Anti-coagulant pharmacology Flashcards
(19 cards)
Unfractionated Heparin MOA
Increase Anti-thrombin capacity to inhibit clotting factors»_space; inhibits II, VII, IX, X, XI
Inhibits Xa and IIa equally
Unfractionated Heparin peak onset
IV»_space; immediate
SQ»_space; 1-2 hours
Unfractionated Heparin adverse effects
Bleeding
Heparin induced thrombocytopenia
Unfractionated Heparin monitoring
Therapeutic level monitoring via PTT
Routine daily monitoring of Hgb, Hct, platelets
Low molecular weight heparin MOA
Increase Anti-thrombin capacity to inhibit clotting factors
Inhibits Xa preferentially
LMWH drug name
Enoxaparin - Lovenox
LMWH adverse effects
Bleeding
Heparin-induced thrombocytopenia
LMWH monitoring
Does not require therapeutic level monitoring
Routine daily monitoring of Hgb, Hct, platelets
LMWH peak onset
4-5 hours after injection
Warfarin MOA
Antagonism of vitamin K»_space; synthesis of Less-functional coagulation factors (VII, IX, X, II)»_space; takes longer to clot
Warfarin advantages
Long duration of activity»_space;usually dosed weekly
Liver metabolism»_space; no need to renal dose adjustments
Less expensive
Warfarin disadvantages
Liver metabolism»_space; LOTS of drug interactions
Weekly injections
High degree of variability»_space; requires weekly INR monitoring
Patient education on consistent dietary vitamin k intake
Dabigatran (Pradaxa) MOA
Direct IIa inhibitor
Inhibits both free and clot bound thrombin
Rivaroxaban (Xarelto) MOA
Direct Xa inhibitor
Apixaban (Eliquis) MOA
Direct Xa inhibitor
DOAC disadvantages
Require renal does adjustments
Very expensive
DOAC advantages
Oral administration
Do not require monitoring
Less drug interactions
Rivaroxaban (Xarelto) dosing
DVT/PE prevention (ortho surgery)»_space; 10 mg PO 1x/day
Treatment of acute DVT/PE»_space; 15 mg PO BID x 21 days followed by 20mg PO 1x/day
Secondary prevention of recurrent DVT/PE»_space; 10 mg PO 1x/day
Apixaban (Eliquis) dosing
Prevention of DVT/PE (ortho surgery)»_space; 2.5 mg PO BID
Treatment of acute DVT/PE»_space; 10mg PO BID x 7 days, followed by 5 mg PO BID
Secondary prevention of recurrent DVT/PE»_space; 2.5 mg PO BID
