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Coagulation Management - Updated
Pharm Assessment 14
19
Pharmacology
Graduate
02/26/2012

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Cards

Term
What is the mechanism of Heparin's anticoagulation effect?
Definition
Heparin binds Antithrombin III -> increasing its affinity for clotting factors -> Inactivates Factors
Term
What can occur in patients that are on heparin for 5-10 days?
Definition
Heparin-induced Thrombocytopenia (HIT)

Antibodies form against Heparin-PF4 complex -> activate platelets to form clots -> more PF4 released -> reacts with heparin PF4 complexes on endothelial cells -> destroys endothelial cells
Term
What drug blocks the reactivation of Vitamin K, by binding epoxide reductase?
Definition
Warfarin
Term
What factors require activation by vitamin K?
Definition
II, VII, IX, X, C, S
Term
What can the delayed onset of Warfarin cause?
Definition
increased clotting due to a procoagulant effect
Term
What is the indications for Warfarin use?
Definition
Deep vein thrombosis
Pulmonary embolism
Arterial fibrillation
Rheumatic heart disease
Mechanical and prosthetic heart valves
Term
What are the Direct Thrombin Inhibitors?
Definition
Hirudin
Lepirudin - recombinant hirudin
Argatroban
Melagatran
Term
What is found in the salivary glands of the medical leech?
Definition
Hirudin
Direct Thrombin inhibitor
Term
How do the Direct Thrombin inhibitors work? (Hirudin, Bivalirudin, Argatroban)
Definition
Specific and potent inhibitor of thrombin

Inhibits thrombin-mediated activation of clotting factors (V,VIII, XI, XIII) and platelets
Term
Can Direct Thrombin inhibitors induce immune-mediated thrombocytopenia?
Definition
No!
Term
What Thrombin inhibitors can be administered Subcutaneously?
Definition
Recombinant Hirudins
Argatroban
Term
What anticoagulant drugs are have effect on both circulating and clot-bound thrombin?
Definition
Direct Thrombin Inhibitors

(Hirudins, Bivalirudin, Argatroban
Term
What Direct Thrombin Inhibitors would be appropriate for a patient with Renal disease?
Definition
Argatroban
Term
What is the Acute and Chronic Therapy for Venous Thrombosis?
Definition
Acute - Heparin

Chronic - Warfarin
Term
What is the acute and chronic therapy for TIA, Thrombotic Stroke?
Definition
Acute - Heparin, Aspirin

Chronic - Aspirin, Clopidigrel
Term
Acute and Chronic Therapy
Unstable angina
Definition
Acute - Heparin, Aspirin, GPIIb/IIIa inhibitors

Chronic - Aspirin, Clopidigrel
Term
Acute and Chronic Therapy
Myocardial Infarction
Definition
Acute - Thrombolytic, Heparin, Aspirin

Chronic - Aspirin
Term
Acute and Chronic Therapy
Atrial Fibrillation
Definition
Acute - Heparin

Chronic - Warfarin
Term
Acute and Chronic Therapy
Angioplasty/Stent
Definition
Acute - Heparin, GPIIb/IIIa inhibitors

Chronic - Aspirin, Clopidigrel
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