Usmle - Pharmacology - Bleeding And Hemostasis

Front 1

Abciximab

Back 1

Chimeric mAb; human Fc joined to mouse Fab directed against human GpIIb/IIIa

Hint 1

Adjunct along with aspirin or heparin in percutaneous coronary intervention

Front 2

Aspirin

Back 2

Non-selective COX inhibitor; irreversibly acetylates COX, leading to inactivation

Front 3

Clopidogrel

Back 3

Inhibit binding of ADP to platelet ADP receptors, ultimately decreasing GpIIb/IIIa expression

Hint 3

Prevention of atherosclerotic events following MI, stroke, or PAD, as well as acute coronary syndrome

Front 4

Dipyridamole

Back 4

PDE inhibitor, leading to decreased TxA2 production

Hint 4

Combined with warfarin, useful for inhibiting embolization from prosthetic valves

Front 5

Eptifibatide

Back 5

Blocks fibrinogen binding site on GpIIb/IIIa receptor

Hint 5

Decrease incidence of ischemic complications associated with acute coronary syndromes

Front 6

Triclopidine

Back 6

Inhibit binding of ADP to platelet ADP receptors, ultimately decreasing GpIIb/IIIa expression

Hint 6

Prevention of TIA and stroke in pts with prior history of cerbral thromboembolic events; prophylaxis post-stent placement; but generally reserved for patients who cannot tolerate other forms of treatment due to side effect profile (TTP, agranulocytosis

Front 7

Tirofiban

Back 7

Blocks fibrinogen binding site on GpIIb/IIIa receptor

Hint 7

Decrease incidence of ischemic complications associated with acute coronary syndromes

Front 8

Argatroban

Back 8

Direct thrombin inhibitor (small molecule inhibitor)

Hint 8

HIT; use during PCI in patients at risk for HIT; monitored with aPTT

Front 9

Dalteparin

Back 9

LMWH; binds to and activates ATIII with subsequent inactivation of Xa

Hint 9

Generally the same indications as heparin, but can be hospital or outpatient

Front 10

Enoxaparin

Back 10

LMWH; binds to and activates ATIII with subsequent inactivation of Xa

Hint 10

Generally the same indications as heparin, but can be hospital or outpatient

Front 11

Fondaparinux

Back 11

Pentapeptide that binds to and activates ATIII with subsequent inactivation of Xa

Hint 11

Prophylaxis of DVT that could result in PE; undergoing hip, knee surgeries

Front 12

Heparin

Back 12

Binds to and activates ATIII, leading to inactivation of factors II and Xa

Hint 12

Acute DVT; PE; prophylaxis for post-operative venous thrombosis; treatment of pregnant women with synthetic valves, risk of DVT, etc.

Front 13

Lepirudin

Back 13

Direct thrombin inhibitor (polypeptide)

Hint 13

HIT; other thromboembolic disorders; monitored with aPTT

Front 14

Warfarin

Back 14

Prevents the regeneration of vitamin K by vitamin K epoxidase; decreases production of II, VII, IX, X C, and S

Hint 14

Prevent progression or recurrence of DVT or PE following initial heparin therapy; prophylaxis in patients w/ hx of MI, prosthetic valves, or chronic Afib

Front 15

Alteplase

Back 15

Fibrin-selective plasminogen activator; specific for plasminogen bound to fibrin

Hint 15

MI; massive PE; acute ischemic stroke (within 3-6h)

Front 16

Streptokinase

Back 16

Activates plasminogen to plasmin, thus promoting fibrinolysis

Hint 16

Clot dissolution in stroke; used more conservatively now

Front 17

Aminocaproic acid

Back 17

Inhibits plasminogen activation

Hint 17

Treatment of fibrinolytic state

Front 18

Aprotinin

Back 18

Blocks the activity of plasmin

Hint 18

Prophylaxis to reduce perioperative blood loss in patients undergoing cardiac bypass surgery

Front 19

Protamine sulfate

Back 19

Sulfate antagonizes the anticoagulant effects of heparin

Hint 19

Bleeding due to heparin

Front 20

Tranexamic acid

Back 20

Inhibits plasminogen activation

Hint 20

Treatment of fibrinolytic state

Front 21

Vitamin K

Back 21

Increases synthesis of clotting factors II, VII, IX, X, and proteins C and S

Hint 21

Bleeding due to warfarin use or deficiency of clotting factors