z-Pharm Heparin
Terms
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VIP
What are the six actions of heparin? -
Actions of heparin:
1. inhibits the action of activated factor Xa and thrombin (factor IIa)
2. inhibits the action of several other serine protease enzymes (XIIa, XIa)
3. inhibits the aggregation of platelets (used in open heart surgery)
4. has a plasma clearing effect: turbid plasma is rapidly cleared of fat chylomicrons by a release of lipase from the blood vessel.
5. binds to vascular lining and neutralizes the postive charge
6. it causes a release of tissue factor pathway inhibitor - Can heparin be given orally?
- No
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VIP VIP VIP
What are the four endogenous modulators of heparin action (with out heparin won't work)? -
1. AT-III (main heparin cofactor)
2. heparin cofactor II (secondary)
3. tissue factor pathway inhibitor (TFPI) - released by heparin to counteract tissue factor
4. platelet factor 4 (heparin neutralizing protein) - patient who has thrombocytosis, IPP, TTP - Describe heparin induced thrombocytopenia:
- Generation of antiheparin platelet factor 4 antibodies. These antibodies activate platelts and endothelial cells
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VIP
Protamine sulfate - This is a powerful heparin antagonist. It combines strongly with the acidic heparin to form a stable salt with loss of anticoagulant activity
- What is the difference between low molecular weight heparins and high?
- Low molecular weight heparins have a better cutaneous bioavailability, longer duration of action, less bleeding, and lesser thrombocytopenia
- Three currently approved indications for low molecular weight heparins.
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1. treatment of DVT
2. management of acute coronary syndromes
3. in surgical procedures - What are direct antithrombin-concentrates used for?
- p.8 Heparin
- What is HIRUDIN?
- A protein from saliva of the medicinal leech that has been manufactored to excrete its anticoagulant effects and be used as anticoagulant management of heparin throbocytopenic patients.
- What is ARGATROBAN?
- A synthetic antithrombin agent that is currently used as an anticoagulant in patients who cannot be treated with heparin.