Term
| Mechanisms of Action for Sodium Heparin (Anticoagulant) |
|
Definition
•Derived from porcine intestinal mucosa
•Inhibits blood clotting reactions
•No fibrinolytic activity
•May prevent clot growth |
|
|
Term
| Indications for Sodium Heparin (Anticoagulant) |
|
Definition
•During cardiac catherization
•Treatment of pulmonary embolism
•Control embolization in A-fib
•During cardiac surgery
•Acute MI
•Pre- and post-percutaneous coronary intervention (PCI)
•Ischemic CVA |
|
|
Term
| Mechanisms of Action ReoPro (Abciximab) |
|
Definition
| •Inhibits glycoprotein IIb/IIIa receptor in the membrane of the platelet •Antiplatelet •Platelet function recovers around 48 hours after administration |
|
|
Term
Indications for ReoPro (Abciximab)
(Antiplatelet)
(Glycoprotein (GP) IIb/IIIa inhibitor) |
|
Definition
•Non ―Q‖ wave MI
•Unstable angina with planned PCI within 24 hours
•Post PCI |
|
|
Term
Contraindications for ReoPro (Abciximab)
(Antiplatelet)
(Glycoprotein (GP) IIb/IIIa inhibitor) |
|
Definition
•Active bleeding
•Bleeding disorders
•Platelet count < 150,000 |
|
|
Term
| Mechanisms of Actions Tirofiban HCL (Aggrastat) |
|
Definition
| •Inhibits glycoprotein IIb/IIIa receptor in the membrane of the platelet •Antiplatelet •Platelet function recovers around 48 hours after administration •Reversibly binds to GP IIb/IIIa receptor on human platelets and inhibits platelet aggregation •Inhibits thrombotic events during ACS management •Made from protein found in rattlesnake venom •Immediate onset and duration for 4 to 6 hours |
|
|
Term
Indications for Tirofiban HCL (Aggrastat)
(Antiplatelet) |
|
Definition
•Treatment of acute coronary syndrome (unstable angina or non-Q wave MI)
•Administered in combination with heparin
•Adjunct therapy for those undergoing percutaneous coronary interventions
•Patients with ACS without ST segment elevation
•Medical management of ACS patients
•Used during PCI or atherectomy |
|
|
Term
| Mechanisms of Action for Bivalirudin (Angiomax) |
|
Definition
| •Thrombin-specific antithrombotic •Reversible polypeptide thrombin inhibitor •Directly inhibits clot-bound and circulating thrombin •Prevents generation of fibrin and other activation of the clotting cascade •Inhibits thrombin-induced platelet activation, granule release, and aggregation •Does not require antithrombin to produce anticoagulant effects •Derived from saliva of leeches |
|
|
Term
Indications for Bivalirudin (Angiomax)
•Antithrombotic |
|
Definition
•For use as an anticoagulant in patients undergoing percutaneous coronary intervention (PCI)
•For patients with or at risk for heparin-induced thrombocytopenia and thrombosis syndrome undergoing PCI
•For use as an anticoagulant in patients with unstable angina undergoing percutaneous transluminal coronary angioplasty (PTCA) |
|
|
Term
Mechanisms of Action Argatroban (Acova)
•Thrombin inhibitor |
|
Definition
•Direct thrombin inhibitor that reversibly binds to the thrombin active site.
•Reversibly binds to the active thrombin site of free and clot-associated thrombin
•Argatroban does not require the co-factor antithrombin III for antithrombotic activity.
•Exerts its anticoagulant effects by inhibiting thrombin-catalyzed or -induced reactions, including fibrin formation; activation of coagulation factors V, VIII, and XIII; activation of protein C; and platelet aggregation.
•Highly selective for thrombin with an inhibitory constant (Ki) of 0.04 μM.
•Capable of inhibiting the action of both free and clot-associated thrombin |
|
|
Term
Indications for Argatroban (Acova)
•Thrombin inhibitor |
|
Definition
•As an anticoagulant for prophylaxis or treatment of thrombosis in patients with heparin-induced thrombocytopenia.
