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Questions and Answers
Which of the following is the mechanism of action for heparin?
Which of the following is the mechanism of action for heparin?
- Interfering with the synthesis of coagulation factors
- Inhibiting the action of coagulation factors
- Binding to thrombin and factor Xa
- Binding to antithrombin III and rapid inactivation of coagulation factors (correct)
What is the source of unfractionated heparin used for commercial purposes?
What is the source of unfractionated heparin used for commercial purposes?
- Dalteparin
- Porcine intestinal mucosa (correct)
- Histamine in mast cells
- Enzymatic depolymerization
Which of the following is a low molecular weight form of heparin?
Which of the following is a low molecular weight form of heparin?
- Heparin
- Warfarin
- Tinzaparin
- Enoxaparin (correct)
Which of the following is NOT a therapeutic use of heparin and LMWHs?
Which of the following is NOT a therapeutic use of heparin and LMWHs?
Which of the following is true about LMWHs?
Which of the following is true about LMWHs?
Which of the following is a potential adverse effect of heparin and LMWH therapy?
Which of the following is a potential adverse effect of heparin and LMWH therapy?
What is the mechanism of action of LMWHs?
What is the mechanism of action of LMWHs?
Which of the following is the primary therapeutic use of urokinase?
Which of the following is the primary therapeutic use of urokinase?
What is the source of therapeutic urokinase?
What is the source of therapeutic urokinase?
What is the mechanism of action of urokinase?
What is the mechanism of action of urokinase?
Which of the following is the standard measure used to monitor the anticoagulant activity of warfarin therapy?
Which of the following is the standard measure used to monitor the anticoagulant activity of warfarin therapy?
What is the goal range for the INR during warfarin therapy for most indications?
What is the goal range for the INR during warfarin therapy for most indications?
What is the mechanism of action of warfarin?
What is the mechanism of action of warfarin?
Which thrombolytic agent has the longest half-life and the greatest binding affinity for fibrin?
Which thrombolytic agent has the longest half-life and the greatest binding affinity for fibrin?
Which thrombolytic agent is NOT approved for the treatment of acute ischemic stroke?
Which thrombolytic agent is NOT approved for the treatment of acute ischemic stroke?
Which thrombolytic agent is contraindicated in patients with a history of intracranial bleeding?
Which thrombolytic agent is contraindicated in patients with a history of intracranial bleeding?
Which thrombolytic agent is derived from culture broths of group C β-hemolytic streptococci?
Which thrombolytic agent is derived from culture broths of group C β-hemolytic streptococci?
Which of the following is the most accurate statement about the anticoagulant effects of warfarin?
Which of the following is the most accurate statement about the anticoagulant effects of warfarin?
Which of the following is NOT a therapeutic use of warfarin?
Which of the following is NOT a therapeutic use of warfarin?
Which of the following is true about the pharmacokinetics of warfarin?
Which of the following is true about the pharmacokinetics of warfarin?
Which of the following is an adverse effect of warfarin therapy?
Which of the following is an adverse effect of warfarin therapy?
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Study Notes
Heparin
- Mechanism of action: binds to antithrombin, enhancing its ability to inactivate thrombin and factor Xa
- Source of unfractionated heparin for commercial purposes: pig intestine or cow lung tissue
- Low molecular weight form of heparin: enoxaparin
- NOT a therapeutic use of heparin and LMWHs: cancer treatment
Low Molecular Weight Heparins (LMWHs)
- Mechanism of action: inhibit factor Xa, preventing thrombin formation
- True about LMWHs: they have a more predictable dosing and pharmacokinetics compared to unfractionated heparin
- Potential adverse effect of heparin and LMWH therapy: bleeding
Urokinase
- Primary therapeutic use: treatment of pulmonary embolism
- Source of therapeutic urokinase: human kidney cell culture
- Mechanism of action: converts plasminogen to plasmin, breaking down fibrin clots
Warfarin
- Mechanism of action: inhibits vitamin K-dependent clotting factors II, VII, IX, and X
- Standard measure used to monitor anticoagulant activity: international normalized ratio (INR)
- Goal range for INR during warfarin therapy for most indications: 2-3
Thrombolytic Agents
- Thrombolytic agent with the longest half-life and greatest binding affinity for fibrin: tenecteplase
- Thrombolytic agent NOT approved for the treatment of acute ischemic stroke: urokinase
- Thrombolytic agent contraindicated in patients with a history of intracranial bleeding: streptokinase
- Thrombolytic agent derived from culture broths of group C β-hemolytic streptococci: streptokinase
Warfarin Pharmacology
- Most accurate statement about the anticoagulant effects of warfarin: it takes several days to reach maximum effect
- NOT a therapeutic use of warfarin: acute coronary syndrome
- True about the pharmacokinetics of warfarin: it has a narrow therapeutic index
- Adverse effect of warfarin therapy: bleeding
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