Term
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Definition
Class: antiplatelet
Mechanism: inhibition of cyclooxygenase; prevents formation of thromboxanes/prostacyclins/prostaglandins
Indications: 1* prevention of CVD events (stroke, TIA, acute/recurrent MI, unstable angina, and chronic angina)
Contraindications: allergy or <19y/o (Reye's syndrome)
Adverse effects: long-term use in high dosease can lead to GI ulceration, nephrotoxicity, and hepatic injury |
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Term
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Definition
Class: antiplatelet
Mechanism: inhibit phosphodiesterase and/or inhibit adenosine uptake, prevent cAMP breakdown or increase cAMP conc., decreases platelet activation and aggregation
Indications: reduce risk of storke in pt w/ transient ischemia of brain or complete ischemic stroke due to thrombosis; intermittent claudication in PVD
Contraindications: heart failure of any severity, allergy, <19y/o
Adverse effects: headache
Admin: oral, w/ aspirin therapy |
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Term
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Definition
Class: antiplatelet
Mechanism: inhibit fibrinogen receptor; inhibits cross-linking of platelets
Indication: acute coronary syndrome, includes stenting or angioplasty pt, PCI
Contraindications: abnormal bleeding <30d prior, severe HTN, major surgery <6mo prior, stroke <30d prior, renal dysfx
Adverse effects: BLEEDING
Admin: IV w/ aspirin, short half life 4-24hrs |
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Term
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Definition
Class: antiplatelet
Mechanism: inhibit fibrinogen receptor; inhibits cross-linking of platelets
Indication: acute coronary syndrome, includes stenting and angioplasty pt, PCI
Contraindications: abnormal bleedind, severe HTN, major surgery recent, stroke recent
Adverse effects: BLEEDING
Admin: IV w/ aspirin, short half-life 4-24hrs |
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Term
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Definition
Class: antiplatelet
Mechanism: inhibition of P2Y (ADP) receptor, increase cAMP, prevents platelet aggregation
Indication: prevent MI or stroke in pt who cannot tolerate aspirin (or have failed on aspirin); adjunct to prevent angioplasty or stenting thrombosis; BETTER FOR ATHERSOCLEROTIC VASCULAR DISEASE
Contraindication: active bleeding, coronary artery bypass graft surgery, prior TIA or stroke
Adverse effects: BLEEDING, neutropenia/granulocytosis, CYP2C19 variability, GI disturbances, dyspnea |
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Term
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Definition
Class: antiplatelet
Mechanism: inhibition of P2Y (ADP) receptor, increase cAMP, prevent platelet aggregation
Indications: prevent MI or stroke in pt who cannot tolerate/failed asprin therapy; adjunct to prevent angioplasty/stenting thrombosis
Contraindications: bleeding, CABG, prior TIA or stroke
Adverse effects: BLEEDING, neutropenia/agranulocytosis, GI disturbances, dyspnea |
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Term
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Definition
Class: antiplatelet, anticoag, hirudin
Mechanism: inhibit thrombin by binding directly to active site of the enzymatic portion; increase aPTT, increase ecarin clotting time assay
Indication: Heparin-induced thrombocytopenia, percutaneous coronary intervention for patients at high risk of HIT, unstable angina/non STEMI, prophylactic admin to prevent postop venous thromboembolism (hip and knee replacements)
Contraindications: MAJOR OVERT BLEEDING
Adverse effects: BLEEDING W/ NO KNOWN ANTIDOTE |
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Term
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Definition
Class: antiplatelet, anticoag, hirudin
Mechanism: inihibit thrombin by binding directly to active site of enzymatic part, increase aPTT, increase ecarin clotting time assay
Indication: prophylactic admin for prevention of postop thromboembolism (hip/knee replacement), stroke prevention in pt w/ non-valvular Afib
Contraindication: MAJOR OVERT BLEEDING
Adverse effects: BLEEDING W/ NO KNOWN ANTIDOTE |
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Term
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Definition
Class: anti-coag
Mechanism: irreversible inactivate thrombin and several other coag factors (esp. Xa); accelerates antithrombin III to inactivate thrombin and Xa
Indications: high or low doses (see separate flash cards)
Contraindication: high risk bleeding, requires close monitoring, previous incidence of HIT
Adverse effects: bleeding, thrombocytopenia |
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Term
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Definition
Class: anti-coag
Mechanism: irreversible inactivate thrombin and several other coag factors (esp. Xa); accelerates antithrombin III to inactivate thrombin and Xa
Indications: prophylaxis of DVT for hip/knee replacement/abdominal surgery/bariatric surgery
Contraindication: high risk bleeding, requires close monitoring, previous incidence of HIT
Adverse effects: bleeding, thrombocytopenia |
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Term
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Definition
Class: anti-coag; heparin antagonist
Mechanism: forms stable complex with heaprin through electrostatic interactions
Indication: heparin-induced thrombocytopenia
Contraindication: fondaparinux overdose |
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Term
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Definition
Class: anti-coag
Mechanism: inhibits platelet activation and fibrin clot formation via direct-selective-reversible inhibition of Xa; decreased conversion of prothrombin to thrombin, decrease conversion fibrinogen to fibrin
Indication: DVT, PE, prophylactic for postop venous thromboembolism, nonvalvular Afib
Contraindication: bleeding
Adverse effect: bleeding |
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Term
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Definition
Class: anti-coag
Mechanism: interferes with normal post-translational modification of clotting factor in liver [inhibit synthesis of factors II, VII, IX, and X]
Indication: prophylaxis or treatment; DVT, PE, systemic embolization (acute MI, prosthetic heart valve, chronic Afib), after MI to reduce death/recurrent MI/thromboembolic events
Contraindication: bleeding, PREGNANCY (hemorrhage and teratogen)
Drug interaction: albumin-bound drugs or P450 metabolic drugs influences plasma concentrations
Adverse effects: overdose (reverse w/ vit k), hemorrhage, Warfarin necrosis (initial decrease in anti-coag factor before decrease in coag factors)
Pharmacokinetics:
Distrubtion: >99% ppb to albumin
Metabolism: hepatic P450 system |
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Term
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Definition
Class: anti-coag
Mechanism: helps to properly modify factors II, VII, IX, and X
Indication: warfarin overdose |
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Term
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Definition
Class: thrombolytic, tissue plasminogen activator
Mechanism: dissolve existing clots; binds fresh thrombus, conformational change, activates plasminogen to plasmin
Indications: MI, acute stroke, acute PE
Contraindications: suspicion of intracranial or intraspinal hemorrhage (confirm by head CT/MRI), current use of oral anticoags, recent heparin tx
Adverse effects: massive fibrinolysis, bleeding, esp. cerebral hemorrhage |
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Term
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Definition
Class: anti-thrombolytic
Mechanism: derivative/analog of amino acid lysine; effective inhibitor for plasmin
Indication: tx overdose/toxic effects of streptokinase and alteprase |
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Term
| selective COX-2 inhibitors |
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Definition
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Term
| high dose heparin indications |
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Definition
DVT
pulmonary embolism
acute arterial occlusion (i.e. acute MI)
prevention of thromboses (not stroke or TIA)
srugery with extracorporeal circulation
hemodialysis
maintenance of open venous catheters |
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Term
| low dose heparin indications |
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Definition
prophylaxis of DVT
prophylaxis of pulmonary embolism
venous thromboembolism |
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