anti-coagulants and anti-thrombotics Flashcards
1
Q
what anti-coagulants do?
A
prevent thrombus formation or expansion
2
Q
main uses of anti-coagulants
A
- unstable angina
- PE
- DVT
- at fibrillation
3
Q
what heparin do?
A
as anti-thrombin III inhibits thrombin IIa and Xa fomation
4
Q
characteristics of heparin
A
- fast onset and short action
- variable effect
- non-teratogenic
- 1-4% risk heparin-induced thrombocytopenia in prolong use
5
Q
what LMWH do?
A
inhibits Xa formation
6
Q
examples of LMWH
A
- dalteparin
- enoxaparine
- beniparin
7
Q
characterisics of LMWH
A
- consistent effect
- longer acting
- less risk of HIT
8
Q
what is protamine?
A
- an antidote for heparin overdose
- prevent haemorhage
- reversal of anti-coagulants effect
9
Q
examples of hirudin
A
- lepirudin - renal
- bivalirudin- renal
- argatroban- liver
10
Q
what hirudin do?
A
- direct thrombin inhibitors
- used in HIT
11
Q
what warfarin do?
A
- reduced clotting factor synthesis
- competitive antagonism with vit K
- low therapeutic index
12
Q
warfarin metabolised by
A
CYP 2C9
13
Q
what combinations of drugs and warfarin will affect?
A
- reduced clotting factor and increase anticoagulant
- increase warfarin effect
- changes in warfarin metabolism
14
Q
characteristics of dabigatran
A
- direct thrombin inhibitor
- unaffected by CYP 450
- rapid onset and offset
15
Q
what is fondaparinux and what it does?
A
- synthetic pentasaccharide
- increase anti-thrombin inactivation of factor Xa
