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Platelet ADP Receptor Blockers Quiz
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Platelet ADP Receptor Blockers Quiz

Created by
@CleanlyBoston

Questions and Answers

What is the mechanism of action for Abciximab?

  • It causes vasodilation by increasing cGMP.
  • It prevents the uptake of adenosine into platelets.
  • It enhances platelet aggregation by inhibiting PDE.
  • It binds to gpIIb/IIIa and blocks platelet binding to fibrinogen. (correct)

    • Which drug is primarily used for prophylaxis in patients with prosthetic heart valves?

  • Tirofiban
  • Abciximab
  • Eptifibatide
  • Dipyidamole (correct)

    • What is a common condition associated with the absence of the gpIIb/IIIa receptor?

  • Von Willebrand disease
  • Hemophilia
  • Glanzmann's thrombasthenia (correct)
  • Thrombocytopenia

    • Which statement correctly describes the action of dipyridamole?

    <p>It inhibits phosphodiesterase, leading to an increase in cGMP and vasodilation.</p> Signup and view all the answers

    Eptifibatide works by which of the following mechanisms?

    <p>It competitively blocks the gpIIb/IIIa receptor.</p> Signup and view all the answers

    Tirofiban is classified as which type of drug?

    <p>A low molecular weight peptide</p> Signup and view all the answers

    What is a limitation of using dipyridamole as an antithrombotic agent?

    <p>Its use is limited to prophylaxis combined with warfarin.</p> Signup and view all the answers

    Which drug can lead to extracellular accumulation of adenosine and prolonged action due to inhibition of uptake in red blood cells?

    <p>Dipyidamole</p> Signup and view all the answers

    What is the primary mechanism by which blockers of platelet ADP receptors exert their effects?

    <p>They irreversibly inhibit the binding of ADP to its receptors on platelets.</p> Signup and view all the answers

    Which of the following drugs is specifically mentioned as having a lower incidence of serious adverse effects compared to another drug?

    <p>Clopidogrel</p> Signup and view all the answers

    What condition can result from genetic deficiencies in enzymes that metabolize clopidogrel?

    <p>Poor therapeutic response to clopidogrel</p> Signup and view all the answers

    Which glycoprotein receptor is involved in the final common pathway for platelet aggregation?

    <p>Glycoprotein IIb/IIIa</p> Signup and view all the answers

    Which agent is specifically indicated for the treatment of hemophilia A?

    <p>Antihemophilic globulin</p> Signup and view all the answers

    What is the approved maintenance dose of clopidogrel for prophylaxis of thrombosis?

    <p>75 mg daily</p> Signup and view all the answers

    What is the primary role of Vitamin K in the body?

    <p>To facilitate clotting factor synthesis</p> Signup and view all the answers

    Why has ticlopidine been largely replaced by clopidogrel in clinical practice?

    <p>Ticlopidine has a higher incidence of serious adverse effects.</p> Signup and view all the answers

    Which of the following factors requires bile salts for absorption?

    <p>Vitamin K1</p> Signup and view all the answers

    What is the role of glycoprotein IIb/IIIa receptor antagonists?

    <p>To prevent platelet aggregation by blocking the final common pathway.</p> Signup and view all the answers

    Which of the following statements best describes clopidogrel's mechanism of action?

    <p>Clopidogrel acts as a prodrug that requires metabolic activation.</p> Signup and view all the answers

    What is one of the local methods to control bleeding?

    <p>Application of thrombin powder</p> Signup and view all the answers

    What is the main action of aminocaproic acid and tranexamic acid?

    <p>Inhibit the fibrinolytic system</p> Signup and view all the answers

    Which of the following agents is classified as a sclerosing agent?

    <p>Ethanolamine oleate</p> Signup and view all the answers

    What is the therapeutic use of Vitamin K?

    <p>To reverse warfarin overdose</p> Signup and view all the answers

    Which vitamin is synthesized by intestinal bacteria?

    <p>Vitamin K2</p> Signup and view all the answers

    What is a key reason for preferring recombinant preparations of plasma fractions over traditional ones?

    <p>They carry a lower risk of infection.</p> Signup and view all the answers

    Which agent is considered a more potent analogue of aminocaproic acid?

    <p>Tranexamic acid</p> Signup and view all the answers

    For which condition is aminocaproic acid primarily recommended as a treatment?

    <p>To prevent bleeding during certain surgeries.</p> Signup and view all the answers

    In what situation is tranexamic acid used as adjunctive therapy?

    <p>For patients with hemophilia.</p> Signup and view all the answers

    What is one indication for the prophylaxis of rebleeding with aminocaproic acid?

    <p>Intracranial aneurysm.</p> Signup and view all the answers

    What therapeutic use does aminocaproic acid NOT serve?

    <p>Treating infections.</p> Signup and view all the answers

    What is the purpose of administering vitamin K to newborns?

    <p>To prevent hypothrombinemia</p> Signup and view all the answers

    Which condition is associated with a bleeding tendency that does not respond to vitamin K?

    <p>Severe hepatic failure</p> Signup and view all the answers

    What can occur if factor activity is less than 5–10% of normal?

    <p>Spontaneous bleeding</p> Signup and view all the answers

    Which coagulation defect is associated with factor VIII deficiency?

    <p>Hemophilia A</p> Signup and view all the answers

    What is the mode of administration for plasma protein preparations used in treating coagulation defects?

    <p>Intravenous administration</p> Signup and view all the answers

    What adverse effects can rapid intravenous administration of parenteral vitamin K1 cause?

    <p>Chest pain and dyspnea</p> Signup and view all the answers

    What type of vitamin K is usually administered to correct deficiencies due to dietary issues?

    <p>Parenteral vitamin K1</p> Signup and view all the answers

    What is the typical dose of vitamin K recommended for newborns after birth?

    <p>1–2 mg</p> Signup and view all the answers

    Vitamin K is administered to all newborns to prevent hypoketosis.

    <p>False</p> Signup and view all the answers

    Severe hepatic failure can lead to a bleeding tendency that does not respond to vitamin K due to reduced synthesis of clotting factors.

    <p>True</p> Signup and view all the answers

    Plasma coagulation factors can cause spontaneous bleeding if their activity exceeds 15% of normal levels.

    <p>False</p> Signup and view all the answers

    Parenteral vitamin K1 is insoluble in water and must be dissolved in oil for administration.

    <p>True</p> Signup and view all the answers

    Factor IX deficiency is also known as Christmas disease.

    <p>True</p> Signup and view all the answers

    The recommended dose of vitamin K for newborns is 2–3 mg after birth.

    <p>False</p> Signup and view all the answers

    Rapid intravenous administration of parenteral vitamin K1 can cause chest pain and dyspnea.

