Anti coagulants Flashcards
Heparin MOA
Acts as catalyst for antithrombin III
Heparin Indications
Prophylaxis for DVT and PE. Used in surgery and IV placement.
Heparin Pharmacokinetics
IV only with an immediate onset of action
Heparin Adverse effects
Hemorrhage (treat with protamine sulfate), Heparin induced thrombocytopenia.
Enoxaparin
LMW heparin
Fondaparinux
Synthetic pentasaccharide of heparin
LMW heparin pharmacokinetics
Injected Subcutaneously.
LMW heparin indications
Used in pregnancy. Lower incidence of HIT.
Lepirudin
Direct thrombin Inhibitor, IV only.
Lepirudin Indications
HIT alternative to heparin with Renal excretion (used in liver failure)
Argatroban
Direct thrombin inhibitor, IV only.
Argatroban Indications
HIT alternative to heparin with liver metabolism (used for renal failure)
Dabigatran
Direct thrombin inhibitor. Oral.
Rivaroxaban
Oral inhibitor of factor Xa
Apixaban
Oral inhibitor of factor Xa
Edoxaban
Oral inhibitor of factor Xa
Warfarin MOA
Inhibits vitamin K epoxidase to stop the synthesis of coagulation factors II, VII, IX and X.
Warfarin Adverse effects
Quickly reduces the levels of protein C so thrombosis can occur within the first few days. Co administer with heparin.
Warfarin reversal
Vitamin K or fresh frozen plasma
Warfarin contraindications
Pregnancy.
Warfarin Drug interactions
Antibiotic absorption, estrogen, aspirin.
Thrombolytic agents MOA
Converts plasminogen to plasmin with lyses thrombus from within.
Thrombolytic agents indications
MI, PE, DVT
Aminocaproic acid
Inhibits plasminogen activation. Used in bleeding disorders and reversal of fibrinolytic therapy.
