Anti-coagulants

Question 1

How does warfarin work?

Answer 1

It inhibits vit K dependent clotting factors 10, 9 (intrinsic) 7 (extrinsic) and 2 (prothombin) (BIG-J)

Question 2

What are the clinical features of warfarin embryopathy?

Answer 2

hypoplasia of the nasal bridge, agenesis of the corpus callosum, congenital heart defects, ventriculomegaly, stippled epiphyses

Question 3

VTE prophylaxis for a <50kg pregnant patient (doses for dalteparin, enoxaparin and tinzparin)

Answer 3

dalteparin=2500units, enoxaparin=20mg, tinzaparin=3500units

Question 4

VTE prophylaxis for a 50kg-90kg pregnant patient (doses for dalteparin, enoxaparin and tinzparin)

Answer 4

dalteparin=5000units, enoxaparin=40mg, tinzaprin=4500units

Question 5

VTE prophylaxis for a 91kg-130kg pregnant patient (doses for dalteparin, enoxaparin and tinzparin)

Answer 5

dalteparin=7500units, enoxaparin=60mg, tinzaparin=7000units

Question 6

What is the mechanism of action of tranexamic acid?

Answer 6

Tranexamic acid is a coagulant (an antifibrinolytic), it’s structure is an analogue of lysine, it inhibits plasminogen by blocking receptors for fibrin and preventing plasminogen or plasmin from degrading fibrin

Question 7

Can warfarin be used in breastfeeding?

Answer 7

Yes

Question 8

What is the mechanism of action for heparin?

Answer 8

activates anti-thrombin III and inactivation of Xa