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Anticoagulant Rxs
N/A
34
Medical
Professional
02/26/2010

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Term
Altepase
Definition
Serine protease that activates plasminogen

Poor activator of plasminogen in absence of fibrin-binding

5-10 min T1/2
Term
Aspirin
Definition
Cyclooxygenase inh (permanent in platelets, temp in endothelium)

Prevents Thromboxane A2 activity
Term
Aspirin toxicity
Definition
1. GI ulceration
2. Nephrotox
3. Hepatic inj
4. Airway hyperreactivity in asthma & Reye's
Term
Clopidogrel (Plavix)
Definition
Inh purinergic receptors

Dec inh of adenyl cyclase

Inc cAMP
Term
Clopidogrel adverse effects
Definition
Neutropenia w ticlopidine

Bleeding
Term
Clopidogrel uses
Definition
Better tolerated and administered to pts w ahtersclerotic vascular disease

Used w aspirin in angioplasty and stenting procedures
Term
Dipyridamole
Definition
Phosphodiesterase inh

Inc cAMP, dec plt aggregation

Used in combo w warfarin & aspririn

Expensive
Term
Dipyridamole adverse effects
Definition
angina in CAD pts
Term
Direct acting anticoagulants
Definition
Heparin
LMWH
Term
Epoprostenol
Definition
Prostacyclin analog

Stim adenyl cyclase, inc cAMP
Term
Eptifibitide
Definition
Inh glycoprotein rec IIb/IIIa
Term
Heparin
Definition
Direct-acting anticoagulant rx administered i.v.

Used following cardiac bypass, PE, acute MI, angioplasty, UA

Inc aPTT 1.5-2.5 times
Term
Heparin complications
Definition
1. Bleeding
2. Thrombocytopenia via development of IgG Ab against
Term
Heparin contraindications
Definition
High risk of bleeding
Term
Heparin half-life
Definition
dose dependent
Term
Heparin mechanism
Definition
Accelerates Antithrombin III rxns
Antithrombin III interacts w activated factors IIa, Xa
Term
Indirect-acting anticoagulants
Definition
Wafarin
Term
LMWH mechanism
Definition
Inh Xa
Term
Lepirudin
Definition
Recombinant hirudin structurally identical to natural peptide

*(Hirudin direct thrombin inh from the salivary glds of the medicinal leech
Term
Lepirudin considerations
Definition
Ab to lepirudin may develop
Term
Low Molecular Weight Heparins
Definition
Depolymerized Heparin

Greater bioavailibility and longer half-life after subQ injection

Generally does not require monitoring due to greater therapeutic index
Term
Low Molecular Weight Heparins adverse effects (2)
Definition
bleeding
thrombocytopenia
Term
Prostacyclin analogs
Definition
inc cAMP which inh plt aggregation
Term
Streptokinase
Definition
Thrombolytic therapy that cleaves
plasminogen, producing plasmin

Large loading doses needed

Antibodies may develop cxing allergic rxn

40-80 min half life
Term
Warfain advantage
Definition
oral
Term
Warfarin
Definition
Indirect-acting anticoagulant
Term
Warfarin Rx interactions
Definition
Coadministration w albumin-bound rxs or rxs that affect P450 metabolism can influence plasma conc.
Term
Warfarin contraindications
Definition
1. Pregnancy
2. Uncontrolled EtOH/Rx abuse
3. Unsupervised dementia/psychosis
Term
Warfarin disadvantage
Definition
Time lag
Term
Warfarin effect diminished w (3)
Definition
Cholestyramine
Barbituates
Vit K
Term
Warfarin enhanced w (4)
Definition
1. Chloral hydrate
2. Chloramphenicol
3. Broad-spec abiotics
4. Anabolic steroids
Term
Warfarin hazards
Definition
Bleeding
Teratogenicity
Drug interactions
Term
Warfarin mechanism
Definition
Warfarin blocks vit K epoxide reductase step in cycling of gamma-carboxylation of glutamate residues on clotting factor proteins necessary for Ca binding
Term
Warfarin uses
Definition
Prophylaxis or treatment of:

Venous thrombosis
PE
Cardiac valve replacement

Post MI
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