Level 1: CH 43-44 Blood Clotting, Anticoagulants, and Lipid Management

Vocabulary-style flashcards covering blood clotting physiology, anticoagulants, thrombolytics, antiplatelets, and antihyperlipidemics.

Platelets

Small blood cells produced in the bone marrow that aggregate at injury sites to form a platelet plug.

Clotting factors

Plasma proteins that participate in coagulation; activated in a cascade to form a fibrin clot.

Thromboxane A2 (TXA2)

A prostaglandin-derived molecule from platelets that promotes vasoconstriction and platelet aggregation.

GP IIb/IIIa receptor

Platelet surface receptor that binds fibrinogen to link platelets during aggregation.

Intrinsic pathway

Coagulation pathway triggered by vascular injury involving factors XII, XI, IX, and VIII.

Extrinsic pathway

Coagulation pathway triggered by tissue factor (III) exposing and activating factor VII.

Prothrombin (Factor II)

Clotting factor converted to thrombin in the common pathway; vitamin K dependent.

Fibrinogen (Factor I)

Plasma protein converted to fibrin by thrombin to form the clot.

Fibrin

Insoluble protein that forms the mesh of a formed clot.

Common pathway

Pathway where thrombin activates fibrin formation from fibrinogen.

Vascular phase

First phase of hemostasis with vasoconstriction to reduce bleeding.

Platelet phase

Second phase where platelets aggregate to form a platelet plug.

Coagulation phase

Third phase: clot formation and stabilization, including clot retraction.

Fibrinolysis

Process of clot breakdown mediated by plasmin.

tPA (tissue plasminogen activator)

Enzyme that converts plasminogen to plasmin to dissolve clots; endothelium source.

Plasmin

Active enzyme that digests fibrin and dissolves clots.

FDPs

Fibrin degradation products released during fibrinolysis.

Thrombus

A clot formed in a blood vessel.

Arterial thrombosis

Clotting in arteries; platelets initiate, fibrin forms, RBCs trapped in fibrin mesh.

Venous thrombosis

Clotting in veins; platelet aggregation with fibrin attaching to RBCs.

DVT

Deep vein thrombosis; clot in deep veins (often legs).

PE

Pulmonary embolism; clot travels to and blocks pulmonary arteries.

Ischemia

Inadequate blood supply to tissue causing potential injury.

Thrombosis risk factors

Immobility, surgery, AFib, artificial valves, OCPs, chemo, infection, cancer, genetic diseases.

Anticoagulants

Drugs that prevent new clots from forming; used for venous thrombosis and prevention.

Antiplatelets

Drugs that prevent platelet aggregation; mainly prevent arterial thrombosis.

Thrombolytics

Drugs that dissolve existing clots by converting plasminogen to plasmin.

Warfarin

Oral anticoagulant that inhibits vitamin K–dependent clotting factor synthesis; monitored by INR.

Heparin

Parenteral anticoagulant that enhances antithrombin III to inactivate thrombin and factor Xa.

LMWH (low-molecular-weight heparin)

More stable, lower bleeding risk; inactivates factor Xa; SQ; less monitoring.

Factor Xa inhibitors

Oral anticoagulants (e.g., apixaban, rivaroxaban, edoxaban, betrixaban) that inhibit Factor Xa.

Direct thrombin inhibitors

Anticoagulants (e.g., dabigatran, argatroban) that directly inhibit thrombin.

Protamine sulfate

Antidote for heparin overdose.

Vitamin K

Antidote for warfarin overdose; essential for synthesizing clotting factors.

INR

International normalized ratio; standardizes PT to monitor warfarin therapy.

PT

Prothrombin time; measures extrinsic pathway clotting.

aPTT

Activated partial thromboplastin time; monitors heparin therapy.

HIT

Heparin-induced thrombocytopenia; immune reaction with clot risk.

Aspirin

Antiplatelet that inhibits COX, reducing thromboxane A2; GI bleeding risk.

Clopidogrel

Antiplatelet (P2Y12 inhibitor) reducing platelet aggregation.

Cilostazol

Antiplatelet with peripheral vasodilation; used for intermittent claudication.

Pentoxifylline

Hemorheologic agent; lowers blood viscosity and improves microcirculation.

Niacin (Nicotinic acid)

Vitamin B3; lowers VLDL/LDL; can cause flushing and hepatic effects.

Cholesterol absorption inhibitor (ezetimibe)

Lowers cholesterol by inhibiting intestinal absorption; often with statins.

Bile-acid sequestrants

Bind bile acids in intestine to reduce LDL; cholestyramine is an example.

Statins (HMG-CoA reductase inhibitors)

Lower LDL, raise HDL by inhibiting cholesterol synthesis; monitor liver and risk of rhabdomyolysis.

Homocysteine

Amino acid; high levels linked to cardiovascular disease; lowered by B6, B12, folic acid.

hs-CRP

High-sensitivity C-reactive protein; marker of inflammation and atherosclerosis risk.

Apolipoproteins

Proteins on lipoproteins; ApoA1 for HDL, ApoB for LDL/VLDL; ApoB-100 common in VLDL/LDL.

HDL

High-density lipoprotein; removes cholesterol; protective (“good” cholesterol).

LDL

Low-density lipoprotein; high cholesterol content; major atherosclerosis risk factor.

VLDL

Very low-density lipoprotein; high triglycerides; precursor to LDL.

Chylomicrons

Liprotein carrying dietary triglycerides and cholesterol to liver.

ApoA-1

Major apolipoprotein of HDL.

ApoB-100

Major apolipoprotein of VLDL and LDL; good risk indicator for CAD.

ApoB-48

Apolipoprotein form associated with chylomicrons.

Peripheral vasodilators

Drugs that increase blood flow by widening peripheral vessels.

Cilostazol (antiplatelet/vasodilator)

Inhibits platelet aggregation and causes peripheral vasodilation.

Pentoxifylline (hemorheologic)

Reduces blood viscosity and improves microcirculation.

Atherosclerosis risk markers

Markers like homocysteine and hs-CRP indicate inflammation and risk.

Nonpharmacologic cholesterol reduction

Dietary changes, exercise, stop smoking to lower lipid levels.

Thrombolytics contraindications

Recent CVA/head trauma/surgery, severe hypertension; risk of bleeding.