Term
| 5 drugs that treat bleeding |
|
Definition
aminocarpoic acid
factor VIII
factor IX
protamine sulfate
vitamine K |
|
|
Term
|
Definition
| inhibit plasminogen activation and stops bleeding |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| protamine sulfate: origin, composition |
|
Definition
derived from fish sperm testes
high arginine (basic) |
|
|
Term
|
Definition
positive protein interacts with negative heparin antagonizing effects
interacts with platelts and fibrinogen stopping bleeding |
|
|
Term
|
Definition
| interferes with anticoagulant activity of warfarin (response takes 24h) causing bleeding |
|
|
Term
|
Definition
iron
folic acid
cyanocobalamin B12
erythropoietin |
|
|
Term
|
Definition
stops growth
mensturation
pregnancy |
|
|
Term
| tx Fe deficiency 2, what the difference |
|
Definition
ferrous sulfate - oral
ferrous gluconate - oral, less GI upset |
|
|
Term
| 6 causes of folic acid deficency |
|
Definition
increased demand: pregnancy, lactation
SI pathology
alcoholism
dihydrofolate reductase inhibitors: methotrexate, trimethoprim |
|
|
Term
| cause of B12 deficiency 4 |
|
Definition
| diet, poor absorption no intrinsic factor (pernicious anemia), loss of reuptake inhibitos |
|
|
Term
|
Definition
oral or SQ
life long if has pernicious anemia |
|
|
Term
|
Definition
| treat anemia due to end stage renal disease, HIV, cancer |
|
|
Term
| 5 categories of blood thinners |
|
Definition
direct thrombin inhibitors
indirect thrombin inhibitors
platelet aggregation inhibitors
GP IIb/IIIa receptor blockers
thrombolytic drugs - not technically anticoagulants |
|
|
Term
| 4 indirect thrombin inhibitors |
|
Definition
heparin
enoxaprin
warfarin
rivaroxban |
|
|
Term
| 2 direct thrombin inhibitors |
|
Definition
|
|
Term
| 6 platelet aggregation inhibitors |
|
Definition
aspirin
copidogrel
parsugrel
ticagrelor
cilostazol
dipyridamole |
|
|
Term
| 3 GP IIb/IIIa receptor blockers |
|
Definition
triofiban
efitfibatide
aciximab |
|
|
Term
|
Definition
streptokinase
urokinase
antistreplase
altelpase (t-PA) |
|
|
Term
| where does heparin come from |
|
Definition
| hg intestinal mucosa or beef tongue |
|
|
Term
|
Definition
glycoasmine and hucoronic / iduronic acid
acetylated/sulfated lucosamine
unsulfated hydroxyl groups |
|
|
Term
|
Definition
| arginine binds lysing on serine protease anti-thrombin III (a clotting inhibitor) |
|
|
Term
| what does high dose heparin inhibit 4 |
|
Definition
|
|
Term
| what does low dose heparin inhibit |
|
Definition
|
|
Term
| what does chronic or intermittent dose heparin inhibit |
|
Definition
reduces AT-III activity
increasing thrombosis |
|
|
Term
|
Definition
IV administration: binds proteins causing hematoma
increased half life in kidney or liver failure
hemorrhage: monitor bleeding time
thrombocytopenia: after 8d therapy can develop anti-platelet antibodies |
|
|
Term
| signs of heparin hypersensitivity 4 |
|
Definition
chills
fever
prophylaxis
uticaria
anaphylaxis |
|
|
Term
| contrindications of heparin 5 |
|
Definition
bleeding disorders
alcoholids
hypersensitivity
surgery to brin, eye, spinal cord
does not cross placenta but shows 13-20% still birth in last trimester |
|
|
Term
|
Definition
deep SC or IV
short term use (days)
acute anticoagulation: IV volus then continous influsion |
|
|
Term
| where is heparin metabolized |
|
Definition
| reticuloendothelial system (liver cirrhosis and kidney failure increase t1/2) |
|
|
Term
|
Definition
DVT
pulmonary embolism
acut eMI
aurgical prophylaxis
dialysis prophylaxis
DOC: pregnancy women with prosthetic valve or venothromboembolism |
|
|
Term
|
Definition
low molecular weight heparin
longer anticoagulation |
|
|
Term
| explain the reactions and clotting factors used in clotting with vitamin K |
|
Definition
(factors II, VII, IX, X: glutamic acid) + (VitK) + (vitamin L epoxide reductase) + (CO2 carboxylation) -->
(factors II, ViI, ix, I: glytamic-COOH/carbodyglutamicA) + (epoxide) -->
binds Ca and causes cell membranes to stick for clotting |
|
|
Term
|
Definition
| blocks vit K epoxide reductase and cofactors for clotting are not activated |
|
|
Term
|
Definition
| hemorrhage: monitor clotting time |
|
|
Term
| what substances increase activity of warfarin 5 |
|
Definition
chronic alcohol
barbituates
gluthemide
grisofulvin
rifampin |
|
|
Term
| what substances decrease activity of warfarin 8 |
|
Definition
acute alcohol
cimetidine
chloramphenicol
cortimoxazole
disulfiram
metronidazole
phenylbutazone
aspirin - not directly |
|
|
Term
| what 2 health conditions are contraindicated with warfarin |
|
