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30 Cards in this Set
- Front
- Back
Phytonadione represents which Vitamin?
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Vitamin K1
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Is Phytonadione lipid or water soluble
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Lipid soluble
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Where is Phytonadione absorbed?
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proximal small intestine
goes from intestine to the lymphatic system |
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What two things must be present for Phytonadione to be absorbed?
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Bile acids and pancreatic juice
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What type of process is the absorption of Phytonadione?
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Saturable and energy-dependent
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Where is phylloquinone (Phytonadione) concentrated? Where does it not accumulate?
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Concentrated in liver initially (conc declines rapidly)
Very little vit K1 accumulates in tissues |
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Vit K mechanism of action?
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Promotes the maturation of coagulation factors
Factors II, VII, IX, X (Prothrombin) |
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How are residues added to prothrombin in activation of prothrombin precursor?
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Carboxylation of glutamic acid residues of prothrombin
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What is formed after the residues are added to prothrombin in the activation of prothrombin precursor?
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Forms gamma-carboxyglutamate residues
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Formation of gamma-carboxyglutamate residues in activation of prothrombin precursor allows what to happen? What element is required?
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Allows prothrombin, IIa to be localized at negatively-charged phospholipid surfaces
also requires Ca++ |
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Dosage forms of Vit K? (2)
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Oral and parenteral
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Vit K usage (4)
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*Treatment of anticoagulant toxicity
*Hypoptrothrombinemia associate with -Obstructive jaundice -Hepatocellular damage *Prevention of hemmorrhagic disease in newborn |
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Heparin is highly positively or negatively charged?
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Negatively!
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Where is heparin found?
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Secretory granules of mast cells
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LMW heparin is prepared from..?
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unfractionated heparin
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unfractionated heparin is administrated in what form?
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Parenteral
-SQ or IV not absorbed from GI tract because of charge and large size |
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Where is unfractionated heparin metabolized and excreted?
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Metabolized in liver and excreted in the urine
doesn't cross placental or transfer into maternal milk |
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Vit K works through activation of...?
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Prothrombin precursor
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Heparin inhibits blood clotting with ..?
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antithrombin III
-Naturally occuring inhibitor of thrombin IIa -Heparin-antithrombin III complex (Can't access thrombin bound to fibrin clots or to cells) |
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Heparin also release and stablizes .... from tissues
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Lipoprotein
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Lipoprotein lipase hydrolyzes substances bound to ..... cells?
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Lipoprotein lipase hydrolyzes substances bound to capillary endothelial cells
Substances include: triglycerides, chylomicrons, VLDLs to form fatty acids and partial glycerides |
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Heparin is available in what forms? (3)
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IV
SQ Intrapulmonary administration of aerosolized heparin |
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How is heparin monitored?
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APTT
Activated partial thromboplastin time |
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What are the toxicity side effects of heparin? (5)
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1) Hemorrhage - chief danger
2) Osteoporosis and spontaneous fractures 3) Hypersensitivity reactions (chills, fever, urticaria, anaphylactic shock (rare)) 4) Transient alopecia 5) Heparin-induced thrombocytopenia |
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In HIT type I, ..... are targeted for removal from circulation and the ...... count decreases by 50-75%
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antibody coated platelets
platelet count |
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Upon heparin withdrawal in HIT type 1 what happens?
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transient and rapid reverse of thrombocytopenia
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In HIT type 2, ......... induced antibodies not only target platelets for destruction but also act as ........ to ...... the platelets.
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heparin induced antibodies
act as agonists to activate the platelets ..leading to platelet aggregation, endothelial injury, and potentially fatal thrombosis |
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Is there a higher incidence of HIT in patients receiving unfractionated heparin or in LMW heparin?
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Higher incidence of HIT in patients recieving unfractionated heparin
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Antidote for heparin toxicity
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Protamine sulfate
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Contraindications for heparin (5)
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Bleeding tendencies
Threatened abortion Recent brain or cord surgery Renal disease Severe hypertensive disease |