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haematology > anti coag drugs > Flashcards

anti coag drugs Flashcards

1
Q

heparin, what does it potentiate?

A

ATIII, immediate effect

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2
Q

unfractioned binds?

A

thrombin

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3
Q

LMWH binds?

A

factor xa

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4
Q

heparin potentiates anti thrombin III

A

either binds xa or thrombin

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5
Q

how do you monitor unfractioned?

A

APTT

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6
Q

LMWH?

A

don’t usually need to monitor

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7
Q

complications?

A

heparin induced thrombocytopaenia (low platelets)

osteoperosis in very long use

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8
Q

to reverse heparin?

A

usually just stop

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9
Q

occasionally in severe bleeding, what can you give?

A

protamine sulphate

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10
Q

what is the effect of protamine sulphate on unfractioned heparin and LMWH

A

complete reversal for unfractioned, partial reversal for LMWH

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11
Q

how does warfarin work?

A

inhibits vitamin K

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12
Q

what does vitamin K do to factors 2,7,9,10?

A

carboxylates them

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13
Q

where are clotting factors produced?

A

liver

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14
Q

antagonism of vitamin K

A

y

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15
Q

when should dose be taken?

A

same time every day

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16
Q

how long does it take to get the full effect of warfarin?

A

3-5 days

17
Q

may need what to cover this period?

A

heparin

18
Q

what is prothrombin time?

A

patients pt in seconds/mean normal pt in seconds to the power of international sensitivity index

19
Q

warfarin - beware of drug interactions!!!

A

y

20
Q

skin bruising, epistaxis, haematuria

A

severe - gastrointestinal, intracerebral, significant drop in hb

21
Q

warfarin reversal - pathway?

A

no action - omit dose - administer oral vitamin K, administer clotting factors

22
Q

how long does vitamin k take to work?

A

6 hours

23
Q

clotting factors?

A

immediate effect

24
Q

what is factor 2?

A

prothrombin

25
Q

heparin - what can it do to platelets and bone?

A

causes thrombocytopenia and long term use can cause osteoporosis

26
Q

how can obstructive jaundice cause bleeds?

A

bile salts are needed to absorb vitamin K in the upper intestine. Vitamin K carboxylises prothrombin, 7,9 and 10

27
Q

to reverse warfarin, what are the steps?

A

do nothing –> omit warfarin dose –> give vitamin K –> give activated clotting factors

28
Q

how long does administered vitamin K take to work?

A

6 hours

29
Q

how long does activated clotting factor take to work

A

immediate effect

30
Q

what is dabigatran?

A

thrombin inhibitor

31
Q

name two factor Xa inhibitors?

A

rivaroxaban and apixaban

32
Q

in arterial clots, what do platelets release that cause further aggregation?

A

thromboxane A2

33
Q

HOW DO YOU MONITOR PATIENTS ON HEPARIN?

A

fbc (thrombocytopenia and osteoporosis)

34
Q

what does heparin help?

A

helps anti thrombin III bind to thrombin and factor 10 a

35
Q

most common thrombophilia?

A

factor V leidig

haematology (20 decks)

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