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50 Cards in this Set
- Front
- Back
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what is the role of prostacyclin PGI2 in the endothelium
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prevent platelet aggragation
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what platelet molecule binds to collagen
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GP1a
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what platelet molecule binds to vWF
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GP1b
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what do platelets release to recruit more platelets
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ADP
5-HT TXA2 |
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what platelet freceptor binds to fibrinogen
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GP IIb/IIIa
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what is the process of coagulation from start to finish
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TF- VIIa activates IX, which activates X, which joins with V and activates II (thrombin)
thrombin turns fibrinogen into fibrin |
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what is the function of AT III
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inactivates cloting factors
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what is the function of plasmin
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clot buster of the body
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what activates plasmin
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t-PA
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which pathway does aPTT test
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intrinsic
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which pathway does PT test
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extrinsic pathway
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what is heparin made of
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a heterogenous mix of mucopolysacharides
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what is the mech of action for heparin
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accelerates the action of AT III by 1000 fold
this degrades factors IX, X, II |
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what does heparin do to aPTT time
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increases it
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what is the time for onset of action with heparin and what prolongs its half life
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immediate
renal or hepatic dysfunction will prolong its effects |
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what are the benifits and features of LMW heparin like enoxaparin
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only effects X, but is still as effective
can be injected SubQ used to prevent DVT |
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what is the function of thrombin (IIa)
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turns soluable fibrin into insoluable fibrin
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what are the common names for
heparin LMW heparin Warfarin |
heparin = Liquaemin
LMW heparin = Lovenox warfarin = Coumadin |
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what are the side effects of heparins
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hemorrhage
osteoperosis allergic rxns decreased platelets heparin-induced thromobocytopenia (HIT) |
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what do you use to reverse a hemorrhage caused by heparin
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protamine sulfate
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what are the contraindications for heparin
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hemophilia, thrombocytopenia, severe HTN
endocarditis, TB, ulcers, abortion, visceral carcinoma hepatic or renal disease brain, spinal chord, eye surgery |
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what are the uses of heparin treatment
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operations
prophylaxis against thrombosis during pregnancy to replace warfarin |
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use of LMW heparins
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AMI
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what is lepirudin (refludan) and what is it used for
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an anticoagulant from leeches
used IV as an anti-coag alternative in heparin-induced thrombocytopenia |
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what is the mech of action for warfarin
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inhibits vit K epoxide reductase
(req for carbox of clotting factors) |
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what clotting factors does warfarin have an effect on
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VII, IX, X, II
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how should warfarin be administered
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slowly over a week
monitor the INR- should be 2 to 3 |
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what are the drug interactions for warfarin
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aspirin- inc bleeding
cimetadine (tagamet)- inhibition of liver enzymes increases effect alcoholics birth control and preg barbituates- increases liver enzumes and dec effect antibiotics |
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warfarin toxicity
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hemorrhage
teratogenic hyperthyroid and hepatic disease |
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what reverses the action of warferin
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Vit K
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what is the mech of action for thrombolytic agents
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convert plasminogen to plasmin and lyse clots
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what are thrombolytic agents used for
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PE
DVT arterial thrombosis stroke |
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what are the thrombolytic agents
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t-PA activatior
streptokinase urokinase anistreplase |
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what is the common name for t-PA activatior
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Alteplase
Activase |
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gen info for t-PA activator (Alteplase, Activase)
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recombinant
selective for fibrin bound plasminogen- clot selective better at coronary reprofusion, but higher risk of stroke expensive |
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gen infor for streptokinase
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allergic responses
not fibrin specific- systemic fibrinolysis might only be good fo one treatment due to Ab formation |
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gen info for Anistreplase (eminase)
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mix of plasminogen and streptokinase
hydrolysed in the blood to become fibrinolytic long duration of action rapid action and clot specific |
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what drug is used to inhibit thronbolytic activity by completely inhibiting plasminogen formation
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Aminocaproic acid (Amicar)
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what is aminocaproic acid (amicar) used for
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bleeding disorders
hemophilia reversal of fibrinolytic therapy phrophylaxis agains rebleeding in aneurysms |
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gen info about tranexamic acid
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inhibits plasminogen activation
useful in upper GI hemorrhage |
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what are the toxicities of aminocaporic acid and tranexamic acid
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can cause thrombosis
hypotension, myopathy, GI discomfort, nasal stuffiness |
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drugs that inhibit thrombogenisis
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aspirin
clopidogrel (plavix) abciximab (reoPro) |
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what is the mech of action fo aspirin
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inhibit the synthesis of TXA2
effects are irreversable and can prolong bleeding time for days |
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what is the mech of action for Clopidogrel (plavix)
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irreversibly blocks the ADP receptor, inhibiting platelet aggrigation
great for pts allergic to aspirin |
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mech of action for abciximab (reopro)
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inhibits GP IIb/IIIa receptors (platelet aggrigation)
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what are the uses for abciximab (reopro)
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angioplasty, stint replacement
unstable angina AMI very expensive |
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gen info for cilostazol (pletal)
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phosphodiesterase III inhibitor
used for intermittent claudication not for CHF |
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gen info for Bivalirudin
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inhibits thrombin and platelet activation
used for percutaneous coronary angioplasty |
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gen info for argatroban
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inhibits thrombin
used in heparin induced thrombocytopenia |
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gen info for ancrod (vipirinex)
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venom of pit viper (phase III trials)
eleminates plasma fibroinogen used for stroke, HI-thrombocytopenia |