    <p>True</p> Signup and view all the answers

    Hemophilia A is characterized by a deficiency of factor X.

    <p>False</p> Signup and view all the answers

    Plasma fractions are commonly prepared from blood pooled from multiple individuals, thus they are associated with a high risk of exposure to infections such as hepatitis and HIV.

    <p>True</p> Signup and view all the answers

    Tranexamic acid is a less potent analogue of aminocaproic acid.

    <p>False</p> Signup and view all the answers

    Aminocaproic acid is utilized as adjunctive therapy in conditions involving excessive fibrinolysis.

    <p>True</p> Signup and view all the answers

    The primary therapeutic use of aminocaproic acid includes the prevention of bleeding from tissues that lack plasminogen activators.

    <p>False</p> Signup and view all the answers

    Prophylaxis for rebleeding from an intracranial aneurysm is a therapeutic use for tranexamic acid.

    <p>True</p> Signup and view all the answers

    Patients lacking the gpIIb/IIIa receptor may have Glanzmann's thrombasthenia.

    <p>True</p> Signup and view all the answers

    Aminocaproic acid should never be used in cases where there is a risk of bleeding due to toxicity from antifibrinolytic drugs.

    <p>False</p> Signup and view all the answers

    Abciximab is a small synthetic peptide that blocks the binding of platelets to fibrinogen.

    <p>False</p> Signup and view all the answers

    Dipyridamole works by inhibiting phosphodiesterase, leading to increased cGMP levels and vasodilation.

    <p>True</p> Signup and view all the answers

    Eptifibatide and tirofiban are both classified as low molecular weight peptides.

    <p>False</p> Signup and view all the answers

    Tirofiban is primarily used to treat patients with hemophilia A.

    <p>False</p> Signup and view all the answers

    The use of dipyridamole is limited to prophylaxis in patients with prosthetic heart valves.

    <p>True</p> Signup and view all the answers

    Eptifibatide binds to the gpIIb/IIIa receptor and enhances platelet activation.

    <p>False</p> Signup and view all the answers

    Dipyridamole's action results in the accumulation of adenosine in platelets and RBCs.

    <p>True</p> Signup and view all the answers

    Vitamin K is essential for the synthesis of factors II, VII, IX, and Y by the liver.

    <p>False</p> Signup and view all the answers

    Aminocaproic acid and tranexamic acid are inhibitors of the hemostatic system.

    <p>False</p> Signup and view all the answers

    Vitamin K2 is synthesized by liver cells in the human body.

    <p>False</p> Signup and view all the answers

    Fresh blood or plasma transfusions serve as sources of coagulation factors.

    <p>True</p> Signup and view all the answers

    Ethamsylate is administered orally to reduce capillary bleeding.

    <p>False</p> Signup and view all the answers

    Thromboplastin is a form of vitamin K necessary for blood coagulation.

    <p>False</p> Signup and view all the answers

    Calcium acts as a coagulant factor and is identified as factor IV.

    <p>True</p> Signup and view all the answers

    Vitamin C is critical for the absorption of vitamin K in the intestine.

    <p>False</p> Signup and view all the answers

    Ticlopidine and clopidogrel both irreversibly inhibit the binding of ADP to its receptors on platelets.

    <p>True</p> Signup and view all the answers

    Clopidogrel is a prodrug that relies on its inactive metabolite for therapeutic efficacy.

    <p>False</p> Signup and view all the answers

    People with genetic deficiencies in the enzymes that metabolize clopidogrel are referred to as poor metabolizers.

    <p>True</p> Signup and view all the answers

    Activation of glycoprotein IIb/IIIa receptors is not essential for platelet aggregation.

    <p>False</p> Signup and view all the answers

    Clopidogrel and ticlopidine have the same incidence of serious adverse effects.

    <p>False</p> Signup and view all the answers

    Eptifibatide is a type of drug that blocks platelet ADP receptors.

    <p>False</p> Signup and view all the answers

    Clopidogrel is approved for prophylaxis of thromboembolism in both cerebrovascular and cardiovascular diseases.

    <p>True</p> Signup and view all the answers

    The maintenance dose of clopidogrel is 75 mg/d orally.

    <p>True</p> Signup and view all the answers

    What distinguishes clopidogrel from ticlopidine in terms of adverse effects?

    <p>Clopidogrel has a lower incidence of serious adverse effects, such as neutropenia and bleeding, compared to ticlopidine.</p> Signup and view all the answers

    Which drug is considered a prodrug that requires metabolic activation to exert its therapeutic effects?

    <p>Clopidogrel is the prodrug that requires metabolic activation.</p> Signup and view all the answers

    What is the primary mechanism by which blockers of glycoprotein IIb/IIIa receptors facilitate their antithrombotic effect?

    <p>They inhibit the final common pathway for platelet aggregation by blocking the receptor complex.</p> Signup and view all the answers

    Explain the genetic variability associated with clopidogrel metabolism.

    <p>Some individuals have genetic deficiencies leading to poor metabolism of clopidogrel, making them 'poor metabolizers.'</p> Signup and view all the answers

    Identify a key reason why ticlopidine is not preferred in current clinical practice.

    <p>Ticlopidine is not preferred due to its serious adverse effects like neutropenia.</p> Signup and view all the answers

    What common vascular diseases is clopidogrel approved to prevent through thrombosis prophylaxis?

    <p>Clopidogrel is approved for prophylaxis in coronary artery disease and peripheral vascular disease.</p> Signup and view all the answers

    How do blockers of platelet ADP receptors influence platelet activation?

    <p>They irreversibly inhibit the binding of ADP to its receptors on platelets.</p> Signup and view all the answers

    What is the maintenance dose of clopidogrel for adults?

    <p>The maintenance dose of clopidogrel is 75 mg per day orally.</p> Signup and view all the answers

    What is Glanzmann's thrombasthenia caused by?

    <p>It is caused by a deficiency of the gpIIb/IIIa receptor.</p> Signup and view all the answers

    What is the primary therapeutic use of dipyridamole?

    <p>It is primarily used for prophylaxis in patients with prosthetic mechanical heart valves.</p> Signup and view all the answers

    Describe the mechanism by which Eptifibatide exerts its antithrombotic effects.

    <p>Eptifibatide competitively blocks the gpIIb/IIIa receptor, preventing platelet aggregation.</p> Signup and view all the answers

    What limitation does dipyridamole have in its use as an antithrombotic agent?

    <p>Its use is limited to prophylaxis when combined with warfarin.</p> Signup and view all the answers

    How does dipyridamole influence adenosine levels in the body?

    <p>It inhibits the uptake of adenosine into platelets and red blood cells, leading to its extracellular accumulation.</p> Signup and view all the answers

    Which patients are indicated for the use of abciximab during coronary intervention?

