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Med ChemTutoring for Anticoagulants, Antiplatelets, and Thrombolytics By Alaina Darby Anticoagulants Which of the following is not an anticoagulant? A. Dabigatran B. Warfarin C. Aspirin D. Heparin Which of the following is true of heparin? A. Strong base B. Weak base C. Weak acid D. Strong acid Which of the following makes heparin acidic? A. Sulfate groups B. Alcohol groups C. Amide groups D. Peptide bonds Which of the following is not involved in the intrinsic pathway? A. XII B. XI C. VII D. II Which of the following does not have a role in both the intrinsic and extrinsic pathways? A. I B. II C. VII D. X Which of the following is activated by heparin? A. Thrombin B. Antithrombin III C. Prothrombin D. Fibrin Which of the following is not true of heparin? A. Is used after MI B. Orally effective C. Short DOA D. Causes HIT Which of the following is a risk factor for developing a DVT? A. Phlebitis B. Pulmonary embolism C. Lower extremity surgery D. Myocardial infarction What is the primary mechanism by which protamine sulfate works? A. Binds to ATIII B. Has coagulant activity C. Has anticoagulant activity D. Strongly basic peptide Which of the following is not an advantage of LMWH over heparin? A. Longer half life B. Less thrombocytopenia C. Higher bioavailability D. Can be given orally Which of the following selectively inhibits Factor Xa but has no effect on thrombin? A. Fondaparinux B. Enoxaparin C. Dalteparin D. Tinzaparin Which of the following is a polypeptide? A. Heparin B. Enoxaparin C. Fondaparinux D. Desirudin Which amino acid sequence binds the thrombin active site? A. D-Phe-Pro-Arg-Pro B. D-Pro-Phe-Arg-Pro C. D-Pro-Arg-Pro-Phe D. D-Pro-Arg-Phe-Pro Which of the following can be used for a patient that has had HIT? A. Heparin B. Argatroban C. Enoxaparin D. Fondaparinux Which of the following is a zwitterion? A. Argatroban B. Dabigatran C. Rivaroxaban D. Epixaban Which of the following is a double prodrug? A. Argatroban B. Dabigatran C. Rivaroxaban D. Epixaban Which of the following is warfarin? A. B. C. D. Which of the following is true of the properties of warfarin? A. Weak acid; (S) isomer is most active B. Weak acid; (R) isomer is most active C. Weak base; (S) isomer is most active D. Weak base; (R) isomer is most active Which of the following should be done for major warfarin overdoses? A. Drug withdrawal B. Give vitamin K C. Give Menadione sodium bisulfite D. B&C E. All of the above Which of the following enhances warfarin activity? A. Vitamin K B. Griseofulvin C. Metronidazole D. Phenobarbital Which of the following enhancers of warfarin effects is not properly paired to its mechanism? A. Phenylbutazole: inhibit CYPs B. Antibiotics: kill microbes in GIT C. Chloramphenicol: inhibit CYPs D. Anabolic steroids: unknown Which of the following can only maintain blood up to 21 days? A. Anticoagulant sodium citrate B. Anticoagulant citrate dextrose C. Anticoagulant citrate phosphate dextrose D. Anticoagulant citrate phosphate dextrose adenine Antiplatelets Which of the following is not included in phase I platelet aggregation? A. Platelets adhere to damaged subendothelial tissues B. Platelets don’t adhere to undamaged endothelial tissue C. Hemostasis is induced D. Release chemical mediators from platelets Which of the following is not true of dipyridamole? A. Induces vasodilation B. Increases levels of cAMP C. Decreases adenosine D. Inhibits PDE3 Which of the following should not be used as sole therapy? A. Warfarin B. Enoxaparin C. Aspirin D. Dipyridamole Into which of the following is prasugrel classified? A. PDE3 inhibitor B. COX inhibitor C. ADP inhibitor D. Glycoprotein IIb/IIIa receptor inhibitor Into which of the following is dipyridamole classified? A. PDE3 inhibitor B. COX inhibitor C. ADP inhibitor D. Glycoprotein IIb/IIIa receptor inhibitor Into which of the following is eptifibatide classified? A. PDE3 inhibitor B. COX inhibitor C. ADP inhibitor D. Glycoprotein IIb/IIIa receptor inhibitor Into which of the following is aspirin classified? A. PDE3 inhibitor B. COX inhibitor C. ADP inhibitor D. Glycoprotein IIb/IIIa receptor inhibitor Which of the following is a prodrug that must be activated by CYP2C19? A. Ticlopidine B. Clopidogrel C. Prasugrel Fibrinolytics For which of the following are fibrinolytics not used? A. Acute MI B. Deep vein thrombosis C. Pulmonary embolism D. Thrombotic stroke Which of the following is the most immunogenic? A. Streptokinase B. Alteplase C. Reteplase D. Tenecteplase Which of the following has the highest specificity for fibrin? A. Streptokinase B. Alteplase C. Reteplase D. Tenecteplase Which of the following is not produced using recombinant DNA technology? A. Streptokinase B. Alteplase C. Reteplase D. Tenecteplase