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11 Cards in this Set
- Front
- Back
Anti-Coagulant Drugs
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Heparin/Enoxaparin
Lepirudin Warfarin/Coumadin Drotrecogin Alpha Dabigatran Etexilate |
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Fibrinolytics
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Streptokinase
Alteplase/Tenecteplase/Reteplase |
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Anti-Platelet Drugs
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Aspirin
Clopidogrel Abciximab |
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Heparin/Enoxaparin
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Heparin MoA: binds to antithrombin and stimulates it to inhibit Factor IXa;
Enoxaparin MoA: selective inhibitor of Factor Xa; Clinical Uses: venous thromboses, pulmonary embolism, unstable angina, acute MI, coronary balloon angioplasty; Toxicity: bleeding, thrombocytopenia, osteoporosis with long treatment |
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Lepirudin
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Recombinant form of leech saliva protein hirudin;
MoA: inhibits soluble thrombin and bound thrombin; Clinical Uses: alternative to heparin in patients with heparin induced thrombocytopenia; Toxicity: bleeding, antibody formation |
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Warfarin/Coumadin
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MoA: inhibits Vit.K epoxide reductase (VKOR) which converts Vit.K epoxide into reduced Vit.K which is needed for the synthesis of Factors II, VII, IX, and X; also inhibits protein C;
RoA: oral, however does not reach CSS until 5 days! AE: bleeding, fetal toxicity, inhibition of protein C can lead to skin and tissue necrosis |
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Drotrecogin Alpha
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Recombinant form of human activated protein C (APC);
MoA: inactivates Factors Va and VIIIa, also interrupts the amplification cycle of inflammation and suppresses TNF-alpha, IL-6, and IL-1B production; Clinical Uses: anti-coagulant, anti-inflammatory effects, septic shock; AE: bleeding |
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Dabigatran Etexilate
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MoA: competitive direct inhibitor of thrombin, preventing the thrombin-mediated conversion of fibrinogen to fibrin;
RoA: oral; fast OoA = 2 hours vs. Warfarin (OoA = 5 days!!); Clinical Uses: prevention of stroke in patients with atrial fibrillation; AE: bleeding |
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Alteplase
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aka: Tenecteplase, Reteplase;
Human recombinant tissue plasminogen activators; MoA: converts plasminogen into plasmin, preferentially activates plasminogen bound to fibrin; RoA: IV; Clinical Uses: MI (w/in 3 hours of onset), pulmonary thromboembolism, ischemic stroke; AE: hemorrhage; CI: any active internal bleeding or hemorrhagic crisis, cerebral vascular lesions, closed head trauma or facial trauma within 3 months, acute pericarditis, recent surgery |
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Clopidogrel
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MoA: irreversibly blocks ADP receptors downregulating GP2b/3a receptors so fibrinogen cannot bind them on the platelet surface;
Clinical Uses: prevention of TIAs and ischemic strokes, used in patients with coronary artery stents; AE: rash, diarrhea, low frequency of GI upsets or bleeding |
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Abciximab
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Humanized monoclonal antibody;
MoA: non-competitively binds to GP2b/3a, inhibiting fibrinogen from binding to them; Clinical uses: coronary stenting procedures, unstable angina |