Anti-Thrombic Therapy Flashcards Preview

Year 2 > Anti-Thrombic Therapy > Flashcards

Flashcards in Anti-Thrombic Therapy Deck (32)
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1
Q

Difference between a thrombus in arterial circulation vs venous circulation

A

Arterial - High pressure forms them + platelet rich

Venous - Low pressure forms them + fibrin rich

2
Q

Result of arterial thrombosis in coronary circulation

A

MI

3
Q

Result of arterial thrombosis in cerebral circulation

A

Stroke

4
Q

Result of arterial thrombosis in peripheral circulation

A

Peripheral vascular disease, rest pain, gangrene

5
Q

How is MI caused by arterial thrombosis diagnosed

A
  1. History
  2. ECG
  3. Cardiac enzymes
6
Q

How is CVA caused by arterial thrombosis diagnosed

A
  1. History + Examination
  2. CT Scan
  3. MRI scan
7
Q

How is Peripheral vascular disease caused by arterial thrombosis diagnosed

A
  1. History
  2. Examination
  3. Ultraosund
  4. Angiogram
8
Q

How is MI treated

A
  1. Aspirin
  2. LMWH or Fondraparinux
  3. Thrombolytic therapy (streptokinase + tissue plasminogen activator)
9
Q

What is streptokinase

A
  1. Breaks down clots in STEMIs (ST elevated MIs)
10
Q

How does streptokinase function

A

Activates plasminogen to plasmin and breaks down fibrin

11
Q

How does Tissue plasminogen activator work

A

Generates plasmin which breaks down fibrin

12
Q

How are strokes treated from thrombosis

A
  1. Aspirin or Clopidogrel, prasugrel, ticagrelor
  2. TPA (narrow window to use this)
  3. Treat risk factors
13
Q

What is cyanosis

A

Blue colouring to the skin due to lack of blood flow

14
Q

How is Venous thrombosis investigated

A
  1. DVT compression ultrasound

2. V/Q or perfusion scan

15
Q

What three conditions can increase risk of venous thrombosis

A
  1. Anti-phospholipid syndrome
  2. Lupus anticoagulant
  3. Hyperhomhocysteinaemia
16
Q

Genetic causes for venous thrombosis

A
  1. Antithrombin deficiency
  2. Protein C deficiency
  3. Protein S deficiency
17
Q

How is Venous thrombosis treated

A
  1. LMWH wight adjusted dose
  2. Oral Warfarin 3-6 months
  3. OR DOAC for 3-6 months
18
Q

Name a DOAC

A

Rivaroxaban

19
Q

How is Heparin levels monitored

A

APTT, aim ratio of 1.8-2.8 by continuous infusion

20
Q

Why is LMWH better than unfratcioned heparin

A
  1. Smaller molecule so less variation in the dose given nd can be really excreted

Used once daily

21
Q

When is LMWH given

A

Treat prophylaxis and for preventing blood clotting

22
Q

How much aspirin is given in arterial thrombosis

A

75-300mg

23
Q

How does clopidogrel act

A

Inhibits ADP-induced platelet aggregation

24
Q

How does Warfarin act

A

Prevents synthesis of active factors II, VII, IX and X

Antagonises vit K

Prolongues PTT

25
Q

Half life of warfarin

A

36 hours

26
Q

Cons of using Warfarin

A
  1. Difficult to use
  2. Individual variation in dose
  3. Need to monitor
  4. Measure INR
27
Q

Target range of warfarin

A

2-3

28
Q

What are DOACs

A

Oral anticoagulant drugs

29
Q

How do DOACs function

A

Act directly on factor II and X

30
Q

Pros os using DOACAs

A

No need for blood monitoring and shorter half lives

31
Q

When are DOACS given

A

Treatment of AF and DVT/PE

32
Q

When can DOACS not be used

A

Pregnancy

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