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22 Cards in this Set
- Front
- Back
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What is the mechanism of action for heparin?
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Accelerates the inactivation of thrombin, and factors IXa Xa by AT II
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What are the therapeutic uses of heparin?
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In Vivo used as an anticoagulant
venous thrombus, pulmonary embolism, IV cannulas Anticoagulant used in pregnancy because it doesnt cross the placenta |
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What effect does heparin have on lipids?
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Lipid clearing effect by activating lipoprotein lipase
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How do you monitor heparin?
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aPTT - monitors common and intrinsic pathway
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What are the adverse effects of heparin?
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bleeding,
thrombocytopenia - type 1 - non immune within 1-2 days - type 2 - immune, more serious, 4-10 days Lepirudin - use in patients with type2 Osteoporosis |
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How do you treat someone with excessive hemorrhaging?
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Plasma and coagulation factors.
Protamine sulfate |
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What are low molecular weight heparins and what are they used for?
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they are fractioned from heparin
Used specifically to enhance ATII inactivation of Xa. (too small to bind to thrombin) |
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What is the indications for low molecular weight heparin?
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deep vein thrombosis, pulmonary embolism, orthopedic use, abdominal series.
unstable angina, non-Q wave MI administer sub-cutaneus anticoagulant of choice for pregnant women |
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What are the percieved advantages of unfractioned heparin?
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longer interval of dosing, slightly increase PTT, does not require monitoring, better predictability, less thrombocytopenia
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What is the mechanism of action for warfarin?
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inhibit synthesis of biologically active K-dependent clotting factors
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What are the Vit K dependent clotting factors?
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factor: II, VII, IX, X
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What are the uses for Warfarin?
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drug of choice for oral anticoagulant, prophylaxis against DVT and PE, used in individuals with prosthetic heart valves. prophylaxis againts arterial thromboembolism in atrial fibrilations,
only effective In Vivo max effect in about a week after administration |
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What do you need to monitor with warfarin?
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extrinsic pathyway - PT
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What is INR?
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(patient PT/normal PT)
goal for INR is 2.0-3.0 prophylaxis for heart valves is 2.5-3.0 |
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What are the adverse reactions with warfarin?
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hemorrhage, maldaptive Vitamin K absorption or metabolism, fibrin, thrombocytopenia
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What are some drug interactions to be aware of with warfarin?
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aspirin and Vit K deficiency, erythromycin and hepatic disease, cephalosporins and thyroid disease, ketoconazole and cimetidine
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What are some drugs that decrease warfarin response?
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cholestyramine, rifampin, oral contraceptives, excess Vit. K
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How do you treat a warfarin overdose?
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whole blood or plasma, Vitamin K
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What are the contraindications of streptokinase?
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surgery of trauma in past 10 days
preextisting bleed Intracranial Trauma Diastolic blood pressure |
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What is anistreplase?
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streptokinase coupled with plasminogen
more specific binding to thrombi |
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What is Alteplase?
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Activates fibrin bound plasminogen more than circulation plasminogen
reperfusion of coronary arteries in acute MI Pulmonary embolism Thrombotic stroke |
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What is Aminocaproic acid?
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inhibits fibrinolysis
lysine analog, competes for plasmin binding site |