    <p>Patients undergoing percutaneous coronary intervention or those with unstable angina.</p> Signup and view all the answers

    How does Tirofiban function in inhibiting platelet aggregation?

    <p>Tirofiban is a low molecular weight peptide that binds to the gpIIb/IIIa receptor.</p> Signup and view all the answers

    What is the effect of phosphodiesterase (PDE) inhibition by dipyridamole on vascular dynamics?

    <p>It leads to increased levels of cGMP, resulting in vasodilation.</p> Signup and view all the answers

    What role does Vitamin K play in liver function related to clotting factors?

    <p>Vitamin K is essential for the synthesis of factors II, VII, IX, and X by facilitating posttranslational modification in liver cells.</p> Signup and view all the answers

    How do aminocaproic acid and tranexamic acid function in hemostatic therapy?

    <p>They act as inhibitors of the fibrinolytic system, preventing the breakdown of fibrin and reducing bleeding.</p> Signup and view all the answers

    What are the indications for administering Vitamin K to newborns?

    <p>Vitamin K is given to prevent hypoprothrombinemia and bleeding disorders in newborns due to insufficient dietary intake.</p> Signup and view all the answers

    What is the significance of bile salts in the absorption of Vitamin K?

    <p>Bile salts are necessary for the intestinal absorption of both Vitamin K1 and K2.</p> Signup and view all the answers

    Describe a local method used to control bleeding.

    <p>Physical methods such as applying pressure or heat coagulation are effective local approaches to control bleeding.</p> Signup and view all the answers

    What are sclerosing agents and their purpose in hemostatic treatment?

    <p>Sclerosing agents, like ethanolamine oleate, cause thrombosis in veins for permanent obliteration and can be used for varicose veins.</p> Signup and view all the answers

    How is antihemophilic globulin used in the context of hemophilia A?

    <p>Antihemophilic globulin is administered to patients with hemophilia A to replace the deficient factor VIII in their coagulation pathway.</p> Signup and view all the answers

    Explain the role of physical agents in local hemostatic methods.

    <p>Physical agents like cooling and pressure promote clot formation by affecting local blood flow and enhancing platelet aggregation.</p> Signup and view all the answers

    What is the importance of administering vitamin K to newborns, particularly premature infants?

    <p>Vitamin K is administered to prevent hypoprothrombinemia in newborns, especially in premature infants who are at higher risk.</p> Signup and view all the answers

    What serious adverse effects can result from rapid intravenous administration of parenteral vitamin K1?

    <p>Rapid intravenous administration can cause dyspnea, chest pain, and potentially death.</p> Signup and view all the answers

    What bleeding tendency is associated with severe hepatic failure?

    <p>Severe hepatic failure can cause a bleeding tendency that does not respond to vitamin K due to reduced synthesis of clotting factors.</p> Signup and view all the answers

    At what factor activity level does spontaneous bleeding typically occur?

    <p>Spontaneous bleeding occurs when coagulation factor activity is less than 5–10% of normal.</p> Signup and view all the answers

    Identify the conditions associated with factor VIII and factor IX deficiencies.

    <p>Factor VIII deficiency is associated with Hemophilia A, while factor IX deficiency is known as Christmas disease or Hemophilia B.</p> Signup and view all the answers

    What is the typical method of administering plasma protein preparations used to treat coagulation defects?

    <p>Plasma protein preparations are typically administered intravenously.</p> Signup and view all the answers

    What dietary-related issues can vitamin K supplementation correct?

    <p>Vitamin K supplementation is primarily used to correct deficiencies caused by inadequate dietary intake or malabsorption.</p> Signup and view all the answers

    Why is it crucial to monitor factor activity levels in patients with hemophilia?

    <p>Monitoring factor activity levels is crucial because levels below 5–10% of normal can lead to serious spontaneous bleeding risks.</p> Signup and view all the answers

    What is a significant risk associated with preparing plasma fractions from pooled blood?

    <p>The significant risk is exposure to infections such as hepatitis and HIV.</p> Signup and view all the answers

    How do aminocaproic acid and tranexamic acid function as inhibitors of fibrinolysis?

    <p>They competitively inhibit plasminogen activation, thereby preventing fibrinolysis.</p> Signup and view all the answers

    Which therapeutic use is associated with tranexamic acid in clinical settings?

    <p>Tranexamic acid is used for prophylaxis against rebleeding from an intracranial aneurysm.</p> Signup and view all the answers

    In what situations is aminocaproic acid utilized to prevent bleeding?

    <p>It is used to prevent bleeding from tissues rich in plasminogen activators, such as during prostatic surgery.</p> Signup and view all the answers

    What is one major clinical application for both aminocaproic acid and tranexamic acid?

    <p>Both agents are used to stop bleeding caused by the toxicity of fibrinolytic drugs.</p> Signup and view all the answers

    How does the potency of tranexamic acid compare to that of aminocaproic acid?

    <p>Tranexamic acid is a more potent analogue of aminocaproic acid.</p> Signup and view all the answers

    Clopidogrel irreversibly inhibits the binding of ADP to its receptors on ______.

    <p>platelets</p> Signup and view all the answers

    Ticlopidine has been largely replaced by ______ because of serious adverse effects.

    <p>clopidogrel</p> Signup and view all the answers

    The maintenance dose of clopidogrel is ______ mg/d orally.

    <p>75</p> Signup and view all the answers

    Clopidogrel is a ______, and its therapeutic efficacy relies entirely on its active metabolite.

    <p>prodrug</p> Signup and view all the answers

    Blockers of platelet ADP receptors include Ticlopidine, Clopidogrel, and ______.

    <p>Prasugrel</p> Signup and view all the answers

    Activation of the glycoprotein IIb/IIIa receptor complex is the 'final common ______' for platelet aggregation.

    <p>pathway</p> Signup and view all the answers

    Individuals with genetic deficiency in the enzymes that metabolize clopidogrel are called ______.

    <p>poor metabolizers</p> Signup and view all the answers

    Eptifibatide and Tirofiban are types of blockers of platelet glycoprotein ______ receptors.

    <p>IIb/IIIa</p> Signup and view all the answers

    Glanzmann's thrombasthenia is a bleeding disorder associated with the absence of the ______ receptor.

    <p>gpIIb/IIIa</p> Signup and view all the answers

    Abciximab is a monoclonal antibody that binds to and blocks the binding of platelets to ______.

    <p>fibrinogen</p> Signup and view all the answers

    Eptifibatide acts by competitively blocking the ______ receptor.

    <p>gpIIb/IIIa</p> Signup and view all the answers

    Dipyridamole primarily inhibits phosphodiesterase leading to an increase in ______.

    <p>cGMP</p> Signup and view all the answers

    The action of dipyridamole involves the inhibition of ______ uptake, leading to its prolonged action.

