Pharmacology of Coagulation

  1. Most of the clotting in the body is through what pathway?
  2. What drug, similar to heparan, facilitates action of antithrombin III to inactivate thrombin and factors IXa and Xa? This is a commonly used anticoagulant.
  3. Heparin is used to treat people with what?
  4. 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
  5. What are two other drugs that work by the same mechanism as Heparin?
    • Enoxaparin
    • Fondaparinux
  6. 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)
  7. What is Warfarin used to treat?
    Thromboses -- usually given after initial heparin, as it takes time to work
  8. The main adverse effect of Warfarin is bleeding. What can be used to counteract this?
    Vitamin K
  9. What is Warfarin counterindicated in (Heparin can be used in this situation)?
  10. 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.
  11. What drug is a newly approved orally active drug that binds to thrombin, directly inhibiting it?
  12. What is Lepirudin's main disadvantage?
    It has to be admininstered parenterally, usually IV
  13. What drug is used in the treatment of thrombosis in people with heparin-induced thrombocytopenia? This is an IV drug.
  14. What are two drugs that are similar to Lepirudin in mechanism of action?
    Bivalirudin and Argatroban
  15. What is a major advantage of Dabigatran?
    Blood monitoring is not required with it
  16. 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
  17. This anti-platelet drug irreversibly binds cyclooxygenase, preventing synthesis of thromboxane A2.
  18. This irreversible anti-platelet drug blocks the ADP receptor on platelets, thereby blocking the action of ADP.
  19. This irreversible anti-platelet drug binds the GP IIb/IIIa receptor, and thereby prevents binding of fibrinogen to platelets.
  20. What are the three irreversible anti-platelet drugs?
    • Aspirin
    • Clopidogrel
    • Abciximab
  21. What two drugs bind the GP IIb/IIIa receptor, thereby preventing binding of fibrinogen to platelets, but do so reversibly?
    Eptifibatide and Tirofiban
  22. What reversible anti-platelet drug blocks PDE III, inhibiting platelet aggregation?
  23. What are the three reversible anti-platelet drugs?
    • Eptifibatide
    • Tirofiban
    • Cilostazol
  24. What are the major uses of anti-platelet drugs?
    Prevention of cardiovascular diseases: myocardial infarction, transient ischemia attacks, and stroke
Card Set
Pharmacology of Coagulation
Pharmacology of Coagulation