Pharm Test 2 Coagulation Disorder Drugs

Front 1

Aspirin

1)MOA
2)CU
3)AE
4)Effect on PT PTT

Back 1

Platelet Aggregation Inhibitor

1)Irreversible inhibition (acetylation) of COX ->inhibits TXA2

2)Prophylaxis for Transient Cerebral Ischemia
Post MI Treatment
Dec Recurrent MIs

3)Gastric Ulcers, Bleeding, Reyes Syndrome
Inc Bleeding TIme

4)NO CHANGE

Front 2

Clopidogrel

1)MOA
2)CU
3)AE

Back 2

Platelet Aggregation Inhibitor

1)Irreversible inhibition of P2Y12 (ADP platelet receptor) ->dec fibrinogen attachment to 2B/3A

2)Acute Coronary Syndrome
Thrombotic Stroke

3)Thrombocytopenia

Front 3

Ticlopidine

1)MOA
2)CU
3)Which is preffered, Ticlopidine or Clopidogrel

Back 3

Platelet Aggregation Inhibitor

1)Irreversible inhibition of P2Y12 (ADP platelet receptor) ->dec fibrinogen attachment to 2B/3A

2)Acute Coronary Syndrome
Thrombotic Stroke

3)Thrombocytopenia, NEUTROPENIA

4)Clopidogrel because no neutropenia

Front 4

Dipyridamole

1)MOA
2)CU
3)Effect by itself>?

Back 4

Platelet Aggregation Inhibitor

1)Inhibits phosphodiesterase and/or Adenosine uptake -> Coronary Vasodilation

2)Prophylaxis for Angina
Prevent Thromboemboli in Heart Valve Patients (give with Warfarin)
Prevent Cerebrovascular Diseases (give with Aspirin)

3)Little effect, must use with Warfarin/Aspirin

Front 5

Cilostazol

1)MOA
2)CU

Back 5

Platelet Aggregation Inhibitor

1)Inhibits Phosphodiesterase ->Vasodilation

2)intermittent Claudication

Front 6

Abciximab

1)MOA
2)CU

Back 6

Platelet Aggregation Inhibitor

1)Monoclonal antibody that blocks Platelet GP 2b/3a receptors

2)Acute Coronary Syndromes

Front 7

Eptifibatide

1)MOA
2)CU

Back 7

Platelet Aggregation Inhibitors

1)Reversible antagonist of 2b/3a

2)Acute Coronary Syndromes

Front 8

Tirofiban

1)MOA
2)CU

Back 8

Platelet Aggregation Inhibitors

1)Reversible antagonist of 2b/3a

2)Acute Coronary Syndromes

Front 9

Heparin (unfractioned)

1)MOA
2)CU
3)AE
4)How to Monitor?
5)How to reverse the bleeding?

Back 9

Anti-Coagulants

1)Activation of Antithrombin 3 -> dec thrombin (2a) (except thrombin already bound to fibrin)

2)Immediate anticoagulation against Pulm Embolism, Stroke, Coronary Syndrome, DVT, MI

3)Heparin Induced Thrombocytopenia (Type 2 HS against PF-4)
4) aPTT assay (tests intrinsic pathway)
5)Protamine Sulfate

Front 10

Enoxaparin

1)MOA

2)Pharmacokinetics

3)Advantage over unfractioned Heparin

Back 10

Anti-coagulant

1)Low Molec Heparin->inhibits Factor 10a ->less effect on thrombin

2)Low Molec = equal efficacy, longer half life, inc Bioavailability, less dosing

3)Do NOT have to monitor Low Molec Heparin (d/t Inc Therapeutic Index)

Front 11

Dalteparin

1)MOA

2)Pharmacokinetics

3)Advantage over unfractioned Heparin

Back 11

Anti-coagulant

1)Low Molec Heparin->inhibits Factor 10a ->less effect on thrombin

2)Low Molec = equal efficacy, longer half life, inc Bioavailability, less dosing

3)Do NOT have to monitor Low Molec Heparin (d/t Inc Therapeutic Index)

Front 12

Tinzaparin

1)MOA

2)Pharmacokinetics

3)Advantage over unfractioned Heparin

Back 12

Anti-coagulant

1)Low Molec Heparin->inhibits Factor 10a ->less effect on thrombin

2)Low Molec = equal efficacy, longer half life, inc Bioavailability, less dosing

3)Do NOT have to monitor Low Molec Heparin (d/t Inc Therapeutic Index)

Front 13

Fondaparinux

1)MOA
2)CU
3)How do you give it

Back 13

Anticoagulant

1)Inhibition of 10a

2)DVT

3)Daily Subcutaneous injection

Front 14

Lepirudin

1)MOA
2)Compare to Heparin
3)How to monitor

Back 14

Anticoagulant

1)Peptide form thrombin inhibitor (alternative to heparin)
2)Can inhibit thrombin already on fibrin
3)aPTT

