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28 Cards in this Set
- Front
- Back
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Heparin MOA
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Activates antithrombin ↓thrombin & Factor Xa
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Heparin clinical use
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immediate anticoagulation for PE, Acute coronary syndrome, MI, DVT, used in pregnancy. Follow PTT
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Heparin Toxicity & antidote
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bleeding, HIT thrombocytopenia, osteoporosis. Antidote for O/D is protamine sulfate, tx for HIT: lepirudin
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Enoxaparin, dalteparin
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act more on factor Xa, better bioavil, longer half life, NOT EASILY REVERSIBLE
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HIT
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IgG antibodies against heparin bound to platelt factor 4
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Tx for DIT
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lepirudin bivalirudin. Derivatives of leech anticoagulant. Inhibit thrombin.
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Track warfarin using PTT or PT
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PT/INR values
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Warfarin uses
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chronic anticoagulation (STEMI, thromboembolism prophylaxis, stroke in A Fib)
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Warfarin 1) overdose 2) severe overdose
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1) vit K aka PHYTONADIONE 2) FFP
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thrombolytics: ex
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alteplase (tPA), "-plases", streptokinase
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tPA & streptokinase: MOA
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conversion of plasminogen to plasmin to cleave thrombin and fibrin. ↑PT & PTT, no change plt count
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tPA & streptokinase: clinical uses
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early MI, early ischemic stroke, direct thrombolysis of pulmonary embolism
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tPA & streptokinase: toxicity?
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bleeding, REPERFUSION ARRYTHMIA
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aminocaproic acid
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thrombolytic toxicity
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Aspirin MOA
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irreversibly inhibit both COX1 COX2 by covalent acetylation: ↑BT, ↓TXA2, PGs.
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Aspirin toxicities
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Gastric ulcer, GI bleed, TINNITUS, reye's, resp alkalosis & metabolic acidosis
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Tx of ASA toxicity
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NaHCO3 in urine
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REPURFUSION ARRHYTHMIA is S/E of:
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thrombolytics (tPA, streptokinase)
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ADP receptor inhibitors: ex
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Clopidogrel, ticlopidine
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Clopidogrel, ticlopidine: MOA
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irreversibly block ADP receptors (nhibit plt agg), & preventing gp2b3a from binding fibrinogen
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Clopidogrel, ticlopidine: uses
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acute coronary syndrome; coronary stenting. ↓ incidence or recurrence of thrombotic stroke
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ticlopidine: Major toxicity
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NEUTROPENIA
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Cilostazol, dipyridamole: MOA
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PDEIII inhibitor, ↑cAMP in pltls, inhibit plt aggregatino; vasodilators.
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Cilostazol, dipyridamole: uses
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intermittent claudication, coronary vasodilation, prevent stroke or TIAs, angina prophylaxis
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GpIIb/IIIa inhibitors: ex
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abciximab, eptifibatide, tirofiban
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GpIIb/IIIa inhibitors: uses
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Acute coronary syndromes, percutaneous transluminal coronary angioplasty
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tx options for acute coronary syndromes:
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GP2b3a inhibitors, ADP receptor inhibitors, Heparin
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vWF deficiency can be helped with what
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OCPs, estrogen can diminish bleeding time
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