Anticoagulant Pharmacology Quiz

<p>Heparin-induced thrombocytopenia (HIT) (C)</p> Signup and view all the answers

<p>Osteoporosis (D)</p> Signup and view all the answers

<p>Inhibition of clotting factor synthesis by reducing Vitamin K (C)</p> Signup and view all the answers

<p>Extensively binds to plasma albumin, around 97% (B)</p> Signup and view all the answers

<p>Aspirin displaces Warfarin from plasma proteins, increasing its free fraction (A)</p> Signup and view all the answers

<p>Prophylaxis of venous thromboembolism (C)</p> Signup and view all the answers

<p>36-48 hours (D)</p> Signup and view all the answers

<p>Elevates cytoplasmic cAMP in vascular tissue and platelets. (D)</p> Signup and view all the answers

<p>Dipyridamole (D)</p> Signup and view all the answers

<p>Management of unstable angina prior to PCI. (B)</p> Signup and view all the answers

<p>Bleeding (C)</p> Signup and view all the answers

<p>Protein C (A)</p> Signup and view all the answers

<p>Inhibits the action of coagulation factors. (B)</p> Signup and view all the answers

<p>Intrinsic pathway (D)</p> Signup and view all the answers

<p>Factor VII (C)</p> Signup and view all the answers

<p>Recent myocardial infarction (A)</p> Signup and view all the answers

<p>Facilitate the conversion of Plasminogen to Plasmin (C)</p> Signup and view all the answers

<p>Teratogenic effects (C)</p> Signup and view all the answers

<p>Drug withdrawal or administration of Vit K (B)</p> Signup and view all the answers

<p>In feces (A)</p> Signup and view all the answers

<p>Life-threatening bleeding (B)</p> Signup and view all the answers

<p>20 hours (D)</p> Signup and view all the answers

<p>Dissolve clots by converting Plasminogen to Plasmin (A)</p> Signup and view all the answers

<p>15,000-20,000 (D)</p> Signup and view all the answers

<p>Prophylaxis of post-operative thrombosis (C)</p> Signup and view all the answers

<p>It is administered by SC or IV bolus followed by slow IV infusion. (D)</p> Signup and view all the answers

<p>Forms a complex with ATIII to inactivate Thrombin and factor Xa. (A)</p> Signup and view all the answers

<p>Heparin has a shorter half-life than LMWH. (D)</p> Signup and view all the answers

<p>Activated partial thromboplastin time (aPTT) (A)</p> Signup and view all the answers

<p>It is safe and does not cross the placenta. (B)</p> Signup and view all the answers

<p>LMWHs are given less frequently, once or twice daily, compared to Heparin. (D)</p> Signup and view all the answers

<p>Hemorrhagic stroke (D)</p> Signup and view all the answers

<p>Pregnancy (A)</p> Signup and view all the answers

<p>Inadequate dietary intake (A)</p> Signup and view all the answers

<p>Injection of Phytonadione (B)</p> Signup and view all the answers

<p>Antiplasmin agents (D)</p> Signup and view all the answers

<p>Diabetes insipidus (C)</p> Signup and view all the answers

<p>Renal damage (A)</p> Signup and view all the answers

<p>Overhydration (C)</p> Signup and view all the answers

A serious complication of heparin and LMWHs, where the body develops antibodies against heparin, leading to decreased platelet count and increased risk of blood clots.

Prolonged use of heparin and LMWHs can weaken bones, increasing the risk of fractures.

A condition where the body overreacts to heparin, usually from porcine sources, causing symptoms like chills, fever, skin rash, and even anaphylaxis.

A potentially life-threatening side effect of heparin and LMWHs, where the body has an immune response to heparin, leading to decreased platelet count and increased risk of blood clots.

A condition which occurs when a blood clot forms in a vein or artery, often as a result of decreased platelet count.

Monoclonal antibody used in preventing cardiac ischemic complications during percutaneous coronary intervention (PCI).

Cyclic peptide that also inhibits platelet aggregation and is used in PCI.

Chemical compound that inhibits platelet aggregation, similar to Abciximab and Eptifibatide.

Drugs that block the GP IIb/IIIa receptor on platelets, preventing them from aggregating and forming clots.

Enzyme that breaks down cyclic AMP (cAMP), a molecule involved in blood vessel dilation and platelet inhibition.

Drug that inhibits PDE III, leading to increased cAMP levels, causing vasodilation and reduced platelet aggregation.

Process of blood clotting involving a complex cascade of proteins.

Natural proteins that regulate or inhibit coagulation, preventing excessive clotting.

