blood/anticoagulants/antiplatelet/thrombolytic drugs
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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| red thrombus | venous thrombosis --> usually due to blood stasis; has low platelet and high fibrin content
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| white thrombus | arterial thrombosis --> associated w/atherosclerosis; high platelet and low fibrin content
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| substance located in the subendothelial matrix that activates platelets when blood comes into contact with it in instances of vascular injury | collagen
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| extrinsic pathway requires what | tissue factor (something outside of blood)
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| common pathway b/w extrinsic and intrinsic pathways | Xa splits prothrombin into thrombin (factor V, PL, Ca present)
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| prothrombin time (PT) | time required for plasma to clot when exogenous tissue factor is added
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| fibrin digesting enzyme responsible for thrombolysis | plasmin (activated by t-PA from plasminogen)
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| converts fibrinogen to fibrin | thrombin
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| helps solidify platelet plugs to patch up small holes, insoluble | fibrin
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| vitamin K dependent factors (4) | II, VII, IX, X (2, 7, 9, 10) - synthesized in the liver; required for clotting cascades
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| white thrombus generally responsible for | for acute MI, stroke, etc; LDL usually involved
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| red thrombus generally responsible for | Deep vein thrombosis (DVT) and pulmonary embolism
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| three potential causes for red thrombus | vessel wall damage (hip/knee surgery), stasis, hypercoagulability
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| are antiplatelet drugs more effect for white thrombus or red thrombus related disorders | white thrombus (atherosclerotosis related) disorders more responsive to antiplatelet drugs (aspirin)
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| heparin | injectible anticoagulant; 5-50 kDa; accelerates antithrombin III (ATIII); inhibits thrombin (IIa) and Xa; requires PT monitoring - good for immediate relief
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| LMWH | low-molecular weight heparins; 1-10 kDa; accelerates ATIII; inhibits Xa, but NOT thrombin; more predictable than heparin; doesn't require PT monitoring - good for home use
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| critical length for binding pocket in antithrombin III (ATIII) | 5 units (highly acidic) - pentasaccharides
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| Fondaparinux | heparin derivative for prevention/treatment of VTE; once daily, predictable; doesn't bind platelets (no heparin-induced thrombocytopenia)
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| direct thrombin inhibitors - parenteral(3) | Hirudin – irreversible binds to thrombin; Bivalirudin – analog of hirudin; Argatroban – non-covalent reversible binding
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| direct thrombin inhibitors - oral (1) | Ximelagatran - non-covalent reversible binding, first oral form.
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| only FDA approved oral anticoagulant in US | warfarin - vitamin K antagonist
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| warfarin MOA | interferes w/synthesis of factors II, VII, IX, X, but their half-life is 8 - 60 hours so requires bridge therapy; target INR 2 - 3; initial PT changes due to depletion of factor 7, but takes a few weeks to turn over factor 10
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Created by:
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