Pharm Test Ii

Front 1

step 1 for clot formation
______ damage
contact activation results in activation of ______ pathway, which is involved in ____ growth and maintenance

Back 1

endothelial; intrinsic; fibrin

Front 2

ADP stimulates _______ aggregation
_____ ____ activates the extrinsic pathway which initiates _____ formation
common pathway activates factor _____

Back 2

platelet; tissue factor; fibrin; X (ten)

Front 3

in the clotting cascase factor _____ has shortest half life and factor ____ has the longest half life

Back 3

VII; X

Front 4

predisposing conditions to clot formation

Back 4

proglonged immboilization
surgery/post op period
trauma to lower limb
preg/contraceptives
heredity
CHF, MI, A-fib (turbulatory flow)
clotting factor deficiency

Front 5

indications for anticoag therapy

Back 5

PE, DVT, A-Fib, heart valve prosthesis, Acute MI, TIA, hip fx

Front 6

MOA of heprin:

binds to antithrombin ____ and inactivates factors ____a, ____a, adn _____a

which results in _____ of clotting factor

Back 6

III, X; XI, XII

depletion

Front 7

route of admin for heparin

Back 7

IV or SQ (prophylactic)

Front 8

All heparins are excreted via

Back 8

kidneys

Front 9

loading dose for heparin

Back 9

70-100 units/kg

Front 10

maintenance dose for heparin

Back 10

18 units/kg/hr

Front 11

adjust dose based on

Back 11

APTT (activated partial prothombin time)
want btwn 60-90 (test Q 6 hr)

Front 12

monitor ____, look for signs of _____

Back 12

CBC; blleding

Front 13

adverse effects of heparin

Back 13

hemorrhage; HIT (heparin induced thrombocytopenia); paradoxical thrombosis

Front 14

tx for overdose:

Back 14

protamine (antidote)
whole blood
fresh frozen plasma

Front 15

examples of LMWH

Back 15

Enoxaparin (Lovenox)
Dalteparin (Fragmin)
Ardeparin (Normiflo)(never used)
Tinzaparin (Innohep) (minimal use)

Front 16

LMWH decreases the chances of _____

Back 16

HIT

Front 17

Fondaparinux (Arixtra)is a _____ and reults in no _____, it is indicated for prophylaxis of _____

Back 17

heparinoid; TCP; DVT

Front 18

LMWH is used in ___ tx by dosing 1mg/kg SQ Q 12 hours (Enoxaparin). No monitoring of ____ is needed. You must check _____-factor ___ assay

Back 18

DVT; PTT; anti; X

Front 19

Vit K is a ______ in the clotting cascade and is synthesized in the _____

Back 19

cofactor; liver

Front 20

Warfarin antagonizes _____, ____ vit K dependent coag factors (II, VII, IX, X, protein ____ and ____)

Back 20

Vit K; depletes; C; S

Front 21

Onset of action of warfarin is

Back 21

1-2 days

Front 22

True coag is obtained in ___-___ days

Back 22

2-7

Front 23

Warfarin is ____ absorbed, highly ____ bound, and metabolized in the _____

Back 23

well; protein; liver

Front 24

The therapeutic goal of warfarin is based on

Back 24

dz your treating

Front 25

test to assess anti-coag of warfarin

Back 25

INR
(pt's PT(s)/mean normal PT (s))^ISI
isi= international sensitivity index

Front 26

Dosing

NEVER _____ warfarin

Back 26

load

Front 27

warfarin should not be used for ____ pts; heparin is used instead

Back 27

pregnant

Front 28

smoking _____ metabolism of warfarin resulting in _____ clotting

Back 28

increases; increased

Front 29

start warfarin ____ day after initiating heparin

Back 29

one

Front 30

starting dose for warfarin

Back 30

5-7.5mg/day

Front 31

side effects of warfarin

Back 31

bleeding; thrombocytopenia

Front 32

drug interactions

Back 32

enzyme inducers (antiepileptics); enzyme inhibitors (Cimetidine (Tagamet) antibiotic)
protein displacement (dig)

Front 33

food interactions with warfarin

other interactions

Back 33

vit k containing foods
antacids

smoking

Front 34

signs of warfarin overdose

Back 34

any unusual bleeding
blood in stools
excessive menses
bruising
excessive nose bleeds
persisent oozing from superficial wounds
bleeding from tumor, ulcer, lesion

Front 35

tx for bleeding secondary warfarin

Back 35

fresh frozen plasma
Vit K (small dose)(not fast enough for active bleeding)

Front 36

some things that potentiate warfarin

Back 36

I-etoh, amiodorone, ees
II-tylenol cipro, tcn, flu vaccine
III-asa, nalidixic acid
IV-cefamandole, cefazolin

Front 37

things that inhibit warfarin

Back 37

I-barbiturates, carbamazepine,
II-dicloxacillin
III-cyclosprine, trazadone

Front 38

a derivate of hirudin (snake venom)

Back 38

Lepirudin (Refludan)

Front 39

Lepirudin can be used as an alternative to ______, it works in the prescence of ____, requires less _____

Back 39

heparin; HIT; monitoring

Front 40

examples of antiplatelet agents

Back 40

asa
Thienopyridines
GPIIb/IIIa inhibitors

Front 41

asa prevents platelet aggregation by blocking _____

Back 41

TxA2

Front 42

introduction of asa reduces relative risks of death by ___ by about 35-50%

Back 42

MI

Front 43

Thienopyridines inhibit ____ dependent activation of _____

examples of these are

Back 43

ADP; GP IIb/IIIa complex

Ticolopidine-slow
Cloidogrel- (plavix) more active, better SE profile

Front 44

these are useful in pts who are ______ to asa or predisposed to ___ bleeding

Back 44

hypersenstive; GI