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Most of the clotting in the body is through what pathway?
Extrinsic
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What drug, similar to heparan, facilitates action of antithrombin III to inactivate thrombin and factors IXa and Xa? This is a commonly used anticoagulant.
Heparin
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Heparin is used to treat people with what?
Thromboses
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The primary adverse effect of Heparin is bleeding. What can be used to counteract this? What other adverse effect can Heparin induce?
- Protamine Sulfate
- Thrombocytopenia
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What are two other drugs that work by the same mechanism as Heparin?
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This drug is an orally active anticoagulant that prevents synthesis of clotting factors that require vitamin K. It inhibits vitamin K epoxide reductase, thereby preventing synthesis of prothrombin, protein C, and factors VII, IX, and X.
Warfarin (Coumadin)
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What is Warfarin used to treat?
Thromboses -- usually given after initial heparin, as it takes time to work
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The main adverse effect of Warfarin is bleeding. What can be used to counteract this?
Vitamin K
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What is Warfarin counterindicated in (Heparin can be used in this situation)?
Pregnancy
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What drug is a recombinant form of hirudin (the active ingredient in leech spit) that binds to thrombin, directly inhibiting its action? This is used in the treatment of thrombosis in people with heparin-induced thrombocytopenia.
Lepirudin
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What drug is a newly approved orally active drug that binds to thrombin, directly inhibiting it?
Dabigatran
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What is Lepirudin's main disadvantage?
It has to be admininstered parenterally, usually IV
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What drug is used in the treatment of thrombosis in people with heparin-induced thrombocytopenia? This is an IV drug.
Lepirudin
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What are two drugs that are similar to Lepirudin in mechanism of action?
Bivalirudin and Argatroban
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What is a major advantage of Dabigatran?
Blood monitoring is not required with it
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What two drugs facilitate the formation of plasmin from plasminogen, dissolving fibrin? These are fibrinolytic, and enhance the formation of plasmin. How are these administered?
- Streptokinase and Alteplase
- IV or Intra-arterially
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This anti-platelet drug irreversibly binds cyclooxygenase, preventing synthesis of thromboxane A2.
Aspirin
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This irreversible anti-platelet drug blocks the ADP receptor on platelets, thereby blocking the action of ADP.
Clopidogrel
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This irreversible anti-platelet drug binds the GP IIb/IIIa receptor, and thereby prevents binding of fibrinogen to platelets.
Abciximab
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What are the three irreversible anti-platelet drugs?
- Aspirin
- Clopidogrel
- Abciximab
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What two drugs bind the GP IIb/IIIa receptor, thereby preventing binding of fibrinogen to platelets, but do so reversibly?
Eptifibatide and Tirofiban
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What reversible anti-platelet drug blocks PDE III, inhibiting platelet aggregation?
Cilostazol
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What are the three reversible anti-platelet drugs?
- Eptifibatide
- Tirofiban
- Cilostazol
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What are the major uses of anti-platelet drugs?
Prevention of cardiovascular diseases: myocardial infarction, transient ischemia attacks, and stroke
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