which statement is correct regarding argatroban?

it binds directly to active site of thrombin

which is TRUE about argatroban?

binds reversibly to catalytic site of thrombin

in regards to bivalirudin, which statement is FALSE?

its administration is associated with thrombocytopenia

which is FALSE regarding lepirudin?

forms irreversible covalent complex when reacting with thrombin

what is the MOA for andexanet alfa?

binds to factor Xa direct inhibitors and acts as a decoy

all are true about apixaban EXCEPT...

common adverse event is thrombocytopenia

which is FALSE about warfarin?

coag factors secreted while on warfarin are fully carboxylated but hypofxnl

which is NOT correct about direct thrombin inhibitors?

their effect is dependent on antithrombin

all of the followings are true about lepirudin EXCEPT...

heparin has a better safety to efficacy ratio than lepirudin

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Direct Thrombin Inhibitors

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Pharmacology Exam 5 Material

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Questions 38

Answers

1
which serves as an essential cofactor for the carboxylation of clotting factors?
factor Xa
factor XII
vitamin K
factor IXa
2
which statement is correct regarding argatroban?
it binds directly to allosteric site of antithrombin
it binds directly to active site of antithrombin
it binds directly to active site of thrombin
it binds directly to exosite of thrombin
3
which is TRUE about argatroban?
binds to both free and fibrin-bound thrombin
binds irreversibly to catalytic site of thrombin
binds reversibly to catalytic site of thrombin
binds to allosteric site on factor Xa
4
which form of warfarin is more potent in producing an anticoagulant response?
R-warfarin
S-warfarin
all the isomers are equipotent
racemix mixture
5
what is the antidote for rivaroxaban?
vitamin k
idarucizumab
andexanet alfa
none of the above
6
which is an adverse effect of bivalirudin?
bleeding
hypertension
angina
thrombocytopenia
7
all are correct about warfarin EXCEPT..
99% protein-bound
crosses placenta
not found in milk
not metabolized by CYP P450s.
8
which standardized test is used to monitor warfarin use?
aPPT
warfarin normalized test
PT
INR
9
the binding affinity for idarucizumab is higher than that of dabigatran to ______
fibrinogen
factor Xa
bivalirudin
thrombin
10
which is a catalytically-inactive factor Xa?
idarucizumab
inactivated Zhzho
apixaban
rivaroxaban
11
in regards to bivalirudin, which statement is FALSE?
binding of bivalirudin to thrombin is reversible
its administration is associated with thrombocytopenia
bivalirudin is a synthetic protein
bivalirudin is orally inactive
12
which is NOT a clinical indication for warfarin?
prevent. of systemic embolization w/ acute MI, prosthetic heart valve, Afib
prevention of venous thromboembolism w/ orthopedic/gynecological surgery
ventricular fibrillation
progression or recurrence of acute DVT or PE
13
which is FALSE regarding lepirudin?
is a recombinant hirudin
forms irreversible covalent complex when reacting with thrombin
more effective and higher therapeutic index than heparin
inhibits circulating and clot-bound thrombin
14
what is the antidote of apixaban?
andexanet alfa
dabigatran
warfarin
idarucizumab
15
which binds to exosite 2 of thrombin?
vitamin K
fibrinogen
heparin
fibrin
16
what is the reference value for INR?
0
2
1
3
17
which is NOT true about dabigatran?
it is a prodrug
the antidote is idarucizumab
monitoring is not mandatory
it is only available by IV
18
which is NOT a clinical indication of direct thrombin inhibitors?
prophylaxis against thrombosis in percutaneous coronary intervention
pulmonary embolism
myocardial infarction
unstable angina
19
what is the MOA for andexanet alfa?
cleaves prothrombin to thrombin
acts as an active analog to factor Xa
competes with factor Xa direct inhibitors for the active site of factor Xa
binds to factor Xa direct inhibitors and acts as a decoy
20
lepirudin may increase aPTT to more than 70 seconds which can lead to...
spontaneous bleeding
embolism
thrombosis
activation of clotting factors
21
what direct oral anticoagulant (DOAC) would be used for a hospital patients w/ restricted mobility?
dabigatran
rivaroxaban
betrixaban
apixaban
22
which of these enzymes reduce vitamin K?
CALU
GGCX
all of the above
VKORC1
23
all are true about apixaban EXCEPT...
metabolized by CYP P450 enzymes
common adverse event is thrombocytopenia
oral factor Xa inhibitor
antidote is andexanet alfa
24
which is NOT a required specific population for DOAC monitoring?
geriatric patients
obese patients
depressed patients
pediatric patients
25
which of the following binds reversibly to catalytic site of thrombin and can be used in patients with HIT?
argatroban & rivaroxaban
lepirudin & rivaroxaban
lepirudin & bivalirudin
bivalirudin & argatroban
26
which is directly inhibited by betrixaban?
factor Xa
thrombin
plasminogen
vitamin K
27
which is FALSE about warfarin?
warfarin has no effect on fully carboxylated clotting factors circulating
warfarin decreases the amount of each vit K-dependent coag factor by 30-50%
the onset of action of warfarin is slow
coag factors secreted while on warfarin are fully carboxylated but hypofxnl
28
in which cases of warfarin toxicity can vitamin K1 be given?
INR of 2-3
INR > 20
INR of 5+
INR <4
29
which is false about warfarin?
it is 100% bioavailable
food decreases absorption
used safety in pregnancy
metabolized by CYP P450s
30
in patients with APS, what would be the anticoagulant of choice?
apixaban
warfarin
rivaroxaban
dabigatran
31
what is molecular target for warfarin?
GGCX
none of the above
CYP2C9
thrombin
32
which of these catalyze the carboxylation of blood clotting factors?
CYP2C9
GGCX
CALU
VKORC1
33
which is an adverse effect of rivaroxaban?
thrombocytopenia
sudden death
hepatotoxicity
bleeding
34
which is NOT correct about direct thrombin inhibitors?
they inhibit both free and clot-bound thrombin
their effect is dependent on antithrombin
their effect is independent of antithrombin
they bind directly to active site of thrombin
35
what are the BBW for andexanet Alfa?
arterial and venous thromboembolic events
cardiac arrest & sudden deaths
all of the above
myocardial infarction and ischemic stroke
36
which binds to the active site of thrombin?
heparin
bivalirudin
fibrin
rivaroxaban
37
all of the followings are true about lepirudin EXCEPT...
heparin has a better safety to efficacy ratio than lepirudin
it is indicated for prophylaxis of thromboembolic disorder
it is a recombinant hirudin
it is an irreversible non covalent complex
38
which medication will be used to neutralize the anticoagulant effect of dabigatran?
andexanet alfa
dabilyse
rivaroxaban
idarucizumab

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