Anti-Coagulents Flashcards
4 general reasons to use an anti-coagulant
Deep vein thrombosis
Mechanical heart valves
Atrial fibrillation
Inherited clot disorders
MAO of heparin
Catalyze anti-thrombin III binding to 2,9,10,11,12
Unfractioned heparin is produced by
Mast cells
Basic repeating unit of unfractioned heparin and binds to______.
Pentasaccharide binds to anti-thrombin III
Heparin catalyze inactivation of multiple coagulation factors including
Factor Xa & Thrombin
How long does anticoagulation effect last after sub cutaneous injection?
1-2 hours
Excessive bleeding & complications of Heparin can be overcome by administering:
Protamine sulfate
For Heparin induced thrombocytopenia use __________ such as ________
Direct thrombin inhibitors
Such as:
Argatroban
Lepirudin
LMWH is ______ than UFH at therapeutic doses
4 times longer
Monitoring of UFH by
Activated partial thromboplastin time
3 bilvalent direct thrombin inhibitors
Hirudin
Bivalirudin
Lepirudin
3 monovalent direct thrombin inhibitors
Argatroban (IV)
Melagatran (oral)
Dabigatran (oral)
Direct thrombin inhibitor safe to use in liver disease
Bilvalirudin
Advantage to use a direct thrombin inhibitor over UFH and LMWH
They inhibit both circulating and clot-bound thrombin
MAO of warfarin
Inhibits γ-carboxylation of vitamin K coagulation factors
Warfarin anticoagulant is manifested after_______, while heparin anticoagulation is seen________.
Warfarin: 3-4 days
Heparin: immediately
Can warfarin cross the placenta?
Yes
FFP and PCC contain
Vitamin k-dependent coagulation factors (factor 2,7,9,10)
Protein C & Protein S
Antidote to warfarin toxicity
Vitamin K
A patient is given prosthetic heart valves and placed on warfarin and _____ given prophylactically.
Dipyridamole
Adverse effects of ticlopidine and clopidogrel
Thrombocytopenic Purpera
Aplastic anemia
Agranulocytosis
Activation of some anti platelet drugs can be inhibited by ______.
Omeprazole
Streptokinase is obtained from
Group C beta-hemolytic streptococci
MAO of thrombolytics
Tissue plasminogen activator (tPA) converts plasminogen to plasmin
MAO of plasmin
Degrades fibrin
Emergency management of coronary thrombosis, DVT, PE, Strokes
Thrombolytics
Fibrinolytics must be given within ___hours of acute MI
3 hours
Treatment of fibrinolytic-induced bleeding
Aminocaproic acid &
Tranexamic acid