    <p>adenosine</p> Signup and view all the answers

    The use of dipyridamole as an antithrombotic agent is limited to prophylaxis with ______ in specific patients.

    <p>warfarin</p> Signup and view all the answers

    Tirofiban is a peptide that binds to the ______ receptor.

    <p>gpIIIb/IIIa</p> Signup and view all the answers

    Agents like abciximab, eptifibatide, and tirofiban have been approved for use in ______ coronary intervention.

    <p>percutaneous</p> Signup and view all the answers

    To correct vitamin deficiency, especially in patients receiving oral ______.

    <p>antibiotics</p> Signup and view all the answers

    Newborns should receive 1-2 mg of vitamin K directly after ______.

    <p>birth</p> Signup and view all the answers

    Severe hepatic failure is associated with a bleeding tendency due to reduced synthesis of ______ factors.

    <p>clotting</p> Signup and view all the answers

    Factor VIII deficiency is known as classic ______.

    <p>hemophilia</p> Signup and view all the answers

    Plasma protein preparations are administered via ______.

    <p>intravenous</p> Signup and view all the answers

    Rapid intravenous administration of parenteral vitamin K1 can cause dyspnea and ______.

    <p>chest pain</p> Signup and view all the answers

    Factor IX deficiency is also known as ______ disease.

    <p>Christmas</p> Signup and view all the answers

    Vitamin K is administered to newborns to prevent ______.

    <p>hypothrombinemia</p> Signup and view all the answers

    Vitamin K is essential for synthesis of factors II, VII, IX, and X by the ______.

    <p>liver</p> Signup and view all the answers

    Both vitamins K1 and K2 require ______ for absorption from the intestine.

    <p>bile salts</p> Signup and view all the answers

    Fresh blood or plasma transfusion serves as sources of ______ factors.

    <p>coagulation</p> Signup and view all the answers

    Antihemophilic globulin is also known as factor ______.

    <p>VIII</p> Signup and view all the answers

    Vitamin K1 is a naturally occurring fat-soluble vitamin present in ______ vegetables.

    <p>green</p> Signup and view all the answers

    Aminocaproic acid and tranexamic acid are inhibitors of the ______ system.

    <p>fibrinolytic</p> Signup and view all the answers

    Sclerosing agents cause thrombosis in veins and permanent ______.

    <p>obliteration</p> Signup and view all the answers

    Vitamin K is administered to all newborns to prevent ______.

    <p>hypoketosis</p> Signup and view all the answers

    Aminocaproic acid is a synthetic agent that competitively inhibits ______ activation.

    <p>plasminogen</p> Signup and view all the answers

    Tranexamic acid is a more potent analogue of ______ acid.

    <p>aminocaproic</p> Signup and view all the answers

    Therapeutic uses of aminocaproic acid include preventing bleeding from tissues rich in ______ activators.

    <p>plasminogen</p> Signup and view all the answers

    Prophylaxis for rebleeding from ______ aneurysm is one of the therapeutic uses of aminocaproic acid.

    <p>intracranial</p> Signup and view all the answers

    Recombinant preparations are recommended when possible due to the risk of exposure to ______ from pooled plasma.

    <p>infections</p> Signup and view all the answers

    Tranexamic acid can be utilized as adjunctive therapy in cases of ______.

    <p>hemophilia</p> Signup and view all the answers

    Match the following drugs used in bleeding disorders with their corresponding actions or indications:

    <p>Vitamin K = To reverse bleeding episodes from warfarin overdose Aminocaproic acid = Inhibition of fibrinolysis Ethamsylate = Reduction of capillary bleeding Thromboplastin = Prepared from mammalian tissues</p> Signup and view all the answers

    Match the following vitamin types with their sources and roles:

    <p>Vitamin K1 = Found in green vegetables Vitamin K2 = Synthesized by intestinal bacteria Vitamin C = Preserves vascular wall integrity Rutin = Antioxidant effect on blood vessels</p> Signup and view all the answers

    Match the following local agents used to control bleeding with their descriptions:

    <p>Thrombin = Applied as powder on the bleeding surface Oxidized cellulose = Forms an adhesive mass on the bleeding site Astringents = Precipitate surface proteins Vasoconstrictors = Reduce blood flow to the affected area</p> Signup and view all the answers

    Match the following systemic agents with their main characteristics:

    <p>Transfusions = Source of coagulation factors Calcium = Known as factor IV Antihemophilic globulin = Used in hemophilia A treatment Vitamin K = Essential for synthesis of clotting factors</p> Signup and view all the answers

    Match the following reactions or conditions with the correct therapeutic use:

    <p>Fresh blood transfusion = Provides coagulation factors Vitamin K therapy = Reversal of warfarin bleeding Tranexamic acid = Prevention of excessive fibrinolysis Ethamsylate = Reduction of capillary bleeding</p> Signup and view all the answers

    Match the symptoms or conditions with the appropriate underlying causes:

    <p>Severe hepatic failure = Can cause bleeding not responding to vitamin K Vitamin K deficiency = Results in a bleeding tendency Factor VIII deficiency = Leads to hemophilia A Low factor activity = Spontaneous bleeding risk increases</p> Signup and view all the answers

    Match the following coagulation components with their functions:

    <p>Factors II, VII, IX, X = Require vitamin K for synthesis Factor VIII = Deficiency leads to hemophilia A Calcium ions = Critical in the coagulation cascade Thromboplastin = Catalyzes the conversion of prothrombin to thrombin</p> Signup and view all the answers

    Match the following methods or treatments with their corresponding conditions they address:

    <p>Tranexamic acid = Treats conditions with high fibrinolytic activity Aminocaproic acid = Adjunctive therapy for excessive bleeding Sclerosing agents = Used for varicose veins Vasoconstrictors = Control bleeding in epistaxis</p> Signup and view all the answers

    Match the following antiplatelet drugs with their characteristics:

    <p>Clopidogrel = Prophylaxis for thromboembolic events Ticlopidine = Associated with serious adverse effects Prasugrel = Used in acute coronary syndrome Cangrelor = Intravenous administration option</p> Signup and view all the answers

    Match the following glycoprotein IIb/IIIa receptor blockers with their indications:

    <p>Abciximab = Used during PCI procedures Eptifibatide = Indicated in acute coronary syndromes Tirofiban = Prevention of cardiac events All = All are used in interventional cardiology</p> Signup and view all the answers

    Match the following characteristics with their respective ADP receptor blockers:

    <p>Clopidogrel = Requires metabolic activation Ticlopidine = Has been largely replaced by clopidogrel Prasugrel = Not recommended for patients with a history of stroke Cangrelor = Rapid onset and offset of action</p> Signup and view all the answers