Warfarin works by inhibiting the production of vitamin K-dependent clotting factors in the liver. These clotting factors include Factors II, VII, IX, and X, which are essential for blood coagulation. The reduction of these factors leads to a decrease in blood clotting activity.

Warfarin is primarily used to prevent and treat Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE). It also plays a role in preventing stroke in patients with atrial fibrillation or those with prosthetic heart valves.

Warfarin is completely absorbed by the body when taken orally. It binds to plasma albumin, a protein in the blood, and is primarily eliminated through the liver. The effects of Warfarin on clotting factors are not immediate, taking 36-48 hours to become noticeable due to the time it takes for the body to break down existing clotting factors.

Some medications can alter Warfarin's effectiveness. CYP-450 inhibitors, like Amiodarone and certain antidepressants, increase Warfarin's anticoagulant activity, making it stronger. Conversely, CYP-450 inducers, like Phenytoin and Carbamazepine, decrease Warfarin's activity, making it less effective.

Aspirin can increase Warfarin's anticoagulant effect by displacing it from plasma proteins, making more free Warfarin available. Additionally, Aspirin inhibits platelet function, further reducing clotting potential.

Heparin is a large, sulfated polysaccharide polymer obtained from porcine intestinal mucosa. It has a molecular weight of 15,000-20,000 and is highly acidic.

Heparin has a short half-life of 1.5 hours. It's administered via subcutaneous (SC) or intravenous (IV) bolus injection, followed by a slow IV infusion. Because it can cause hematomas, intramuscular (IM) administration is avoided.

Low-molecular-weight heparins (LMWHs) like Enoxaparin, Deltaparin, and Tinzaparin have a smaller molecular weight (2000-6000) compared to standard heparin. They exhibit greater bioavailability, a longer duration of action (3-12 hours), and are typically given once or twice daily via subcutaneous (SC) injection.

Heparin and LMWHs exert their anticoagulant effects by binding to antithrombin III (ATIII). This complex then inactivates thrombin (IIa) and factor Xa, preventing the conversion of fibrinogen into fibrin. LMWHs primarily inactivate factor Xa, while heparin inactivates both.

Heparin and LMWHs are used for a range of conditions like acute venous thrombosis (DVT and PE), prevention of postoperative thrombosis, acute myocardial infarction (MI), revascularization, and during angioplasty and stent placement. They are also safe for use during pregnancy.

LMWHs are safe in pregnancy and do not require monitoring. Heparin's activity is monitored by the activated partial thromboplastin time (aPTT) test, aiming for a 1.5-2.5 fold increase compared to the normal control.

Protamine is a basic molecule that can neutralize heparin's anticoagulant activity. It functions as an antidote for heparin overdose or unwanted anticoagulation.

Protamine, a basic molecule, can neutralize the acidic nature of heparin, serving as an antidote for heparin overdose or unwanted anticoagulation.

A medication that hinders the formation of blood clots by inhibiting the activation of clotting factors, particularly factor VII. It requires regular monitoring of its effect via the INR test.

A measure of how long it takes for blood to clot, used to monitor the effectiveness of anticoagulant medications like Warfarin.

A drug that can cause birth defects or harm to the fetus during pregnancy.

A medication that dissolves existing blood clots by activating plasminogen into plasmin, which breaks down fibrin meshwork.

A medication that acts as a protease-activated receptor-1 (PAR-1) antagonist, preventing thrombin-mediated platelet activation, thus reducing the tendency of platelets to form clots.

A medication used to dissolve existing clots and re-open blood flow to the heart or other tissues affected by a clot.

An enzyme that catalyzes the conversion of plasminogen to plasmin, thereby breaking down fibrin clots and promoting reperfusion.

Drugs that dissolve blood clots by activating plasminogen, which breaks down fibrin in clots.

Treatment of acute myocardial infarction (heart attack), acute ischemic stroke (excluding hemorrhagic stroke), deep vein thrombosis (DVT), and pulmonary embolism (PE).

The effectiveness of thrombolytics is limited to the first 2-6 hours after the onset of the clot.

Pregnancy, patients with healing wounds, intracranial bleeding, brain tumor, head trauma, and metastatic cancer.

Vitamin K deficiency, genetic mutations of clotting factors (like Factor VIII and IX), drug-induced effects, and thrombocytopenia (low platelet count).

Phytonadione (vitamin K) is given orally or parenterally.

Desmopressin is a vasopressin V2 receptor agonist that increases plasma concentrations of von Willebrand factor and Factor VIII, used in von Willebrand disease or mild hemophilia A.

Drugs like aminocaproic acid, tranexamic acid, and aprotinin inhibit plasminogen activation, preventing fibrinolysis and managing acute bleeding episodes in hemophilia.