Definition
hepatic disease
vitamin K dericiency
augment response |
|
|
Term
| administration o warfarin 2 |
|
Definition
|
|
Term
| how is warfarin distributed |
|
Definition
99% bound to albumin
prevents spread to CSF, placenta, milk |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| anticoagulation perdictable and does not require clotting monitoring |
|
|
Term
| administration rivaroxban |
|
Definition
|
|
Term
|
Definition
| recombinate from leech saliva made in yeast |
|
|
Term
|
Definition
irreversible thrombin antagonist
1 lepirudin: 1 thrombin |
|
|
Term
|
Definition
|
|
Term
|
Definition
| reversible thrombin antagonist |
|
|
Term
|
Definition
|
|
Term
|
Definition
venous thrombosis
artial fibrillation |
|
|
Term
|
Definition
| irreversibly block thromboxane A2 synthesis from arachadonic acid in platelets |
|
|
Term
|
Definition
prolonged bleeding
hemorrhagic stroke
GI bleeds |
|
|
Term
| metabolism of aspiring timing |
|
Definition
| effects life span of plate ets 7-10d |
|
|
Term
|
Definition
| prophylaxis of stroke, MI, infarcts |
|
|
Term
|
Definition
| selective inhibitor of ADP binding to platelet receptor (synergistic to aspirin |
|
|
Term
|
Definition
| prophylaxis: stroke, MI, post-MI infarcts |
|
|
Term
|
Definition
| inhibit ADP pathway involved in fibrinogen and platelet binding (prodrug) |
|
|
Term
|
Definition
| platelet inhibition of ADP induced platelet aggregation |
|
|
Term
|
Definition
| fastest onset of platelet aggregation inhibitors |
|
|
Term
|
Definition
| inhibit ADP pathway in fibrinogen and platelet aggregation and vasodilation |
|
|
Term
|
Definition
increased HR
ventricular tachycardia |
|
|
Term
| administration cilostazol |
|
Definition
| co-administration with aspirin 23-33% inhibition of AD{ |
|
|
Term
|
Definition
| intermittent claduication |
|
|
Term
|
Definition
| increased cAMP inhibiting cyclic neculotide phosphodiesterase in platelets |
|
|
Term
| administration of dipyridamole 2 |
|
Definition
within warfarin: inhibits embolism from prosthetic valves
with aspirin: mild increase in aspirin effects |
|
|
Term
|
Definition
increase effects of aspirin
prophylaxis: embolization from prosthetic valves (with warfarin) |
|
|
Term
|
Definition
| mimic arginine-glycine-aspartic acid on fibrinogen |
|
|
Term
|
Definition
| IV adjunct to percutaneous coronary intervention |
|
|
Term
|
Definition
| prophylaxis: cardiac ischemia complications |
|
|
Term
|
Definition
|
|
Term
| administration efitfibatide 2 |
|
Definition
usually with aspirin and heparin
IV adjunct to percutaneous coronary intervention |
|
|
Term
| how long does efitfibatide last |
|
Definition
| platelet function returns in 6-12h |
|
|
Term
|
Definition
| prophylaxis: cardiac ischemia complication |
|
|
Term
|
Definition
| monoclonal Ab aginst receptor blocks fibrinogen binding |
|
|
Term
|
Definition
| IV adjunct to percutaneous intrvention |
|
|
Term
|
Definition
| platelet function returns in 24-48h |
|
|
Term
|
Definition
| prophylaxis: cardiac ischemia complications |
|
|
Term
|
Definition
activates plasmin which breaks down fibrin
degrades fibrinogen factors V and VII |
|
|
Term
|
Definition
increased plasmin may cause bleeding by dissolving platelet plugs
hypersensitivity to BCS |
|
|
Term
| signs of streptokinase hypersensitivity 3 |
|
Definition
|
|
Term
| streptokinase administration |
|
Definition
must give enough to overwhelm antibodies to avoid hypersensitivity
give within 4h of MI then infuse for 1h |
|
|
Term
|
Definition
|
|
Term
|
Definition
DVT
pulmonary embolism
MI
peripherial arterial
thrombosis/emboli
unclotting cathetcs and shunts |
|
|
Term
|
Definition
| human cultures of fetal renal cells |
|
|
Term
|
Definition
| enzyme degrades fibrinenzyme degrades fibrin |
|
|
Term
|
Definition
|
|
Term
|
Definition
| only use when pr is sensitive to streptokinase |
|
|
Term
|
Definition
streptokinase and noncovalent 1:21 complex plasminogen
acetylates catalytic site of plasminogen so its inactive until fibrin binds |
|
|
Term
|
Definition
|
|
Term
| metabolism of antistreplase |
|
Definition
de-acetylation lengths thrombolytic effect after IV injection
t1/2 90min |
|
|
Term
|
Definition
DVT
pulmonary embolism
MI
peripherial arterial
thrombosis/emboli
unclotting cathetcs and shunts |
|
|
Term
|
Definition
| low affinity for plasminogen but rapidly binds plasminogen bound to fibrin in thrombus (fibrin selective at low dose) |
|
|
Term
|
Definition
|
|
Term
|
Definition
DVT
pulmonary embolism
MI
peripherial arterial
thrombosis/emboli
unclotting cathetcs and shunts
DOC for older clots |
|
|
