Med Chem Tutoring for Anticoagulants, Antiplatelets, and Thrombolytics By Alaina Darby

Anticoagulants

Which of the following is not an anticoagulant? Dabigatran Warfarin Aspirin Heparin C

Which of the following is true of heparin? Strong base Weak base Weak acid Strong acid D

Which of the following makes heparin acidic? Sulfate groups Alcohol groups Amide groups Peptide bonds A

Which of the following is not involved in the intrinsic pathway? XII VII II C

Which of the following does not have a role in both the intrinsic and extrinsic pathways? II VII X C

Which of the following is activated by heparin? Thrombin Antithrombin III Prothrombin Fibrin B Which inactivates thrombin

Which of the following is not true of heparin? Is used after MI Orally effective Short DOA Causes HIT B

Which of the following is a risk factor for developing a DVT? Phlebitis Pulmonary embolism Lower extremity surgery Myocardial infarction C A and B are things that can happen due to a DVT

What is the primary mechanism by which protamine sulfate works? Binds to ATIII Has coagulant activity Has anticoagulant activity Strongly basic peptide D

Which of the following is not an advantage of LMWH over heparin? Longer half life Less thrombocytopenia Higher bioavailability Can be given orally D (but can be given at home IM!)

Which of the following selectively inhibits Factor Xa but has no effect on thrombin? Fondaparinux Enoxaparin Dalteparin Tinzaparin A

Which of the following is a polypeptide? Heparin Enoxaparin Fondaparinux Desirudin D

Which amino acid sequence binds the thrombin active site? D-Phe-Pro-Arg-Pro D-Pro-Phe-Arg-Pro D-Pro-Arg-Pro-Phe D-Pro-Arg-Phe-Pro A I think there may have been a question comparing the argatroban structure to the peptide sequence… know that.

Which of the following can be used for a patient that has had HIT? Heparin Argatroban Enoxaparin Fondaparinux B

Which of the following is a zwitterion? Argatroban Dabigatran Rivaroxaban Epixaban B

Which of the following is a double prodrug? Argatroban Dabigatran Rivaroxaban Epixaban B

Which of the following is warfarin? A. B. C. D.

Which of the following is true of the properties of warfarin? Weak acid; (S) isomer is most active Weak acid; (R) isomer is most active Weak base; (S) isomer is most active Weak base; (R) isomer is most active A

Which of the following should be done for major warfarin overdoses? Drug withdrawal Give vitamin K Give Menadione sodium bisulfite B&C All of the above E

Which of the following enhances warfarin activity? Vitamin K Griseofulvin Metronidazole Phenobarbital C

Phenylbutazole: inhibit CYPs Antibiotics: kill microbes in GIT Which of the following enhancers of warfarin effects is not properly paired to its mechanism? Phenylbutazole: inhibit CYPs Antibiotics: kill microbes in GIT Chloramphenicol: inhibit CYPs Anabolic steroids: unknown A

Which of the following can only maintain blood up to 21 days? Anticoagulant sodium citrate Anticoagulant citrate dextrose Anticoagulant citrate phosphate dextrose Anticoagulant citrate phosphate dextrose adenine B

Antiplatelets

Platelets adhere to damaged subendothelial tissues Which of the following is not included in phase I platelet aggregation? Platelets adhere to damaged subendothelial tissues Platelets don’t adhere to undamaged endothelial tissue Hemostasis is induced Release chemical mediators from platelets D

Which of the following is not true of dipyridamole? Induces vasodilation Increases levels of cAMP Decreases adenosine Inhibits PDE3 C

Which of the following should not be used as sole therapy? Warfarin Enoxaparin Aspirin Dipyridamole D

Into which of the following is prasugrel classified? PDE3 inhibitor COX inhibitor ADP inhibitor Glycoprotein IIb/IIIa receptor inhibitor C

Into which of the following is dipyridamole classified? PDE3 inhibitor COX inhibitor ADP inhibitor Glycoprotein IIb/IIIa receptor inhibitor A

Into which of the following is eptifibatide classified? PDE3 inhibitor COX inhibitor ADP inhibitor Glycoprotein IIb/IIIa receptor inhibitor D

Into which of the following is aspirin classified? PDE3 inhibitor COX inhibitor ADP inhibitor Glycoprotein IIb/IIIa receptor inhibitor B

Which of the following is a prodrug that must be activated by CYP2C19? Ticlopidine Clopidogrel Prasugrel B

Fibrinolytics

For which of the following are fibrinolytics not used? Acute MI Deep vein thrombosis Pulmonary embolism Thrombotic stroke B

Which of the following is the most immunogenic? Streptokinase Alteplase Reteplase Tenecteplase A

Which of the following has the highest specificity for fibrin? Streptokinase Alteplase Reteplase Tenecteplase D

Which of the following is not produced using recombinant DNA technology? Streptokinase Alteplase Reteplase Tenecteplase A