pharm antiplatelet, thrombolytic 4-25-06
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- plasmin is the major ___________ enzyme. It breaks down both _______ and _______
- fibrinolytic enzyme. It accelerates breaks down of both fribin and fibrinogen yielding fibrin splip products and degradation products, respectively.
- Fibrinogen is converted to fibrin by _________
- thrombin
- tPA and urokinase promote the converson of ______ to ________ thereby increasing fibrinolysis.
- plasminogen to plasmin
- Various stimuli activate a blood proactivator to a blood activator that promotes conversion of _________ to ____ thereby increasing fibrinolysis
- plasminogen to plasmin
- Streptokinase and anistreplase both activate and Activator that increases convesion of plasminogen to plasmin.
- 0
- Aminocaproic acid:____________ fibrinolysis.
- inhibits fibrinolysis by inhibition of plasminogen conversion to plasmin.
- 4 examples of thrombolytics include: ________, _________, _____________, and ___________
- Streptokinase, urokinase, tPA(altepalse), APSAC (anistreplase)
- Thrombolytics work by directly or indirectly aiding the conversion of ___________ to __________, which cleaves ______ and ________ clots. tPA specifically coverts _______________ to plasmin
- Directly or indirectly aid conversion of plaminogen to plasmin, which cleaves thrombin and fribrin clots. It is claimed that tPA specifically coverts fribrin-bound plasminogen to plasmin.
- T/F: clinical use of thrombolytics is for DVTs
- False: used for early MI and early ischemic stroke
- pts. receiving thrombolytic medication are at most risk for: ______
- bleeding
- When a break in the endothelium occurs _________ and _________ are exposed.
- collagen and vWF
- Platelets are activated by binding what two macromolecules? The two structures expressed by the platelets involved in this process are __________ and _________ and they bind to _________ and __________, repectively
- Platelets bind to collagen and vWF. The two structures expressed by platelets that are involved in this process are GP 1a and GP 1b. GP 1a and GP 1b bind to collagen and vWF, respectively.
- After platelet activation _________ is expressed on their surface. What is the role of this structure?
- after platelets are activated they express GP IIb/IIIa. This molecule is important in platlelet-platelet aggregation.
- _________ and _________ interaction is needed in order for platelet aggregation to occur.
- GP IIb/IIIa and fribinogen
- 5-HT, _______, and ________ are molecules that play a role in the glycoprotein expression of activated platelets.
- 5-HT, ADP, and TxA2 are molecules that play a role in the glycoprotein expression of activated platelets.
- Aspirin acts by inhibiting production of ________ that in turn inhibits glycoprotein expression in activated platelets.
- TxA2
- ___ and ____ irreversibly block ADP receptors, thus preventing glycoprotein _____ expresssion.
- ticlopidine and clopidogrel; glycoprotein IIb/IIIa
- This antibody drug targets the _______ on platelets.
- Abciximab targets glycoprotein receptor IIb/IIIa
- T/F: Copidogrel & ticlopidine inhibit platelet aggregation by irreversibly inhibiting the ADP pathway involved in the binding of fibrinogen
- TRUE
- Copidogrel & ticlopidine used for ______ ________ syndrome, coronary _______, and it has been shown to decrease the incidence or recurrence of___ ____.
- it is used for acute coronary syndrome, coronary stenting. Decreases incidence or recurrence of thrombotic stroke
- Ticlopidine is associated with_________ as a side effect.
- Ticlopidine causes neutropenia and it is reserved for those who cannot tolerate aspirin.
- Abciximab binds to __________ on activated platelets.
- gp IIb/IIIa
- Abciximab is used for ___________ and ________ _________ ___________ ___________
- acute coronary syndromes and percutanous transluminal coronary angioplasty
- Abciximab toxiciites are _______ and ________
- bleeding and thrombocytopenia
- Aspirin ________ and (reversibly/irreversibly) inhibits COX1 and COX2 to prevent the conversion of _______ to prostaglandins.
- acetylates and irreversably inhibits COX-1 and COX-2. Prevents conversion of arachidonic acid to prostaglandins
- T/F: aspirin has an effect of PT, PTT
- false it has no effect
- What are the 4 A's of aspirin and NSAIDS in general
- Antipyretic, Analgesic, Anti-inflam, antiplatelet
- Important Aspirin toxicities include _________, bleeding, hyperventilation, __________- in children, and CN ____ toxicity
- gastric ulceration, bleeding, hyperventilation, Reyes syndrome and tinnitus (CNVIII).