9) Thrombosis Flashcards
What is the class for Unfractionated heparin
Indirect thrombin inhibitors
What is the mechanism for Unfractionated heparin
Bind antithrombin, potentiating formation of antithrombin-coagulation factor complex (Xa, IIa)
What are the therapeutics for Unfractionated heparin
Prevention and treatment of venous thromboembolism
What are the important side effects for Unfractionated heparin
HIT, bleeding
What are the other side effects for Unfractionated heparin
Osteoporosis
What are the miscellaneous for Unfractionated heparin
Given parenterally; monitored via PTT (want 2-2.5X normal value); reversed by protamine
What is the class for Dalteparin (Fragmin)
Indirect thrombin inhibitors
What is the mechanism for Dalteparin (Fragmin)
LMWH that inhibits thrombin less effectively than Xa
What are the therapeutics for Dalteparin (Fragmin)
Prevent thrombosis and embolism from clots
What are the important side effects for Dalteparin (Fragmin)
Bleeding
What are the miscellaneous for Dalteparin (Fragmin)
Monitored by heparin assay (anti-factor Xa); longer half-life than heparin (1-2/day); reversed by protamine
What is the class for Enoxaparin (Lovenox)
Indirect thrombin inhibitors
What is the mechanism for Enoxaparin (Lovenox)
LMWH that inhibits thrombin less effectively than Xa
What are the therapeutics for Enoxaparin (Lovenox)
Drug of choice in pregnancy; prevention and treatment of venous thromboembolism
What are the important side effects for Enoxaparin (Lovenox)
HIT; bleeding; osteoporosis and thrombocytopenia uncommon
What are the miscellaneous for Enoxaparin (Lovenox)
Can be monitored by heparin assay (anti-factor Xa); longer half-life than heparin (1-2/day); reversed by protamine
What is the class for Tinzaparin (Innohep)
Indirect thrombin inhibitors
What is the mechanism for Tinzaparin (Innohep)
LMWH that inhibits thrombin less effectively than Xa
What are the important side effects for Tinzaparin (Innohep)
HIT; osteoporosis and thrombocytopenia uncommon
What are the other side effects for Tinzaparin (Innohep)
Bleeding
What are the miscellaneous for Tinzaparin (Innohep)
Monitored by heparin assay (anti-factor Xa); longer half-life than heparin (1-2/day); reversed by protamine
What is the class for Fondaparinux (Arixtra)
Indirect thrombin inhibitors
What is the mechanism for Fondaparinux (Arixtra)
Synthetic polysaccharide that binds active site of antithrombin; inhibits Xa
What are the therapeutics for Fondaparinux (Arixtra)
Given for HIT
What are the other side effects for Fondaparinux (Arixtra)
Bleeding
What are the miscellaneous for Fondaparinux (Arixtra)
No antidote
What is the class for Warfarin (Coumadin)
Vitamin K antagonist
What is the mechanism for Warfarin (Coumadin)
Blocks vitamin K-dependent gamma-carboxylation of factors II, VII, IX, X, Protein C and S (does not affect already synthesized factors)
What are the therapeutics for Warfarin (Coumadin)
Long-term anticoagulation
What are the important side effects for Warfarin (Coumadin)
Thrombosis (Protein C depression)
What are the other side effects for Warfarin (Coumadin)
Bleeding
What are the miscellaneous for Warfarin (Coumadin)
Metabolism enhanced by drugs that induce P450 activity (e.g., barbiturates); monitored by PT/INR; reversed by vitamin K and factor concentrates; contraindicated in pregnancy (teratogen)
What is the class for Bivalirudin (Angiomax)
Direct thrombin inhibitor
What is the mechanism for Bivalirudin (Angiomax)
Inactivate fibrinogen-bound AND unbound thrombin; irreversible
What are the therapeutics for Bivalirudin (Angiomax)
Percutaneous coronary intervention (PCI)
What are the important side effects for Bivalirudin (Angiomax)
Bleeding