occured against Heparin, used during coronary angioplasty
What acts in the liver to inhibits the synthesis of Vit K dependend Clotting Factor II, VII, IX, X?
Warfarin, Kumadin
What does Warfarin inhibit?
Vitamin K epoxide reductase
Will vitamin K deficiency, liver disease and hypermetabolic states increase or decrease the action of warfarin?
Increases the activity of Warfarin
What causes decreased activity of Warfarin?
hereditary resistance, hypothyroidism, and pregnancy
What is the treatment for an overdose of Warfarin?
What is a side effect in warfarin not seen in other anticoagulants?
vitamin K (competative antagonism) or plasma or prothrombin complex

contraindicated with pregnancy
what will drugs that increase catabolism do to warfarin
these drugs will inducing enzymes that will break it down
what will vitamin K do to warfarin
it will increase clotting factor synthesis and make it so you need more (it is the anti-drug)
What will sulfonamides do to Warfarin?
it displaces protien binding sites, unclear how this effects it?
What is the mechanism of action of aspirin?
it inhibits cyclo-oxygenase which inhibits thromboxane A2 and prostacyclin which are anti-platelet and anti-clotting
What might be the advantage of taking very low doses of Aspirin regularly?
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
What is the mechanism of action for Ticlopidine and Clopidogrel bisulfate?
inhibits ADP-R on platelets preventing platelet aggregation
If you couldn't use aspirin as a prophalactic for a post-MI patient, what would you use?
Clopidogrel bisulfate (Plavix)
What would you use for a patient who had just had angioplasy and stent placement?
Clopidogrel (plavix)
What drugs inhibit platelet activation by inhibiting the ligand binding to the IIb and IIIa receptor via the R-blockade
Abciximab and Eptifibatide
What do the IIb/IIIa complex do?
They act as a receptor mainly for fibrinogen and vitronectin
What are the clinical uses for Abciximab and Eptifibatide?
prevents throbotic complications in acute coronary syndrome-IV, and for percutaneous coronary intervention
What do plasminogen activators do?
they cause lysis of formed clots in arteries and viens
What are they useful for?
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
what are the two plasminogen activators?
alteplase and streptokinase
better against newly formed clots
What do they do to plasminogen?
convert plasminogen to plasmin and plasmin can break up the clot
What is the difference between K1 and K2?
K2 is made in the human tissues and K1 is found in the diet-primarily in leafy green vegetables
What are the clinical uses for Vitamin K?
given to all newborns to prevent hemorrhagic disease (esp common in premies)

used to reverse bleeding episodes caused by oral anticoagulants
What is Aminocaproic Acid used for- what is it opposite to?

What are the side effects?
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