    Match the following complications with the corresponding antiplatelet drug:

    <p>Clopidogrel = May lead to bleeding in poor metabolizers Ticlopidine = Associated with neutropenia Aspirin = Gastrointestinal bleeding Prasugrel = High risk of bleeding post-stroke</p> Signup and view all the answers

    Match the following indications with their respective treatments:

    <p>Coronary artery disease = Clopidogrel Peripheral vascular disease = Ticlopidine Acute coronary syndrome = Eptifibatide Thrombosis prevention = Prasugrel</p> Signup and view all the answers

    Match the following characteristics with their respective platelet aggregation pathways:

    <p>Glycoprotein IIb/IIIa = Final common pathway for aggregation ADP receptors = Inhibit activation of glycoproteins Thromboxane A2 = Stimulates platelet activation Collagen = Initiates platelet adhesion</p> Signup and view all the answers

    Match the following drugs with their mechanism of action:

    <p>Clopidogrel = Inhibits ADP receptor binding Abciximab = Inhibits glycoprotein IIb/IIIa receptor Eptifibatide = Blocks fibrinogen binding Tirofiban = Inhibits platelet aggregation</p> Signup and view all the answers

    Match the following drugs with their metabolization status:

    <p>Clopidogrel = Requires conversion to active metabolite Ticlopidine = Less commonly used due to side effects Prasugrel = More predictable pharmacokinetics Eptifibatide = Administered intravenously, no metabolism needed</p> Signup and view all the answers

    Match the following platelet inhibitors with their specific actions:

    <p>Abciximab = Blocks binding of platelets to fibrinogen Eptifibatide = Competitively blocks the gpIIb/IIIa receptor Tirofiban = Binds to gpIIIb/IIIa receptor Dipyridamole = Inhibits phosphodiesterase leading to increased cGMP</p> Signup and view all the answers

    Match the following platelet inhibitors with their usage:

    <p>Abciximab = Percutaneous coronary intervention Eptifibatide = Unstable angina Tirofiban = Post-MI treatment Dipyridamole = Prophylaxis with warfarin in prosthetic heart valves</p> Signup and view all the answers

    Match the following drugs with their origin or type:

    <p>Abciximab = Monoclonal antibody Fab fragment Eptifibatide = Synthetic peptide Tirofiban = Low molecular weight peptide Dipyridamole = Phosphodiesterase inhibitor</p> Signup and view all the answers

    Match the following drugs with their effect on adenosine:

    <p>Eptifibatide = No effect on adenosine Tirofiban = No effect on adenosine Abciximab = No effect on adenosine Dipyridamole = Inhibits uptake of adenosine into platelets</p> Signup and view all the answers

    Match the following drugs with their specific therapeutic limitation:

    <p>Abciximab = Not used for chronic treatment Eptifibatide = Short duration of action Tirofiban = Requires renal adjustment Dipyridamole = Limited to prophylaxis in mechanical heart valves</p> Signup and view all the answers

    Match the following conditions with the associated receptor deficiency:

    <p>Glanzmann's thrombasthenia = gpIIb/IIIa receptor deficiency Hemophilia A = Factor VIII deficiency Factor IX deficiency = Christmas disease Severe hepatic failure = Reduced synthesis of clotting factors</p> Signup and view all the answers

    Match the following drugs with their mechanism of platelet activity modulation:

    <p>Abciximab = Monoclonal antibodies preventing aggregation Eptifibatide = Competitive receptor antagonist Tirofiban = Direct receptor binder Dipyridamole = cGMP increase through PDE inhibition</p> Signup and view all the answers

    Match the following types of actions to the corresponding drugs:

    <p>Abciximab = Prevention of platelet aggregation Eptifibatide = Reversible receptor blockade Tirofiban = Direct interaction with platelet glycoproteins Dipyridamole = Modulation of vascular tone through adenosine</p> Signup and view all the answers

    Match the vitamin K usage with its corresponding purpose:

    <p>Vitamin K in newborns = Prevention of hypothrombinemia Parenteral vitamin K1 = Correction of dietary deficiency Vitamin K for patients on antibiotics = Prevention of vitamin deficiency Vitamin K administration in severe hepatic failure = Not effective for bleeding tendency</p> Signup and view all the answers

    Match the coagulation factor deficiencies with their corresponding conditions:

    <p>Factor VIII deficiency = Hemophilia A Factor IX deficiency = Christmas disease Factor activity less than 5-10% = Spontaneous bleeding Severe hepatic failure = Bleeding tendency due to reduced factors</p> Signup and view all the answers

    Match the adverse effects with their corresponding causes related to vitamin K1:

    <p>Rapid intravenous administration = Dyspnea Parenteral vitamin K1 in oil = Potential for fatal reactions Impaired hepatic function = Ineffectiveness of vitamin K</p> Signup and view all the answers

    Match the dosing recommendations for vitamin K with the target groups:

    <p>Newborns = 1-2 mg after birth Patients with dietary deficiency = Correct dosage as required Patients on oral antibiotics = Replenishment dosage as necessary Severe hepatic failure patients = Higher doses may be required for effect</p> Signup and view all the answers

    Match the implications of vitamin K deficiency with their related effects:

    <p>Spontaneous bleeding = Factor activity below 5-10% Reduced synthesis of clotting factors = Bleeding tendency in liver disease Impaired blood coagulation = Increased bleeding risk Vitamin K administration = Clotting factors synthesis correction</p> Signup and view all the answers

    Match the treatment methods for coagulation disorders with their attributes:

    <p>Plasma protein preparations = Intravenous administration Vitamin K for dietary deficiency = Corrects specific vitamin needs Factor VIII treatment = Used for hemophilia A Factor IX treatment = Indicated for Christmas disease</p> Signup and view all the answers

    Match the following therapeutic uses with the correct drug:

    <p>Aminocaproic acid = Prevent bleeding from prostatic surgery Tranexamic acid = Stop bleeding caused by fibrinolytic drug toxicity</p> Signup and view all the answers

    Match the conditions to the factors they are associated with:

    <p>Hemophilia A = Factor VIII Christmas disease = Factor IX Hypothrombinemia in newborns = Vitamin K dosage Spontaneous bleeding = Factor activity below threshold</p> Signup and view all the answers

    Match the following drugs with their potency:

    <p>Aminocaproic acid = Synthetic agent that competes in plasminogen activation Tranexamic acid = Has a similar mechanism as aminocaproic acid</p> Signup and view all the answers

    Match the reason for administering vitamin K with the related scenarios:

    <p>To newborns = Prevent vitamin K deficiency bleeding During liver failure = Address restricted factor synthesis In dietary deficiency cases = Avoid deficiency-related bleeding To patients on antibiotics = Prevent secondary vitamin deficiency</p> Signup and view all the answers

