5. Anticoagulant and Inherited Bleeding Flashcards
Contraindications of anticoagulant and inherited bleeding disorders (3)
Aspirin
NSAIDs
Antithrombotic medication (anticoagulants, antiplatelets)
Indications for oral anticoagulation (4)
AF
DVT
Heart valve disease/ mechanical heart valves
Thrombophilia
Types of oral anticoagulants (4)
Coumarins
Indanediones
Direct thrombin inhibitors
Factor Xa inhibitor
Types of wafarin drug interactions (2)
Potentiating drugs
Inhibiting drugs
Examples of warfarin potentiating drugs (4)
Amiodarone
Antibiotics
Alcohol (with liver disease)
NSAIDs
Examples of warfarin inhibiting drugs (4)
Carbamazepine, barbiturates
Cholesystramine
Griseofulvin
Alcohol (without liver disease)
Dangers of warfarin (overdose)
Haemorrhage
How do anti platelet drugs affect clotting (2)
Inhibiting platelet aggregation
Inhibiting thrombus formation in arterial circulation
Examples of anti platelet medications (8)
Low dose aspirin Clopidogrel Dipyridamole Prasugrel and aspirin Abciximab Eptifibate and aspirin Ticagrelor Tirofaban
Definition of inherited bleeding disorder
Acquired defects which affect blood coagulation
What may inherited bleeding disorders affect (3)
Coagulation cascade
Platelet number
Platelet function
Combo
Types of rare bleeding disorders (2)
Inherited defects of other factors in coagulation pathway (not FVIII, IX, XI)
Inherited defect of platelet number/function
Types of haemophilia (3)
Haemophilia A
Haemophilia B
Haemophilia C
Genetics of haemophilia (2)
Sex-linked recessive inheritance
Males affected, females carriers
Definition of Haemophilia A
FVIII deficiency
Definition of Haemophilia B
FIX deficiency
Treatment of severe/moderate Haemophilia A
Use of recombinant factor VIII
Treatment of mild/carriers of Haemophilia A (2)
DDAVP
Very mid - oral tanexamic acid
Treatment of Haemophilia B (2)
No response to DDAVP
Prophylactic cover requires recombinant FIX
Definition of von Willebrand disease
Deficiency of von Willebrand factor
Genetics of von Willebrand disease (2)
Autosomal dominant
Both sexes equally affected
Types of von Willebrand disease (3)
Type 1 (dominant, mild) Type 2 (dominant, mild) Type 3 (recessive, severe)
Treatment of von WIllebrand disease (2)
Majority respond to DDAVP
Very mild cases - oral tranexamic acid
LA issues with inherited bleeding disorders (2)
IDB, lingual infiltration, post. sup. nerve block
Buccal infiltration, intra-ligamentary, intra-papillary safe
Definition of thrombophilia
Acquired condition superimposed on a genetic condition
Increased risk of what with thrombophilia
Clot development
Types of inherited bleeding syndromes (4)
Protein C deficiency
Protein S deficiency
Factor V leiden
Antithrombin III deficiency
How can acquired syndromes be obtained (7)
Antiphospholipid syndrome (lupus anticoagulants) Oral contraceptives Surgery Trauma Cancer Pregnancy Immobilisation
Types of platelet abnormalities (3)
Thrombocytopenia
Thrombocythaemia
Qualitative disorders (normal platelet number but abnormal function)
Definition of thrombocytopenia
Reduced platelet numbers
Definition of thrombocythaemia
Increased platelet numbers
Types of thrombocytopenia (3)
Idiopathic
Drug-related
Secondary to lymphoproliferative disorder
Types of inherited qualitative disorders (3)
Bernard Soulier syndrome
Hermansky Pudlak
Glanzmann’s thromboasthenia
Types of acquired qualitative disorders (4)
Cirrhosis
Drugs
Alcohol
Cardiopulmonary bypass
Definition of Haemophilia C
Deficiency of FXI
