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Parenteral Anticoagulation
Overview
25
Anthropology
Pre-School
11/28/2013

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Term
Glycosaminoglycan
Definition
found in the secretory granules of mast cells- extracted for porcine intestina mucosa
Term
unfractionated heparin
Definition
enhances activity of antithrombin, no intrinsic activity, binds antithrombin III and catalyzes inactivation of thrombin and factor Xa in a 1:1 ratio
Term
neutralizes heparin by forming an inactive protamine-heparin complex
Definition
Protamine
Term
Used when low clinical probability of DVT or PE assessed; high negative predictive value
Definition
D-Dimer Test
Term
used with large doses of heparin exceeding plasma concentrations of > 1 unit/ml
Definition
activated clotting time (ACT)
Term
used to establish therapeutic aPTT's in institutions or in patients with unreliable aPTTs
Definition
Plasma heparin concentrations
Term
unfractionated heparin AEs
Definition
hemorrhage, osteoporosis, hyperkalemia, hypersensitivity reactions, thrombocytopenia
Term
occurs 5-14 days after initiation of heparin; decrease from baseline by at least 50%, very low platelet counts (<15,000) rare
Definition
HIT Clinical Diagnosis
Term
differs from other hirudins: small synthetic molecule derived from arginine
Definition
Argatroban
Term
Argatroban
Definition
binds only to activate catalytic siste of thrombin; ability to inhibit clot boundd thrombin, eliminated by hydroxylated and aromatization in liver to inactive metabolites
Term
Argatroban monitoring
Definition
aPTT or ACT
Term
Lepirudin monitoring
Definition
aPTT
Term
Bivalrudin monitoring
Definition
aPTT or ACT
Term
Argatroban elimination
Definition
hepatic
Term
Lepirudin elimination
Definition
Renal
Term
Bivalrudin elimination
Definition
Proteolysis and renal
Term
DVT prophylaxis in pts undergoing surgery for hip replacement; does not have an indication for the txt of HIT
Definition
Desirudin (Iprivask)
Term
synthetic active pentasaccharide
Definition
Fondaparinux (Arixtra)
Term
Fondaparinux
Definition
specific pentasaccharide units bind specifically but reversibly to ATIII and selectively inactivates factor Xa
Term
surface receptor for von Willebrand factor and fibrinogen
Definition
GPIIb/IIIa
Term
thrombin and collagen are platelet agonists
Definition
activate GPIIb/IIIa receptors
Term
allows bridging to adjacent platelets
Definition
receptor/fibrinogen complex
Term
chimeric monoclonal antibody (Fab); Irreversibly binds to GPIIb/IIIa receptor
Definition
Abciximab (Reopro)
Term
cyclic peptide inhibitor of fibrinogen binding sites of GPIIb/IIIa
Definition
Eptifibatide (Integrillin)
Term
Tyrosine derivative (non-peptide) inhibitor of GPIIb/IIIa
Definition
Tirofiban (Aggrastat)
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