    Match the following conditions with their related drug usage:

    <p>Aminocaproic acid = Tissues rich in plasminogen activators Tranexamic acid = Lung surgery</p> Signup and view all the answers

    Match the following drugs with their action against bleeding:

    <p>Aminocaproic acid = Prevents rebleeding Tranexamic acid = Adjunctive therapy in hemophilia</p> Signup and view all the answers

    Match the following drugs with their recommendation based on exposure risk:

    <p>Recombinant preparations = Recommended to reduce infection risk Aminocaproic acid = Used in conditions lacking plasminogen activators Tranexamic acid = Used to stop bleeding from toxicity Plasma fractions = High risk associated with hepatitis and HIV</p> Signup and view all the answers

    Match the following descriptions with the correct drug:

    <p>Aminocaproic acid = Utilized in excessive fibrinolysis Tranexamic acid = Effective in surgical bleeding scenarios</p> Signup and view all the answers

    Study Notes

    Blockers of Platelet ADP Receptors

    • Agents: Ticlopidine, Clopidogrel, Prasugrel
    • These drugs irreversibly inhibit ADP binding to platelet receptors, preventing glycoprotein IIb/IIIa activation necessary for platelet aggregation with fibrinogen.
    • Clopidogrel is approved for thrombus prophylaxis in cerebrovascular and cardiovascular diseases, particularly for coronary artery disease and peripheral vascular disease, with a maintenance dose of 75 mg/day orally.
    • Clopidogrel is a prodrug; its efficacy depends on conversion to an active metabolite. Genetic variations may lead some individuals to be “poor metabolizers,” limiting the drug's effectiveness.
    • Ticlopidine has largely been replaced by clopidogrel due to serious side effects like neutropenia and increased bleeding risks, which are less frequent with clopidogrel.

    Blockers of Platelet Glycoprotein IIb/IIIa Receptors

    • Agents: Abciximab, Eptifibatide, Tirofiban
    • Activation of glycoprotein IIb/IIIa receptors signals the final pathway for platelet aggregation and fibrinogen binding. Individuals lacking this receptor suffer from Glanzmann's thrombasthenia, a bleeding disorder.
    • Abciximab (a monoclonal antibody fragment) directly blocks glycoprotein IIb/IIIa, inhibiting platelet-fibrinogen binding.
    • Eptifibatide is a small synthetic peptide that competitively inhibits the IIb/IIIa receptor.
    • Tirofiban is a low molecular weight peptide that attaches to the glycoprotein IIIb/IIIa receptor.
    • These agents are indicated for patients undergoing percutaneous coronary interventions, unstable angina, and post-myocardial infarction conditions.

    Dipyridamole

    • Inhibits phosphodiesterase (PDE) to increase cGMP levels, promoting vasodilation and reducing platelet activity.
    • Also inhibits adenosine uptake in platelets and red blood cells, leading to extracellular accumulation and extended effects.
    • Primarily used for prophylaxis in patients with prosthetic heart valves, often combined with warfarin.

    Systemic Agents for Bleeding Disorders

    • Vitamin K: Necessary for synthesis of coagulation factors II, VII, IX, and X. Available in oral and injectable forms.
    • Vitamin C and Rutin: Maintain vascular wall integrity.
    • Fresh blood/plasma transfusions: Provide necessary coagulation factors.
    • Plasma Fractions: Includes thromboplastin (factor III), antihemophilic globulin (factor VIII), and calcium.
    • Aminocaproic and Tranexamic acid: Inhibit the fibrinolytic system.
    • Ethamsylate (Dicynone): Reduces capillary bleeding when given intramuscularly.

    Vitamin K

    • Sources: Vitamin K1 (phytomenadione) found in green vegetables; Vitamin K2 synthesized by intestinal bacteria.
    • Bile salts are required for absorption of both K1 and K2.
    • Medicinal uses include reversing bleeding from warfarin overdose, addressing dietary deficiencies, and preventing neonatal hypothrombinemia.
    • Adverse effects can occur with rapid intravenous administration of vitamin K1.

    Plasma Fractions

    • Coagulation factor deficiencies can lead to spontaneous bleeding when factor activity drops below 5-10% of normal.
    • Hemophilia A (factor VIII deficiency) and Hemophilia B (factor IX deficiency) are common hereditary bleeding disorders.
    • Plasma preparations for treatment are often derived from multiple donors, risking infection exposure. Recombinant products are preferred when available.

    Inhibitors of Fibrinolysis

    • Aminocaproic Acid: Competes with plasminogen, reducing activation.
    • Tranexamic Acid: More potent analog of aminocaproic acid with similar action.
    • Therapeutic uses include preventing bleeding in surgeries involving rich tissues in plasminogen activators and treating hemorrhages due to fibrinolytic drug toxicity.

    Blockers of Platelet ADP Receptors

    • Agents: Ticlopidine, Clopidogrel, Prasugrel
    • These drugs irreversibly inhibit ADP binding to platelet receptors, preventing glycoprotein IIb/IIIa activation necessary for platelet aggregation with fibrinogen.
    • Clopidogrel is approved for thrombus prophylaxis in cerebrovascular and cardiovascular diseases, particularly for coronary artery disease and peripheral vascular disease, with a maintenance dose of 75 mg/day orally.
    • Clopidogrel is a prodrug; its efficacy depends on conversion to an active metabolite. Genetic variations may lead some individuals to be “poor metabolizers,” limiting the drug's effectiveness.
    • Ticlopidine has largely been replaced by clopidogrel due to serious side effects like neutropenia and increased bleeding risks, which are less frequent with clopidogrel.

    Blockers of Platelet Glycoprotein IIb/IIIa Receptors

    • Agents: Abciximab, Eptifibatide, Tirofiban
    • Activation of glycoprotein IIb/IIIa receptors signals the final pathway for platelet aggregation and fibrinogen binding. Individuals lacking this receptor suffer from Glanzmann's thrombasthenia, a bleeding disorder.
    • Abciximab (a monoclonal antibody fragment) directly blocks glycoprotein IIb/IIIa, inhibiting platelet-fibrinogen binding.
    • Eptifibatide is a small synthetic peptide that competitively inhibits the IIb/IIIa receptor.
    • Tirofiban is a low molecular weight peptide that attaches to the glycoprotein IIIb/IIIa receptor.
    • These agents are indicated for patients undergoing percutaneous coronary interventions, unstable angina, and post-myocardial infarction conditions.

    Dipyridamole

    • Inhibits phosphodiesterase (PDE) to increase cGMP levels, promoting vasodilation and reducing platelet activity.
    • Also inhibits adenosine uptake in platelets and red blood cells, leading to extracellular accumulation and extended effects.
    • Primarily used for prophylaxis in patients with prosthetic heart valves, often combined with warfarin.

