Hematopoietic Drugs Exam 3

1. Factor V and thrombin inhibitor - Heparin...
2. Vitamin K antagonist - Warfarin (Coumadin)
3. Direct Thrombin inhibitors ? Argatroban (Acova)

1. Vessel Spasm
2. Formation of the Platelet Plug
3. Blood Coagulation
4. Clot Retraction
5. Clot Lysis

blood clot within a vessel or the heart

Arterial - begin w/ formation of a platelet plug, which is reinforced w/ fibrin

Venous - begin with fibrin, & enmesh RBC & platelets

Prevention and treatment of thromboembolic disorders.

Rapid

hemophiliacs, Von Willdebrand disorder

1. Given when rapid onset of anticoagulation desired
2. Heparin (Unfractionated)
3. Given IV or SC, no oral absorption
4. Decreases fibrin formation ? by promoting...
5. Plasma levels vary ? monitor PTT
6. Hepatic metabolism, renal excretion,
7. Half life: 1.5 hrs (normal renal, liver function)
8. Hemorrhage/bleeding is the principal...
9. Protamine sulfate ? antidote for too much heparin

1. Enoxaprin (Lovenox), Dalteparin (Fragmin)
2. Given SQ
3. Advantages;
4. Given on a fixed dose schedule
5. PTT monitoring not required
6. Less likely to cause thrombocytopenia
7. Can be used at home
8. Adverse effects - bleeding

1. Argatroban (Acova)
2. Action: direct inhibition of thrombin
3. IV ? 2mcg/kg/min, if liver prob. 0.5 mcg/kg/min
4. Pharmacokinetics ? short half-life (45 min), liver metabolism
5. Treatment alternative for patients with HIT
6. Adverse effects: bleeding, allergic reactions (dyspnea, cough, rash)
7. Costly

1. General use: prevention of thrombosis
2. Actions: suppresses platelet aggregation and prolongs...
3. Contraindications: hypersensitivity, ulcers, active...
4. Precautions: any patient with a risk of bleeding.
5. Interactions: concurrent use with NSAIDs, heparin,...
6. Aspirin
7. Adenosine Diphosphate Receptor Antagonists- Ticlopine...
8. Glycoprotein IIb/IIIa Receptor Antagonists ?

1. Inhibition of cyclooxygenase
2. > thromboxane A can?t be synthesized...
3. Adenosine Diphosphate Receptor Antagonists
4. Inhibits platelet aggregation by...
5. Ticlopine (Ticlid)
6. Indicated to prevent ischemic stroke.
7. Can cause life threatening hematologic reactions.
8. Clopidogrel (Plavix)
9. secondary prevention of ischemic stroke, MI,...
10. Adverse events about the same as ASA.

1. 81 to 325 mg per day.
2. SE: bleeding problems, and anaphylaxis

1. ? Super aspirins?
2. most effective antiplatelet therapy.
3. $$$$$
4. Blockage of platelet receptors to inhibit the final step in aggregation.
5. Can block aggregation from any path.
6. Used short-term to prevent ischemic events.
7. May be given with heparin and ASA therapy.
8. Bleeding is the primary adverse event.

1. Protein extracted from streptococci cultures.
2. Given to remove thrombi that have formed.
3. Prototype thrombolytic drug.
4. Indicated in acute MI, DVT, massive PE.
5. Adverse effects
6. Bleeding is major complication
7. Hypotension
8. fever

1. Produced by recombinant DNA technology
2. Indicated in MI (slightly better than streptokinase), pulmonary embolus, acute ischemic stroke
3. $$$$$ 7 to 8 x steptokinase
4. Adverse effects
5. Bleeding
6. GUSTO ? global utilization of streptokinase and tPA for occluded coronary arteries