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22 Cards in this Set

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