2013-11-4 Anti-Coag Rx

Question 1

Arterial vs. Venous Thrombosis
COLOR
VASC ∆s
MECH
TX

Answer 1

COLOR: art=white + plts/fibr; ven=red, RBCs/fib)
VASC: art=damage, ven=no damage
MECH: art=sheer stress; ven=stasis, hypercoag
TX: art=anti-plts; ven=anti-coags

Question 2

list 3 ADP P2Y_12 recep antagonists

Answer 2

clopidogrel, prasugrel, ticagrelor

*more for ACS. tica = reversible

Question 3

dipyrimidole

Answer 3

used w/ ASA for stroke

Question 4

how to reverse heparin

Answer 4

protamine sulfate

°°doesn’t work w/ fondaparinux

Question 5

targets of heparin

Answer 5

IIa and Xa
—LMWHs are much more Xa>IIa
—monitor aPTT, [Xa] if you’re rich

Question 6

targets of warfarin + MECH

Answer 6

TARGETS: I, VII*, IX, X, APC/S**

• short half-life—> show falsely low PT/INR early on
• *short half-life —> hypercoaguable state —> warf skin necrosis

MECH: WARFARIN INHIBITS THE SYNTHESIS OF ACTIVE COAGULATION FACTORS

Question 7

Warfarin skin necrosis

Question 8

does warfarin cause birth defects

Answer 8

why yes it does, during early fetal development

Question 9

reverseing warfarin/rat poison

Answer 9

Vitamin K

Question 10

Treatment for HIT

Answer 10

fondaparinux actually

—also Argatroban, Bivalirudin -> both —| thrombin

Question 11

dabigatran, rivaroxaban, apixaban

Answer 11

dabig —| IIa
rivarox, apix —| Xa

-a fib, ortho surg

Question 12

herbs/supplements and other drugs that cause bleeding

Answer 12

SSRI —> GI bleed  w/ NSAID, anticoaga
Feverfew/willow bark – contain salicin
Gingko
Garlic
Ginger
Fish oil
PC-SPES