Anticoagulant Agents
Unfractionated Heparin (60 to 100 kDa)
01. Which of the following statements about Unfractionated Heparin is wrong?
A. Mucopolysaccharides polymers
B. Exctracted from bovine lung tissues
C. Extract from Porcine intestinal mucosa
D. High affinity for antithrombin III
E. Increase amount of fibrin formation
Answer: E. Increase amount of fibrin formation
UFHs catalyze inactivation of factor Xa and IIa by AT-III ultimately reducing the amount of fibrin formation. LMWHs also bind to AT-III but preferably inhibit factor Xa rather than IIa but ultimate result is reduced amount of fibrin formation.
02. Which of the following statements about low melecular weight heparin(LMWHs) is wrong?
A. Molecular weight 2 to 10 kDa
B. Produce by UFH fragmentation
C. Prefer inhibition of Xa rather than IIa
D. Have less half-life than UFH
E. Treat pulmonary & venous thrombo emboli
Answer: D. Have less half-life than UFH
LMWHs have more predictable pharmacokinetics profile with longer half-life.
LMWHs: Enoxaparin, Tinzaparin, Dalteparin
03. A synthetic Pentasaccharide that inhibit factor X through the action of AT-III is following?
A. Enoxaparin
B. Tinzaparin
C. Dalteparin
D. Fondaparinux
E. All of the above
Answer: D. Fondaparinux
04. A drug that is mixture of heparin sulfate, dermatan sulfate and chondroitin sulfate extracted from porcine mucosa is following?
A. Enoxaparin
B. Tinzaparin
C. Dalteparin
D. Fondaparinux
E. Danaparoid
Answer: E. Danaparoid
This drug have similar MOA as LMWHs.
Direct Thrombin Inhibitors
05. Following is a 65 amino acid recombinant derivative of hirudin, the anticoagulant found in saliva of medicinal leech?
A. Lepirudin
B. Bivalirudin
C. Dabigatrin
D. Argatroban
E. Danaparoid
Answer: A. Lepirudin
06. Following is a synthetic 20 amino acid derivative of hirudin?
A. Lepirudin
B. Bivalirudin
C. Dabigatrin
D. Argatroban
E. Danaparoid
Answer: B. Bivalirudin
07. Following statements about hirudin derivatives(Lepirudin & Bivalirudin) is wrong?
A. Administered Parentrally
B. Inhibit thrombin activity without AT-III
C. Reduce formation of thrombi
D. Lepirudin has 20 amino acid
E. Direct thrombin inhibitors
Answer: D. Lepirudin has 20 Amino acids
Lepirudin has 65 amino acid while Bivalirudin has 20 amino acids.
08. Which of the following is first orally active direct thrombin inhibitor?
A. Lepirudin
B. Bivalirudin
C. Dabigatran
D. Argatroban
E. All of the above
Answer: C. Dabigatran
Used to prevent stroke in patients with atrial fibrillation.
09. A drug used to prevent stroke in patients with atrial fibrillation has a adverse effect of following?
A. Bleeding
B. Abdominal pain
C. Gastric bleeding
D. Esophageal reflux
E. All of the above
Answer: E. All of the above
10. Which of the following direct thrombin inhibitor is also associated with GI disturbance?
A. Lepirudin
B. Bivalirudin
C. Dabigatran
D. Argatroban
E. All of the above
Answer: C. Dabigatran
Anti platelets drugs
11. Following statements about Aspirin is wrong?
A. Inhibit COX
B. Reduce Thromboxane A2 level
C. Treat Myocardial infarction
D. Decrease thrombosis after coronary stenting
E. Anti platelets drugs
F. None of these
Answer F. None of these
12. A that Drug elevate cGMP in platelets by inhibition of phosphodiesterase activity to decrease aggregation?
A. Dipyridamole
B. Cilostazol
C. Aspirin
D. A & B
E. All of the above
Answer: D. A & B
13. A that Drug elevate cGMP in platelets by inhibition of phosphodiesterase activity to decrease aggregation?
A. Ticlopidine
B. Cilostazol
C. Aspirin
D. A & B
E. All of the above
Answer: B. Cilostazol
Along with Dipyridamole
14. A Thienopyridine drug covalently bind to P2Y12 receptors on platelets to prevent ADP-mediated aggregation and adhesion to fibrin?
A. Ticlopidine
B. Cilostazol
C. Dipyridamole
D. Aspirin
E. Lepirudin
Answer: A. Ticlopidine (Clopidogrel, Prasugrel)
15. A Thienopyridine drug covalently bind to P2Y12 receptors on platelets to prevent ADP-mediated aggregation and adhesion to fibrin?
A. Clopidogrel
B. Cilostazol
C. Dipyridamole
D. Aspirin
E. Lepirudin
Answer: A. Clopidogrel (Ticlopidine, Prasugrel)
16. A Thienopyridine drug covalently bind to P2Y12 receptors on platelets to prevent ADP-mediated aggregation and adhesion to fibrin?
A. Prasugrel
B. Cilostazol
C. Dipyridamole
D. Aspirin
E. Lepirudin
Answer: A. Prasugrel
17. Following drug have to be bioactivated by hepatic CYP enzymes before activation?
A. Prasugrel
B. Cilostazol
C. Dipyridamole
D. Aspirin
E. Lepirudin
Answer: A. Prasugrel (Clopidogrel, Ticlopidine)
All theinopyridines.
18. A drug that reduces the interaction of platelets via the GPIIIa/IIb receptors to fibrogen thus decreasing platelets aggregation?
A. Abciximab
B. Eptifibatide
C. Tirofiban
D. A & B
E. All of the above
Answer: E. All of the above
Abciximab causes hypotension and atrial fibrillation.
Tirofiban causes thrombocytopenia when combined with heparin.
19. A drug that is a cyclized heptapeptide with high affinity for fibrinogen receptor is following?
A. Abciximab
B. Eptifibatide
C. Tirofiban
D. A & B
E. All of the above
Answer: B. Eptifibatide
Abciximab is a Fab fragment of a monoclonal antibody directed against GPIII/IIIa.
Thrombolytic Agents
19. Tissue plasminogen activators released by endothelial cells to activate fibrin bound plasminogen to plasmin. Plasmin then cleaves fibrin strands to cause the disintegration of clot. A drug used as Human tPA?
A. Alteplase
B. Reteplase
C. Tenecteplase
D. A & B
E. All of the above
Answer: E. All of the above
20. A drug is a 47 kDa protein produced by beta-haemolytic streptococcus that combines with plasminogen to produce plasmin is following?
A. Alteplase
B. Streptokinase
C. Tirofiban
D. Lepirudin
E. Prasugrel
Answer: B. Streptokinase
This drug is less clot specific bcoz it doesn't require the presence of fibrin to activate plasminogen. High doses required to overcome antibody immunity in patients who has previous streptococcal infection.
21. A drug is a serine protease that cleaves plasminogen to plasmin that can then degrade formed clot?
A. Alteplase
B. Streptokinase
C. Urokinase
D. Lepirudin
E. Prasugrel
Answer: C. Urokinase
Lack of clot specificity predispose patients to a systemic lytic state. Used to clear massive pulmonary emboli
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