•As an anticoagulant in patients with or at risk for heparin-induced thrombocytopenia undergoing percutaneous coronary intervention (PCI). |
|
|
Term
| Which drug is derived from porcine intestinal mucosa? |
|
Definition
|
|
Term
| Contraindications for Sodium Heparin |
|
Definition
•Active bleeding
•Blood dyscrasias |
|
|
Term
| How long does it take for the platelet function to recover after receiving ReoPro (Abciximab)? Is it reversible? |
|
Definition
•Platelet function recovers around 48 hours after administration
•It is not reversible |
|
|
Term
| How long does it take for the platelet function to recover after receiving Tirofiban HCL (Aggrastat)? Is it reversible? |
|
Definition
•Platelet function recovers around 48 hours after administration
•Reversibly binds to GP IIb/IIIa receptor on human platelets and inhibits platelet aggregation |
|
|
Term
| Which drug is made from protein found in rattlesnake venom? |
|
Definition
| Tirofiban HCL (Aggrastat) |
|
|
Term
| Precautions for ReoPro (Abciximab) |
|
Definition
•Monitor for thrombocytopenia
•Use in conjunction with heparin |
|
|
Term
| Contraindications for Sodium Heparin |
|
Definition
•Active bleeding
•Blood dyscrasias |
|
|
Term
| Contraindications for Sodium Heparin |
|
Definition
•Active bleeding
•Blood dyscrasias |
|
|
Term
| Which Antiplatelet drug has an immediate onset and duration of 4 to 6 hours? |
|
Definition
| Tirofiban HCL (Aggrastat) |
|
|
Term
| Antithrombotic that does not require antithrombin to produce anticoagulant effects? |
|
Definition
|
|
Term
| Antiplatelet that is indicated for patients with ACS without ST segment elevation |
|
Definition
| Tirofiban HCL (Aggrastat) |
|
|
Term
| Adjunct therapy for those undergoing percutaneous coronary interventions |
|
Definition
| Tirofiban HCL (Aggrastat) |
|
|
Term
| Which antiplatelet is administered in combination with heparin? |
|
Definition
| Tirofiban HCL (Aggrastat) |
|
|
Term
| During therapy with Aggrastat, patients should be monitored for potential bleeding. When bleeding cannot be controlled with pressure what should you do? |
|
Definition
| Infusion of Aggrastat and heparin should be discontinued. |
|
|
Term
| What drug is used to reverse the effects of heparin post catheterization or coronary artery bypass graft (CABG)? |
|
Definition
|
|
Term
| Drug Classification for Bivalirudin (Angiomax) |
|
Definition
|
|
Term
| Indicated for patients with or at risk for heparin-induced thrombocytopenia AND thrombosis syndrome undergoing PCI |
|
Definition
Bivalirudin (Angiomax)
•Antithrombotic |
|
|
Term
Mechanisms of Action for Aspirin
•Analgesic
•Antiplatelet |
|
Definition
•Anti-inflammatory action:
•Inhibits prostaglandin synthesis
•Enhances antigen removal and reduces the spread of inflammation in ground substances
•Analgesic action (primarily peripheral)
•Antipyretic action:
•Lowers body temperature in fever by indirectly causing centrally mediated peripheral vasodilation and sweating
•Inhibits prostaglandin synthesis
•Antiplatelet action
•Powerful inhibition of platelet aggregation
•Permanent inhibition of prostaglandin H synthase 1 or cyclooxygenase (COX)-1
•Blocks synthesis of precursor to thromboxane A2
•Impedes hepatic synthesis of blood coagulation factors, possibly via inhibition of vitamin K activity |
|
|
Term
Indications for Aspirin
•Analgesic
•Antiplatelet |
|
Definition
•Relief of pain of low or moderate intensity
•Prevent recurrence or prophylaxis in MI
•As part of antithrombotic treatment in AMI
•Prophylaxis against thromboembolism (DVT, TIA) |
|
|
Term
Contraindications for Aspirin
•Analgesic
•Antiplatelet |
|
Definition
•Hypersensitivity or allergy to salicylates
•History of GI ulceration, bleeding, or other disorders
•Recent history of surgery
•Severe anemia
•Vitamin K deficiency
•Hemophilia or other coagulopathies
•Asthma
•Congestive heart failure
•Pregnancy (third trimester) |
|
|
Term
Precautions for Aspirin
•Analgesic
•Antiplatelet |
|
Definition
•Observe for signs of bleeding (petechiae, ecchymosis, bleeding gums, black or bloody stools, cloudy or bloody urine).
