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L3 - CV Pharm 3

Clin Pharm Ex 1

QuestionAnswer
The RAAS system is triggered by... ↓kidney perforation @juxtaglomerular apparatus = ↓CO
What is the goal of the RAAS system? ↑ CO by ↑ perfusion pressure by ↑ H2O retention
When is the RAAS system detrimental? when P has CHF = hypertension
How can we prevent the RAAS system fxn? inhibit ACE
Most ACEIs are "pro" drugs converted by which mech? liver metabolism, excreted by kidneys
Which ACEIs are most commonly used & given orally? Enalapril & Benazepril
If ACEIs are not effective, what other drugs could be used? Angiotensin II receptor antagonists (blockers = ARBs)
What are the benefits of using ARBs instead of ACEIs? more effective & ↓cardiac remodeling w/scar tissue
Platelet aggregation is stimulated by... ADP, TBX A2, 5-HT, PGI2
↑ platelet Ca concentration... promote aggregation
↑ cAMP... inhibit aggregation
Plasminogen → Plasmin by local agents = digests fibrin chains Fibrinolysis (clot break↓)
Balance btw thrombosis & fibrinolysis is... normal
Rapid oscillation btw thrombosis & fibrinolysis DIC
Highly sulfated glycosaminoglycan polymer; activates anti-throbmin Heparin
Anti-throbmin inhibits which CFs? IX, X, XI, XII, & thrombin
Heparin must be given... IV + SQ maintenance doses
More predictable, ↓ thrombin inhib, & ↑ focus on CF Xa than Heparin Low Molecular Weight Heparin (LMWH)
LMWH can be given... SQ
Ex of LMWH agents: Deltaprin Na & Enoxaprin
Synth derivative of dicoumarol, inhib Vit K Epoxide Reductase Warfarin
Warfarin has... good oral bioavail & ↑ prot binding
NSAID that reduces PGs & TBX A2 = reducing platelet aggregation Aspirin
Thienopyridine w/metabolites that inhib platelet aggregation; useful esp in cats Copidogrel
Non-specific plasminogen activator; 1st line tx for human stroke victims Strepotkinase
naturally occurring vs of Streptokinase in blood & ECM Urokinse
Recombinant tissue plasminogen activator Alteplase
What's a major benefit of using Alteplase? ↑ affinity for fibrin in thrombi, ↓ affinity for free plasminogen
Created by: Dr_B.Phillips22
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