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41 Cards in this Set
- Front
- Back
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Name the 5 categories of antiplatelet drugs
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COX Inhibitor
ADP Receptor Antagonists GP Iib/IIIa Receptor Antagonists Phosphodiesterase Inhibitors Miscellaneous |
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Which coagulation factors are Vitamin K dependent?
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2, 7, 9, 10
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Which coagulation factors are Anti-thrombin III impacted?
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2, 9, 10, 11, 12
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Which drug inhibits the Vitamin-K dependent factors?
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warfarin
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Which drug inhibits the Anti-thrombin III factors?
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heparin
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Aspirin
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Antiplatelet by two mechanisms:
1) ADP Receptor Inhibitor 2) Irreversibly inhibits platelet-released or phoshoplipid-released COX in Arachidonic Acid Pathway low-dose targets thromboxane over prostaglandin in pathway Acetyl-salicylic Acid (ASA) Side effects: GI |
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Anagrelide
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Antiplatelet
Phosphodiesterase Inhibitor=>increased cAMP IV only used for thrombocythemia assoc. with myeloproliferative disorders |
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Cilostazole
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Antiplatelet
Phosphodiesterase Inhibitor=>increased cAMP use for peripheral vascular disease (PVD) |
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Dipyridamole
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Antiplatelet
Phosphodiesterase Inhibitor=>increased cAMP 3rd line—never use alone |
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Clopidogrel
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Antiplatelet
ADP Receptor Antagonist use if allergic to aspirin Plavix irreversible inhibition of platelet binding Indication: prophylaxis of thromboembolic events pro-drug so need functioning liver monitor with liver function test for 3 months |
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Ticlopidine
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Antiplatelet
ADP Receptor Antagonist use if allergic to aspirin irreversible inhibition of platelet binding pro-drug so need functioning liver monitor with liver function test for 3 months |
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Abciximab
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Antiplatelet
GP IIb/IIIa Receptor Antagonist monoclonal AB, so antibodies possible IV recovery in 4 to 48 hours |
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Eptifibatide
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Antiplatelet
GP IIb/IIIa Receptor Antagonist IV recovery in 4 to 48 hours |
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Tirofiban
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Antiplatelet
GP IIb/IIIa Receptor Antagonist IV recovery in 4 to 48 hours |
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Pentoxifyline
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Miscellaneous Antiplatelet Drug
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Name the 4 categories of anticoagulants
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Anti-thrombin III Enhancers
Vitamin K Inhibitors Thrombin Inhibitors Factor Xa Inhibitors |
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Heparin
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Anticoagulant
Anti-thrombin III Enhancer Antagonist: Protamine Sulfate; whole blood of FFP watch Scr/BUN |
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Warfarin
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Anticoagulant
Vitamin K Inhibitor Coumadin Tx of DVT & prophylaxis Antagonist: Vitamin K Don't expect instant change in INR with dose change due to factor 2 having 24 hour half life. Give heparin. |
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Dalteparin
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Anticoagulant
Anti-thrombin III Enhancer Low Molecular Weight Heparin Tx of DVT & prophylaxis for abdominal and hip surgery Antagonist: Protamine Sulfate; whole blood of FFP watch Scr/BUN |
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Enoxaparin
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Anticoagulant
Anti-thrombin III Enhancer Low Molecular Weight Heparin Prophylaxis of DVT for abdominal and hip surgery Antagonist: Protamine Sulfate; whole blood of FFP watch Scr/BUN |
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Tinzaparin
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Anticoagulant
Anti-thrombin III Enhancer Low Molecular Weight Heparin Tx of DVT Antagonist: Protamine Sulfate; whole blood of FFP watch Scr/BUN |
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Argatroban
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Anticoagulant
Thrombin Inhibitor Prophylaxis of DVT in hip surgery short 1/2 life of 2 - 4 hours |
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Bivalirudin
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Anticoagulant
Thrombin Inhibitor Prophylaxis of DVT in hip surgery short 1/2 life of 2 - 4 hours |
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Desirudin
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Anticoagulant
Thrombin Inhibitor short 1/2 life of 2 - 4 hours |
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Lepirudin
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Anticoagulant
Thrombin Inhibitor (Irreversible!) Prophylaxis of DVT in hip surgery short 1/2 life of 2 - 4 hours |
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Fondaparinux
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Anticoagulant
Factor Xa Inhibitor |
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What system is responsible for naturally dissolving clots?
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Fibrinolytic System
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Where do thrombolytics work?
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They activate plasminogen to plasmin that dissolves the fibrin clot to soluble D-dimers
Similar to tissue plasminogen activator (tPA) |
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Alteplase
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Thrombolytic
IV aids in conversion of plasminogen to plasmin which initiates local fibrinolysis (degrades fibrin in clot) side effect: Ab |
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Reteplase
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Thrombolytic
IV aids in conversion of plasminogen to plasmin which initiates local fibrinolysis (degrades fibrin in clot) side effect: Ab |
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Streptokinase
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Thrombolytic
IV aids in conversion of plasminogen to plasmin which initiates local fibrinolysis (degrades fibrin in clot) Derived from bacterial protein--can't use 2 times in 12 month period due to immune response side effect: Ab |
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Tenecteplase
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Thrombolytic
IV aids in conversion of plasminogen to plasmin which initiates local fibrinolysis (degrades fibrin in clot) side effect: Ab |
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Urokinase
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Thrombolytic
IV aids in conversion of plasminogen to plasmin which initiates local fibrinolysis (degrades fibrin in clot) side effect: Ab |
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What category of drug do you use to dissolve a clot?
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Thrombolytic
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Which test do you watch closely with warfarin?
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old=Prothrombin time (PT)
new=International Normalized Ratio (INR) |
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Which tests do you watch closely with heparin?
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Activated Clotting Time (ACT) & Activated Partial Thromboplastin Time (aPTT)
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Which test do you use to evaluate platelet function?
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Bleeding time/Platelet count
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What is the normal and goal values for PT?
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nl = 10 – 13 secs
goal = 15 – 26 |
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What is the normal and goal values for aPTT
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nl = 30 – 50 secs
goal = 50 – 70 |
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What is the normal and goal values for INR?
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nl = 1.0
goal = 2.0 to 3.0 or 2.5 – 3.5 for mechanical valve |
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What are the normal and goal value for ACT?
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nl = 70 – 180 secs
goal = 350 – 500 |