•Do not use enteric-coated aspirin products in emergency situations. |
|
|
Term
Mechanisms of Action for Clopidogrel (Plavix)
•Antiplatelet
•Anticoagulant |
|
Definition
•Thienopyridine that inhibits platelet aggregation by selectively preventing the binding of adenosine diphosphate (ADP) to its platelet receptor
•Inhibits subsequent ADP-mediated activation of the glycoprotein IIb/IIIa complex
•Results in prolongation of bleeding time due to inhibition of clotting
•Irreversible modification of platelet ADP receptor; lasts the lifetime of the platelet |
|
|
Term
Indications for Clopidogrel (Plavix)
•Antiplatelet
•Anticoagulant |
|
Definition
•Reduction of atherosclerotic events in patients with recent stroke, MI, or established peripheral arterial disease
•To improve outcome of patients with acute coronary syndrome and acute MI undergoing PCI (including with stent placement)
•Combination therapy with aspirin in patients with acute coronary syndrome and acute MI not undergoing PCI |
|
|
Term
| Discontinue use of what medication for 7 days prior to elective surgery? |
|
Definition
|
|
Term
| Contraindications for Clopidogrel (Plavix) |
|
Definition
•Drug hypersensitivity
•Acute pathologic bleeding, such as peptic ulcer or intracranial hemorrhage
•Lactating mothers |
|
|
Term
| Mechanisms of Action for Enalapril (Vasotec) |
|
Definition
| •Inhibition of conversion of angiotensin I to angiotensin II, blocking vasopressor activity and aldosterone secretion •Reduction in blood pressure due to reduced vasoconstriction (afterload) •Reduction in pulmonary capillary wedge pressure (measure of preload) and pulmonary vascular resistance |
|
|
Term
Indications for Enalapril (Vasotec)
•Antihypertensive |
|
Definition
•Mild to moderate hypertension (may combine a diuretic in therapy)
•Post-myocardial infarction (to minimize ventricular remodeling; usually initiated 6 hours after onset of symptoms)
•Post-myocardial infarction for preload and afterload reduction
•Congestive heart failure |
|
|
Term
Contraindications for Enalapril (Vasotec)
•Antihypertensive |
|
Definition
•Pregnancy
•Hypersensitivity to ACE inhibitors
•Pre-existing hypotension
•Cardiogenic shock
•Cautious use in renal impairment or renal artery stenosis, hypovolemia, hepatic insufficiency, diabetes mellitus, diuretic or dialysis therapy, and conditions where hypotension would present a potential hazard (e.g., cerebrovascular insufficiency) |
|
|
Term
| Exerts its anticoagulant effects by inhibiting thrombin-catalyzed or -induced reactions, including fibrin formation; activation of coagulation factors V, VIII, and XIII; activation of protein C; and platelet aggregation. |
|
Definition
Argatroban (Acova)
•Thrombin inhibitor |
|
|
Term
| Capable of inhibiting the action of both free and clot-associated thrombin |
|
Definition
Argatroban (Acova)
•Thrombin inhibitor |
|
|
Term
| Exercise caution when administering Argatroban to patients with hepatic impairment by? |
|
Definition
| Starting with a lower dose and carefully titrating until the desired level of anticoagulation is achieved. |
|
|
Term
| Which drug isfor use as an anticoagulant in patients with unstable angina undergoing percutaneous transluminal coronary angioplasty (PTCA)? |
|
Definition
Bivalirudin (Angiomax)
•Antithrombotic |
|
|
Term
| Which drug is used for post-myocardial infarction (to minimize ventricular remodeling)? How long before ventricular remodeling usually start? |
|
Definition
-Enalapril (Vasotec)
-usually initiated 6 hours after onset of symptoms |
|
|
Term
| Reversibly binds to GP IIb/IIIa receptor on human platelets and inhibits platelet aggregation |
|
Definition
| Tirofiban HCL (Aggrastat) |
|
|
Term
•Thrombin-specific antithrombotic
•Reversible polypeptide thrombin inhibitor
•Directly inhibits clot-bound and circulating thrombin |
|
Definition
|
|
Term
•Direct thrombin inhibitor that reversibly binds to the thrombin active site.