    Systemic Agents for Bleeding Disorders

    • Vitamin K: Necessary for synthesis of coagulation factors II, VII, IX, and X. Available in oral and injectable forms.
    • Vitamin C and Rutin: Maintain vascular wall integrity.
    • Fresh blood/plasma transfusions: Provide necessary coagulation factors.
    • Plasma Fractions: Includes thromboplastin (factor III), antihemophilic globulin (factor VIII), and calcium.
    • Aminocaproic and Tranexamic acid: Inhibit the fibrinolytic system.
    • Ethamsylate (Dicynone): Reduces capillary bleeding when given intramuscularly.

    Vitamin K

    • Sources: Vitamin K1 (phytomenadione) found in green vegetables; Vitamin K2 synthesized by intestinal bacteria.
    • Bile salts are required for absorption of both K1 and K2.
    • Medicinal uses include reversing bleeding from warfarin overdose, addressing dietary deficiencies, and preventing neonatal hypothrombinemia.
    • Adverse effects can occur with rapid intravenous administration of vitamin K1.

    Plasma Fractions

    • Coagulation factor deficiencies can lead to spontaneous bleeding when factor activity drops below 5-10% of normal.
    • Hemophilia A (factor VIII deficiency) and Hemophilia B (factor IX deficiency) are common hereditary bleeding disorders.
    • Plasma preparations for treatment are often derived from multiple donors, risking infection exposure. Recombinant products are preferred when available.

    Inhibitors of Fibrinolysis

    • Aminocaproic Acid: Competes with plasminogen, reducing activation.
    • Tranexamic Acid: More potent analog of aminocaproic acid with similar action.
    • Therapeutic uses include preventing bleeding in surgeries involving rich tissues in plasminogen activators and treating hemorrhages due to fibrinolytic drug toxicity.

    Blockers of Platelet ADP Receptors

    • Agents: Ticlopidine, Clopidogrel, Prasugrel
    • These drugs irreversibly inhibit ADP binding to platelet receptors, preventing glycoprotein IIb/IIIa activation necessary for platelet aggregation with fibrinogen.
    • Clopidogrel is approved for thrombus prophylaxis in cerebrovascular and cardiovascular diseases, particularly for coronary artery disease and peripheral vascular disease, with a maintenance dose of 75 mg/day orally.
    • Clopidogrel is a prodrug; its efficacy depends on conversion to an active metabolite. Genetic variations may lead some individuals to be “poor metabolizers,” limiting the drug's effectiveness.
    • Ticlopidine has largely been replaced by clopidogrel due to serious side effects like neutropenia and increased bleeding risks, which are less frequent with clopidogrel.

    Blockers of Platelet Glycoprotein IIb/IIIa Receptors

    • Agents: Abciximab, Eptifibatide, Tirofiban
    • Activation of glycoprotein IIb/IIIa receptors signals the final pathway for platelet aggregation and fibrinogen binding. Individuals lacking this receptor suffer from Glanzmann's thrombasthenia, a bleeding disorder.
    • Abciximab (a monoclonal antibody fragment) directly blocks glycoprotein IIb/IIIa, inhibiting platelet-fibrinogen binding.
    • Eptifibatide is a small synthetic peptide that competitively inhibits the IIb/IIIa receptor.
    • Tirofiban is a low molecular weight peptide that attaches to the glycoprotein IIIb/IIIa receptor.
    • These agents are indicated for patients undergoing percutaneous coronary interventions, unstable angina, and post-myocardial infarction conditions.

    Dipyridamole

    • Inhibits phosphodiesterase (PDE) to increase cGMP levels, promoting vasodilation and reducing platelet activity.
    • Also inhibits adenosine uptake in platelets and red blood cells, leading to extracellular accumulation and extended effects.
    • Primarily used for prophylaxis in patients with prosthetic heart valves, often combined with warfarin.

    Systemic Agents for Bleeding Disorders

    • Vitamin K: Necessary for synthesis of coagulation factors II, VII, IX, and X. Available in oral and injectable forms.
    • Vitamin C and Rutin: Maintain vascular wall integrity.
    • Fresh blood/plasma transfusions: Provide necessary coagulation factors.
    • Plasma Fractions: Includes thromboplastin (factor III), antihemophilic globulin (factor VIII), and calcium.
    • Aminocaproic and Tranexamic acid: Inhibit the fibrinolytic system.
    • Ethamsylate (Dicynone): Reduces capillary bleeding when given intramuscularly.

    Vitamin K

    • Sources: Vitamin K1 (phytomenadione) found in green vegetables; Vitamin K2 synthesized by intestinal bacteria.
    • Bile salts are required for absorption of both K1 and K2.
    • Medicinal uses include reversing bleeding from warfarin overdose, addressing dietary deficiencies, and preventing neonatal hypothrombinemia.
    • Adverse effects can occur with rapid intravenous administration of vitamin K1.

    Plasma Fractions

    • Coagulation factor deficiencies can lead to spontaneous bleeding when factor activity drops below 5-10% of normal.
    • Hemophilia A (factor VIII deficiency) and Hemophilia B (factor IX deficiency) are common hereditary bleeding disorders.
    • Plasma preparations for treatment are often derived from multiple donors, risking infection exposure. Recombinant products are preferred when available.

    Inhibitors of Fibrinolysis

    • Aminocaproic Acid: Competes with plasminogen, reducing activation.
    • Tranexamic Acid: More potent analog of aminocaproic acid with similar action.
    • Therapeutic uses include preventing bleeding in surgeries involving rich tissues in plasminogen activators and treating hemorrhages due to fibrinolytic drug toxicity.

    Blockers of Platelet ADP Receptors

    • Agents: Ticlopidine, Clopidogrel, Prasugrel
    • These drugs irreversibly inhibit ADP binding to platelet receptors, preventing glycoprotein IIb/IIIa activation necessary for platelet aggregation with fibrinogen.
    • Clopidogrel is approved for thrombus prophylaxis in cerebrovascular and cardiovascular diseases, particularly for coronary artery disease and peripheral vascular disease, with a maintenance dose of 75 mg/day orally.
    • Clopidogrel is a prodrug; its efficacy depends on conversion to an active metabolite. Genetic variations may lead some individuals to be “poor metabolizers,” limiting the drug's effectiveness.
    • Ticlopidine has largely been replaced by clopidogrel due to serious side effects like neutropenia and increased bleeding risks, which are less frequent with clopidogrel.