Front 15

Bivalirudin

1)MOA
2)Compare to Heparin
3)How to monitor

Back 15

Anticoagulant

1)Synthetic thrombin inhibitor (alternative to heparin)
2)Can inhibit thrombin already on fibrin
3)aPTT

Front 16

Argatroban

1)MOA
2)Compare to Heparin
3)How to monitor

Back 16

Anticoagulant

1)Small molecule thrombin inhibitor (alternative to heparin)
2)Can inhibit thrombin already on fibrin
3)aPTT

Front 17

Warfarin

1)MOA
2)Pharmacokinetics
3)AE
4)Contra
5)How to Monitor
6)Antidote
7)How to give

Back 17

Anti Coagulant

1)Inhibits Vitamin K Epoxide Reductase

2)Longer Anticoagulant (8 to 12 hrs)
Narrow Therapeutic Index

3)Hemorrhage, Cutaneous Necrosis, Teratogenic

4)Pregnant
5)PT
6)Vit K or Frozen Plasma
7)Oral

Front 18

Streptokinase

1)MOA
2)CU
3)AE
4)How to Monitor

Back 18

Thrombolytic/Fibrinolytic

1)Catalyze conversion of Plasminogen -> Inc Plasmin -> cleave thrombin and fibrin clots

2)Early MI and Ischemic Stroke (earlier the administration, better the effectiveness)

3)Bleeding

4)Inc PT, Inc PTT, NO CHANGE in platelet count

Front 19

Urokinase

1)MOA
2)CU
3)AE
4)How to Monitor

Back 19

Thrombolytic/Fibrinolytic

1)Catalyze conversion of Plasminogen -> Inc Plasmin -> cleave thrombin and fibrin clots

2)Early MI and Ischemic Stroke (earlier the administration, better the effectiveness)

3)Bleeding

4)Inc PT, Inc PTT, NO CHANGE in platelet count

Front 20

Alteplase

1)MOA
2)CU
3)AE
4)How to Monitor

Back 20

Thrombolytic/Fibrinolytic

1)Catalyze conversion of Plasminogen -> Inc Plasmin -> cleave thrombin and fibrin clots

2)Early MI and Ischemic Stroke (earlier the administration, better the effectiveness)

3)Bleeding

4)Inc PT, Inc PTT, NO CHANGE in platelet count

Front 21

Reteplase

1)MOA
2)CU
3)AE
4)How to Monitor

Back 21

Thrombolytic/Fibrinolytic

1)Catalyze conversion of Plasminogen -> Inc Plasmin -> cleave thrombin and fibrin clots

2)Early MI and Ischemic Stroke (earlier the administration, better the effectiveness)

3)Bleeding

4)Inc PT, Inc PTT, NO CHANGE in platelet count

Front 22

Tenecteplase

1)MOA
2)CU
3)AE
4)How to Monitor

Back 22

Thrombolytic/Fibrinolytic

1)Catalyze conversion of Plasminogen -> Inc Plasmin -> cleave thrombin and fibrin clots

2)Early MI and Ischemic Stroke (earlier the administration, better the effectiveness)

3)Bleeding

4)Inc PT, Inc PTT, NO CHANGE in platelet count

Front 23

Anistreplase

1)MOA
2)CU
3)AE
4)How to Monitor

Back 23

Thrombolytic/Fibrinolytic

1)Catalyze conversion of Plasminogen -> Inc Plasmin -> cleave thrombin and fibrin clots

2)Early MI and Ischemic Stroke (earlier the administration, better the effectiveness)

3)Bleeding

4)Inc PT, Inc PTT, NO CHANGE in platelet count

Front 24

Aminocaproic Acid

1)MOA
2)CU

Back 24

Plasminogen Activating Inhibitor

1)Inhibits plasminogen activation
2)Treat bleeding assoc with fibrinolytic therapy

Front 25

Protamine Sulfate

1)MOA

2)How Does it Do This

Back 25

Plasminogen Activating Inhibitor

1)Antagonizes Heparin

2)Arginine is cationic, thus interacts with anionic heparin to form complex with anticoagulant activity

Front 26

Vitamin K

1)MOA
2)CU
3)How long to reverse warfarin effects?

Back 26

Plasminogen Activating Inhibitors

1)y-carboxylation of factors 2,7,9,10,Protein C,Protein S

2)Stops bleeding d/t oral anticoagulants (eg: warfarin)

3)24 Hours

Front 27

Plasma Fractions

1)MOA

2)CU

Back 27

Plasminogen Activating Inhibitors

1)Provides coagulation factors

2)Hemophilia A (Factor 8 defic)
Christmas Disease (Hemophilia B or Factor 9 Defic)