•Reversibly binds to the active thrombin site of free and clot-associated thrombin |
|
Definition
|
|
Term
•Low molecular weight
•Anticoagulant
•Inhibit thrombin generated by factor Xa
•Inhibit thrombin indirectly by formation of a complex with antithrombin III |
|
Definition
|
|
Term
| •Anticoagulant effect when used alone •In heparinized patients, it neutralizes both anticoagulant effects |
|
Definition
Protamine Sulfate
•Reversal agent of heparin |
|
|
Term
•Tissue plasminogen activator from recombinant DNA
•Fibrin specific
•Dissolves stable fibrin clots |
|
Definition
|
|
Term
•Inhibit thrombin generated by factor Xa
•Inhibit thrombin indirectly by formation of a complex with antithrombin III |
|
Definition
Lovenox (Enoxaparin)
•Anticoagulant |
|
|
Term
| Precautions for Lovenox (Enoxaparin) |
|
Definition
•Monitor for thrombocytopenia.
•Reduce dosage in patients that weigh < 45 kg or with renal impairment. |
|
|
Term
| Contraindications for Lovenox (Enoxaparin) |
|
Definition
•Bleeding disorder
•Platelet count < 150,000 |
|
|
Term
| Contraindications for Protamine Sulfate |
|
Definition
| •Patients with allergies to seafood |
|
|
Term
•Fibrin specific
•Dissolves stable fibrin clots |
|
Definition
|
|
Term
•Catalyzes with fibrin
•Converts plasminogen into plasmin |
|
Definition
|
|
Term
| Blocks synthesis of precursor to thromboxane A2 |
|
Definition
|
|
Term
| Impedes hepatic synthesis of blood coagulation factors, possibly via inhibition of vitamin K activity |
|
Definition
|
|
Term
| Permanent inhibition of prostaglandin H synthase 1 or cyclooxygenase (COX)-1 |
|
Definition
|
|
Term
| Inhibits subsequent ADP-mediated activation of the glycoprotein IIb/IIIa complex |
|
Definition
Clopidogrel (Plavix)
•Antiplatelet
•Anticoagulant |
|
|
Term
| Which anticoagulant drug should you not give to lactating mothers? |
|
Definition
Clopidogrel (Plavix)
•Antiplatelet
•Anticoagulant |
|
|
Term
Indications for Integrilin (Eptifibatide)
•Antiplatelet
•Glycoprotein (GP) IIb/IIIa inhibitor |
|
Definition
•Non ―Q‖ wave MI
•Unstable angina medically managed
•Non ―Q‖ wave Mi or unstable angina undergoing PCI |
|
|
Term
| Mechanisms of Action for integrilin (Eptifibatide) |
|
Definition
| •Antiplatelet •Inhibits platelet aggregation by preventing binding of fibrinogen and other ligans to GP Iib/IIIa receptors |
|
|
Term
| Indicated for patients with unstable angina that is medically managed |
|
Definition
Integrilin (Eptifibatide)
•Antiplatelet
•Glycoprotein (GP) IIb/IIIa inhibitor |
|
|
Term
Mechanisms of Action for Lovenox (Enoxaparin)
•Anticoagulant |
|
Definition
•Low molecular weight
•Anticoagulant
•Inhibit thrombin generated by factor Xa
•Inhibit thrombin indirectly by formation of a complex with antithrombin III |
|
|
Term
Indications for Lovenox (Enoxaparin)
•Anticoagulant |
|
Definition
•Non ―Q‖ wave MI
•Unstable angina |
|
|
Term
| Route for Lovenox (Enoxaparin) |
|
Definition
|
|
Term
| For use as an anticoagulant in patients with unstable angina undergoing percutaneous transluminal coronary angioplasty (PTCA) |
|
Definition
|
|
Term
| Which drug is derived from the saliva of leeches? |
|
Definition
|
|
Term
| Contraindications for Argatroban (Acova) |
|
Definition
•Overt major bleeding
•Hypersensitivity to drug or its components |
|
|
Term
| Clopidogrel (Plavix) inhibits subsequent ADP-mediated activation of what? |
|
Definition
| glycoprotein IIb/IIIa complex resulting in prolongation of bleeding time due to inhibition of clotting |
|
|
Term
|
Definition
-acute MI in adults
-coronary ischemia with new onset left bundle branch block (LBBB)
-coronary thrombus |
|
|
Term
| Indications for Activase (tPA) |
|
Definition
-acute MI in adults
-used within 4 - 6 hours of onset of symptoms |
|
|
