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34 Cards in this Set
- Front
- Back
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Name the 3 ways hemostasis is acheived
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1) VC
2) Platelet fcn (Agg) 3) Fibrin formation (Clot) |
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Which form of hemostasis is critical in "clean cuts"?
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Platelet function
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Describe Clot Formation in 4 steps
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1) Damage
2) vWF binds 3) Platelets secrete ADP, TXA2 & 5-HT 4) Aggregation via GPIIb/IIIa & fibrinogen |
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Draw the clotting cascade in your mind
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Great job!
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Describe the body's 4 normal clot inhibition mechanisms.
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1) PGI2 - Prostacyclin
2) Thrombomodulin binds thrombin and activates C & S 3) Heparin sulfate catalyzes ATIII to bind 1000x faster to CFs 4) TFPR 5) (PGI2) |
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What CF activates the Intrinsic pathway?
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CF XII
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Heparin sodium
Drug class: General mech & 3 results: |
Heparin sodium is an anticoagulant
It catalyzes ATIII to bind 1000x faster to CFs No Intrinsic pathway, No common pathway, No thrombin. (NO II, IX, X, XI, XII) |
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Heparin Risks (5)
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1) Hemorrhage
2) Clotting (HIT) 3) Osteoporosis 4) Low platelets (so don't use in brain or eye surgery) 5) Don't use with infective endocarditis, TB, poss miscarriage, or carcinoma. |
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Heparin is reversed with:
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Protamine sulfate or Vit K.
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Heparin is used for (3)
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DVT, PE, substitute for warfarin in pregos.
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LMW Heparin is called:
- Details (3): |
Enoxaprin/Lovenox
May be used after MI Lower risk of HIT Ok in pregos |
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Lepirudin is from:
Drug class: is used for: is administered: |
hirudin from leaches
Anticoagulant Tx of HIT IV only |
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Warfarin/Coumadin Mechs (3)
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* Inhibs Vit K Reductase enzyme
* No reduced Vit K = No CFs = NO II, VII, IX, X (No extrinsic or common) * shortens t1/2 of C & S |
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Warfarin
Drug class: Uses (2): Details (4): |
Anticoagulant
DVT, PE In vivo only Takes >1 wk to titrate Use enoxapril to transition Monitor INR - want 2-3. |
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Warfarin Contraindications (3)
Risk of what in pregnancy? |
Cimetadine/tagamet & ETOH = P450 metab issues
BCP or prego - hypercoag states Barbituates Teratogenic |
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What are the two other anticoags we need to know?
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Dabigatran
Rivoroxaban |
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Clot Busting Mech (Fibrinolysis)
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Plasmin degrades fibrin, so clot busting drugs must either increase plasmin conversion or lyse clots
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Clot Busters are used for (4)
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MI, DVT, PE, Standard CVAs
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Two Clot Busting Drugs are:
Their mixture drug is: |
TPA & Streptokinase
Anistreplase |
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TPA Details (4)
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Made endogenously from endo cell
Exogenously made with recomb DNA * CLOT-SELECTIVE Expensive, with higher CVA risk |
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List three anti-coags
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Heparin sodium (& Enoxapril)
Lepirudin Warfarin |
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Streptokinase Details (2)
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Protein product
Only used once per pt bc it is prone to Type I Hypersensitivity immune reactions |
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Antifibrinolytics mech
Risks |
Reverse fibrinolysis by inhibiting plasminogen synthesis
Risk of clots and nasal stuffiness (no joke!) |
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What is Lysteda?
Drug class? |
A new drug to tx heavy menses.
Antifibrinolytic |
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Anti-platelet drugs (3)
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1) Aspirin
2) Clopidigrel/Plavix 3) Abcixzimab |
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Aspirin mech & dose
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Aspirin irrev inhibits TXA2. Effects last 7-10 days.
325 mg dose recommended. |
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Clopidigrel
Drug class: Mech: |
Anti-platelet
It irrev inhibits ADP recs, causing decreased platelet aggregation |
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Clopidigrel Details (3)
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OK to use during MI
OK to use in aspirin allergies No PG effect (vs aspririn) = no GI issues. |
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Abciximab mech
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Fab ab that inhibits GPIIb/IIIa to prevent vWF binding.
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Abciximab Details (3)
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IV only
Used with heparin for CV surgery Use in acute AMI & unstable angina |
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What is protamine sulfate used for?
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To reverse anticoagulants
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Which drug eliminates the Intrinsic Clotting Pathway?
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Heparin sodium
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Which drug eliminates the Extrinsic Clotting Pathway?
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Warfarin
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What is the difference between Heparin sulfate and Heparin sodium?
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Heparin sulfate is endogenous; Heparin sodium is exogenous
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