    Blockers of Platelet Glycoprotein IIb/IIIa Receptors

    • Agents: Abciximab, Eptifibatide, Tirofiban
    • Activation of glycoprotein IIb/IIIa receptors signals the final pathway for platelet aggregation and fibrinogen binding. Individuals lacking this receptor suffer from Glanzmann's thrombasthenia, a bleeding disorder.
    • Abciximab (a monoclonal antibody fragment) directly blocks glycoprotein IIb/IIIa, inhibiting platelet-fibrinogen binding.
    • Eptifibatide is a small synthetic peptide that competitively inhibits the IIb/IIIa receptor.
    • Tirofiban is a low molecular weight peptide that attaches to the glycoprotein IIIb/IIIa receptor.
    • These agents are indicated for patients undergoing percutaneous coronary interventions, unstable angina, and post-myocardial infarction conditions.

    Dipyridamole

    • Inhibits phosphodiesterase (PDE) to increase cGMP levels, promoting vasodilation and reducing platelet activity.
    • Also inhibits adenosine uptake in platelets and red blood cells, leading to extracellular accumulation and extended effects.
    • Primarily used for prophylaxis in patients with prosthetic heart valves, often combined with warfarin.

    Systemic Agents for Bleeding Disorders

    • Vitamin K: Necessary for synthesis of coagulation factors II, VII, IX, and X. Available in oral and injectable forms.
    • Vitamin C and Rutin: Maintain vascular wall integrity.
    • Fresh blood/plasma transfusions: Provide necessary coagulation factors.
    • Plasma Fractions: Includes thromboplastin (factor III), antihemophilic globulin (factor VIII), and calcium.
    • Aminocaproic and Tranexamic acid: Inhibit the fibrinolytic system.
    • Ethamsylate (Dicynone): Reduces capillary bleeding when given intramuscularly.

    Vitamin K

    • Sources: Vitamin K1 (phytomenadione) found in green vegetables; Vitamin K2 synthesized by intestinal bacteria.
    • Bile salts are required for absorption of both K1 and K2.
    • Medicinal uses include reversing bleeding from warfarin overdose, addressing dietary deficiencies, and preventing neonatal hypothrombinemia.
    • Adverse effects can occur with rapid intravenous administration of vitamin K1.

    Plasma Fractions

    • Coagulation factor deficiencies can lead to spontaneous bleeding when factor activity drops below 5-10% of normal.
    • Hemophilia A (factor VIII deficiency) and Hemophilia B (factor IX deficiency) are common hereditary bleeding disorders.
    • Plasma preparations for treatment are often derived from multiple donors, risking infection exposure. Recombinant products are preferred when available.

    Inhibitors of Fibrinolysis

    • Aminocaproic Acid: Competes with plasminogen, reducing activation.
    • Tranexamic Acid: More potent analog of aminocaproic acid with similar action.
    • Therapeutic uses include preventing bleeding in surgeries involving rich tissues in plasminogen activators and treating hemorrhages due to fibrinolytic drug toxicity.

    Blockers of Platelet ADP Receptors

    • Agents: Ticlopidine, Clopidogrel, Prasugrel
    • These drugs irreversibly inhibit ADP binding to platelet receptors, preventing glycoprotein IIb/IIIa activation necessary for platelet aggregation with fibrinogen.
    • Clopidogrel is approved for thrombus prophylaxis in cerebrovascular and cardiovascular diseases, particularly for coronary artery disease and peripheral vascular disease, with a maintenance dose of 75 mg/day orally.
    • Clopidogrel is a prodrug; its efficacy depends on conversion to an active metabolite. Genetic variations may lead some individuals to be “poor metabolizers,” limiting the drug's effectiveness.
    • Ticlopidine has largely been replaced by clopidogrel due to serious side effects like neutropenia and increased bleeding risks, which are less frequent with clopidogrel.

    Blockers of Platelet Glycoprotein IIb/IIIa Receptors

    • Agents: Abciximab, Eptifibatide, Tirofiban
    • Activation of glycoprotein IIb/IIIa receptors signals the final pathway for platelet aggregation and fibrinogen binding. Individuals lacking this receptor suffer from Glanzmann's thrombasthenia, a bleeding disorder.
    • Abciximab (a monoclonal antibody fragment) directly blocks glycoprotein IIb/IIIa, inhibiting platelet-fibrinogen binding.
    • Eptifibatide is a small synthetic peptide that competitively inhibits the IIb/IIIa receptor.
    • Tirofiban is a low molecular weight peptide that attaches to the glycoprotein IIIb/IIIa receptor.
    • These agents are indicated for patients undergoing percutaneous coronary interventions, unstable angina, and post-myocardial infarction conditions.

    Dipyridamole

    • Inhibits phosphodiesterase (PDE) to increase cGMP levels, promoting vasodilation and reducing platelet activity.
    • Also inhibits adenosine uptake in platelets and red blood cells, leading to extracellular accumulation and extended effects.
    • Primarily used for prophylaxis in patients with prosthetic heart valves, often combined with warfarin.

    Systemic Agents for Bleeding Disorders

    • Vitamin K: Necessary for synthesis of coagulation factors II, VII, IX, and X. Available in oral and injectable forms.
    • Vitamin C and Rutin: Maintain vascular wall integrity.
    • Fresh blood/plasma transfusions: Provide necessary coagulation factors.
    • Plasma Fractions: Includes thromboplastin (factor III), antihemophilic globulin (factor VIII), and calcium.
    • Aminocaproic and Tranexamic acid: Inhibit the fibrinolytic system.
    • Ethamsylate (Dicynone): Reduces capillary bleeding when given intramuscularly.

    Vitamin K

    • Sources: Vitamin K1 (phytomenadione) found in green vegetables; Vitamin K2 synthesized by intestinal bacteria.
    • Bile salts are required for absorption of both K1 and K2.
    • Medicinal uses include reversing bleeding from warfarin overdose, addressing dietary deficiencies, and preventing neonatal hypothrombinemia.
    • Adverse effects can occur with rapid intravenous administration of vitamin K1.

    Plasma Fractions

    • Coagulation factor deficiencies can lead to spontaneous bleeding when factor activity drops below 5-10% of normal.
    • Hemophilia A (factor VIII deficiency) and Hemophilia B (factor IX deficiency) are common hereditary bleeding disorders.
    • Plasma preparations for treatment are often derived from multiple donors, risking infection exposure. Recombinant products are preferred when available.

    Inhibitors of Fibrinolysis

    • Aminocaproic Acid: Competes with plasminogen, reducing activation.
    • Tranexamic Acid: More potent analog of aminocaproic acid with similar action.
    • Therapeutic uses include preventing bleeding in surgeries involving rich tissues in plasminogen activators and treating hemorrhages due to fibrinolytic drug toxicity.

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    Test your knowledge on ADP receptor blockers like Ticlopidine, Clopidogrel, and Prasugrel. This quiz covers their action, mechanism of inhibition, and clinical implications. Perfect for students in pharmacology or medical courses!

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