Hosam Mohamed-
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)
