heparin, LMWH, fondaparinux
What are the indirect thrombin inhibitors? (3)
dabigatran, argatroban
What are the direct thrombin inhibitors? (2)
rivaroxaban, apixaban, edoxaban, betrixaban
What are the direct factor Xa inhibitors? (4)
a
Which one doesn't cross-react with HIT antibodies?
a) argatroban
b) dabigatran
a
Which one has a short half-life; requiring continuous IV infusion?
a) argatroban
b) dabigatran
b
Which is the DOAC (oral)?
a) argatroban
b) dabigatran
b
Which has a fixed response/ predictable pk?
a) argatroban
b) dabigatran
b
Which is a prodrug?
a) argatroban
b) dabigatran
reversible/selective inhibitors of free & clot-bound factor Xa; reduce thrombin generation, suppress platelet aggregation and fibrin formation
Oral Direct Factor Xa inhibitors MOA?
d
Which has the least hepatic metabolism; least DDI ?
a) rivaroxaban
b) apixaban
c) edoxaban
d) betrixaban
d
Which has the longest half-life?
a) rivaroxaban
b) apixaban
c) edoxaban
d) betrixaban
competitive inhibitor of vitamin K epoxide reductase complex 1 (VKORC1)
Warfarin MOA?
s-warfarin
Which enantiomer of Warfarin is more active?
R-warfarin
S-warfarin
CYP2C9
Which enzyme metabolizes S-Warfarin?
CYP2C9; VKORC1
30% of Caucasians have a less active form of ________; while 90% Asians
have a less active form of _______ , increasing their sensitivity
c
Which has the longest half-life?
a) reteplase
b) alteplace
c) tenecteplase
c
Which is the most specific to fibrin?
a) reteplase
b) alteplace
c) tenecteplase
a
Which is the cheapest/easiest to produce?
a) reteplase
b) alteplace
c) tenecteplase
b
Which has the shortest half-life?
a) reteplase
b) alteplace
c) tenecteplase
4-5 days
How long does it take to achieve the full anti-thrombotic effect of
Warfarin?
if given alone can cause paradoxical transient hypercoagulable state; heparin drugs because of fast action
Why do we overlap Warfarin?
What drugs do we do it with?
f; only new anticoag factors
Warfarin inhibits old and new coagulation factors. T/F?
d
Where is Warfarin's primary sight of action?
a) kidney
b) blood
c) heart
d) liver
competitive/reversible inhibitors that bind directly to the active site of thrombin; antagonizing its downstream effects; no fibrin clot
Direct Thrombin inhibitors MOA?
a
Which is platelet rich?
a) white thrombi
b) red thrombi
b
Which can result in DVT or PE?
a) white thrombi
b) red thrombi
b
Which is fibrin rich?
a) white thrombi
b) red thrombi
disrupted atherosclerotic plaques
White thrombi is caused by?
slow blood flow in valve cusps of the deep veins of the calf
Where is Red thrombi usually found?
surgery, contraceptives, HRT, venous catheter, trauma, immobilization, pregnancy
What are causes of Venous Thromboembolism (VTE)? (7)