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22 Cards in this Set
- Front
- Back
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heparin - mechanism
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- catalyzes activation of antithrombin III, decreaing thrombin and Xa
- short half life |
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heparin - clinical use
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- immdiate anticoagulation for PE, stroke, angina, MI, DVT
- can be used during pregnancy - follow PPT |
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heparin - toxicity
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- bleeding
- thrombocytopenia - drug-drug interaction - to reverse it, used protamine sulfate (+ and binds to - heparin) |
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low molecular weight heparin (LMWH)
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- enoxaparin
- act more on Xa - better bioavailability - 2-4X longer half life - can be give subcutaneously and w/o lab assistance - not easily reversabile |
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warfarin (coumadin) - mechanism
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- interferes w/ normal synthesis and y-carboxylation of VtK-dep clotting factors 2, 7, 9, 10 and proteins C, S
- affects extrinsic pathway and increases PT |
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warfarin (coumadin) - clinical use
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- chronic anticoagulation
- can't use w/ pregnant - follow PT times |
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warfarin (coumadin) - toxicity
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- bleeding
- teratogenic, drug-drug interactions- if overdose, treat w/ IV vit K and fresh frozen plasma |
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heparin vs warfarin
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- large, small
- IV or SC, oral - acts on blood, acts on liver - lasts hours, lasts weeks - inhibits coagulation in vitro, does not - monotor PTT, monotor PT |
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thrombolytics - drug names
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- streptokinase
- urokinase - tPA (alteplase) - APSAC (anistreplase) |
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thrombolytics - mechanism
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- aid conversion of plasmogen to plasmin, which cleaves thrombin and fibrin clots
- tPA specifically converts it to plasmin |
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thrombolytics - clinical use
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- early MI
- early ischemic stroke |
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thrombolytics - toxicity
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- bleeding
- contraindicated in pts w/ active bleedin, hx of intracranial bleeding, recent surgery, or severe hypertension |
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aminocaproic acid
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inhibits fibrinolysis by stoping plasminogen to plasmin
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aspirin - mechainsm
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- acetylates and irreversibly inhibits cyclooxygenase (COX-1 and COX-2)
- prevents conversion of arachidonic acid to prostaglandins - no effect on PT or PTT |
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aspirin - clinical use
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- antipyretic
- analgesic - anti-inflamm - antiplatelet drug |
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aspirin - toxicity
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- gastric ulceration
- bleeding - hyperventilation - reye's syndrom - tinnitus |
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clopidogrel, ticlopidine - mechanism
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- inhibis platelet aggregation by irreversibly blocking ADP receptors
- inhibits fibrinogen binding by preventing glycoprotein IIb/IIIa expression |
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clopidogrel, ticlopidine - clinical use
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- accute coronary syndrome
- coronary stenting - decreased indicence of recurrence of thrombotic stroke |
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clopidogrel, ticlopidine - toxicity
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- neutropenia
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abciximab - mechanism
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- binds glycoprotein receptor IIb/IIIa on activated platelets
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abciximab - clinical use
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- accute coronary syndrome
- percutaneous transluminal coronary angioplasty |
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abciximab - toxicity
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- bleeding
- thrombocytopenia |
