Term
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Definition
Stage 1- Platelet Plug Formation
Stage 2- Coagulation |
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Term
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Definition
-Platelets adhere to collagen in damaged vessel
-activated-massive aggregation of platelets through granule release of
TXA2 and ADP |
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Term
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Definition
| -fibrin cross linking of platelet formation |
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Term
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Definition
-Vascular injury at site of action
-Growth: Due to platelet adhesion
-Blood flow stops, coagulation takes place, and local tissue injury via loss blood flow |
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Term
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Definition
-vascular injury not evident at site of initiation
-growth due to coagulation**
-source of DVT's*** |
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Term
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Definition
-Prevention of arterial thrombosis
-Prevention of MI
-Prevention of stroke w/hx of TIA
-GPIIb/IIIa antagonists
*unstable angina
*stent intervention |
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Term
| Anti-platelet drugs (ex.s) |
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Definition
COX inhibitors
-aspirin, indometh, ibuprofen,
cAMP modulators
-dipyridamole
ADP receptor antagonist
-clopidogrel
Glycoprotein IIb/IIIa receptor antagonis
-Abciximab |
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Term
| Feedback inhibition of AA Cascade |
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Definition
-PGE and PGD exit platelet and attach to surface receptor
-receptor increases level of cAMP
-Phospholipase to AA is dampened |
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Term
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Definition
-block COX in platelets
-COX 1 predominant form in platelets |
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Term
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Definition
-increases cAMP
-dampens production of AA from Phospholipase A |
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Term
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Definition
-blocks PGI in endothelial cells
-lower PGI lead to decreased cAMP
-therefore AA is increased leading to more aggregation |
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Term
| Anticoagulants: Parenteral |
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Definition
-Heparin drug of choice
-iv or sc admin
-fast acting
-plasma levels highly variable**
-Intensive monitoring required
-CAN be used in pregnancy |
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Term
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Definition
-Warfarin drug of choice
-oral admin, slow onset of activity
-antagonizes vitamin K
-CANNOT be used in pregnancy
-Drug interactions serious concern |
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Term
| Coagulation cascade: Vit. K inhibitors vs. Heparin |
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Definition
Vit K.: Factor VII, IX, X, and prothrombin
Heparin: XIa, IXa, Xa, and thrombin |
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Term
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Definition
-heparin binds to anithrombin
-this complex binds to and inhibits thrombin
-there no aggregation is possible |
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Term
| low MW heparin vs. heparin |
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Definition
-Low MW only cuases destruction of Factor Xa
-Heparin will destroy both thrombin and factor Xa |
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Term
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Definition
-pulmonary embolism
-evolving stroke
-massive deep vein thrombosis
-low dose for post-op venous thrombosis and combo with thrombolytic activity with MI |
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Term
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Definition
-Hemorrhage
-Heparin-induced thrombocytopenia
-Allergy |
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Term
Heparin Antidote?
Warfarin Antidote? |
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Definition
-Protamine inactivates heparin
-Vitamin K reverses effects of coumadin |
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Term
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Definition
-Acute MI
-Atrial Fib
-Pulmonary embolism
-Heart valve disease and replacement |
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Term
| Direct thrombin inhibitor |
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Definition
-bind to freely circulating and clot-bound thrombin
-Lipirudin is parenteral DTI for HITs |
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Term
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Definition
-dissolve existing blood clots
-plasmin degrades fibrin matrix of clots
-most effective: given within 4-6 hours of onset |
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Term
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Definition
-Tissue plasminogen activator
-Converts plasminogen to plasmin only at site of clot |
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Term
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Definition
-derived from bacteria
-forms stable complex with plasminogen
-cheap
-**foreign protein-->can only be used once** |
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Term
| Tissue Plasminogen Activator |
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Definition
-released from endothelial cells
-binds to fibrin and converts plasminogen to plasmin
-CLOT SPECIFIC: site of action is limited, less likely for hemorrhage
-expensive |
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