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17 Cards in this Set

  • Front
  • Back
Heparin
Activates Antithrombin= ↓IIa & ↓Xa

Immediate Anticoagulation
PE, DVT, stroke, MI, acue coronary syndrome
Used during pregnancy

monitor PTT (intrinsic path)

Tox: osteoporosis, bleeding
Heparin-induced Thrombocytopenia= autoantibody production destroys platelets and overactivates remaining ones= thrombocytopenic, hypercoag state
Rx for Heparin tox?
Protamine Sulfate

Pos. compound that binds negatively charged heparin
Enoxaprin
Low Molecular Weight Heparin

Acts more on Xa
Better bioavailability and longer 1/2 life
Admin w/o laboratory monitoring
Not easily reversible
Argathrombin
Direct Thrombin Inhibitors

Heparin-induced Thrombocytopenia
Lepirudin
Direct Thrombin Inhibitors

Heparin-induced Thrombocytopenia
Bivalirudin
Direct Thrombin Inhibitors

Heparin-induced Thrombocytopenia
Warfarin
Interferes with γ-carboxylation of Vitamin K dependent factors:
↓2, 7, 9, 10, C, S

Chronic anticoagulation
Monitor PT/INR

Tox: TERATOGENIC, SKIN/TISSUE NECROSIS (in acquired Protein C deficiencies), bleeding, metabolized by P450
Rx for Warfarin tox?
Vit. K and Fresh Frozen Plasma
Streptokinase
Thrombolytic
Aids conversion of plasminogen into plasmin= cleaves thrombin and fibrin clots

Early MI, Ishemic Stroke (w/in 3 hrs)

CONTRA: active bleed, history of intracranial bleeds, recent surgery, severe hypertension

↑PT, ↑PTT, normal platelet count
Urokinase
Thrombolytic
Aids conversion of plasminogen into plasmin= cleaves thrombin and fibrin clots

Early MI, Ishemic Stroke (w/in 3 hrs)

CONTRA: active bleed, history of intracranial bleeds, recent surgery, severe hypertension

↑PT, ↑PTT, normal platelet count
Alteplase (tPA)
Thrombolytic
Aids conversion of plasminogen into plasmin= cleaves thrombin and fibrin clots

Early MI, Ishemic Stroke (w/in 3 hrs)

CONTRA: active bleed, history of intracranial bleeds, recent surgery, severe hypertension

↑PT, ↑PTT, normal platelet count
Antistreplase (APSAC)
Thrombolytic
Aids conversion of plasminogen into plasmin= cleaves thrombin and fibrin clots

Early MI, Ishemic Stroke (w/in 3 hrs)

CONTRA: active bleed, history of intracranial bleeds, recent surgery, severe hypertension

↑PT, ↑PTT, normal platelet count
Rx for thrombolytic tox?
Aminocaproic Acid

Inhibitor of fibrinolysis
Aspirin
Irreversible COX-1 and COX-2 inhibitor= ↓TXA2= ↑bleeding time
No effect on PT and PTT

Antiplatelet drug

Tox: gastric ulceration, bleeding, hyperventilation, Reye's syndrome, tinnitus (CN8)
Clopidogrel
Irreversible blocks ADP receptors on platelets= ↓glycoprotein IIb/IIIa expression

Acute coronary syndrome, coronary stenting, ↓incidence or recurrence of thrombotic stroke
Ticlopidine
Irreversible blocks ADP receptors on platelets= ↓glycoprotein IIb/IIIa expression

Acute coronary syndrome, coronary stenting, ↓incidence or recurrence of thrombotic stroke

Tox: neutropenia, bone marrow tox
Abciximab
Binds glycoprotein IIb/IIIa on activated platelets= ↓aggregation

Acute coronary syndromes

Tox: bleeding, thrombocytopenia