anti-platelet/ anti-coagulant

Question 1

warfarin mechanism of action

Answer 1

• vitamin K antagonist
• inhibits vitamin K reductase and therefore stops the activation of vitamin K dependent zymogens
• needs bridge therapy because it only stops new vitamin K dependent zymogens from forming so there is the current storage

Question 2

warfarin antidote

Answer 2

1. plasma
2. vitamin K
3. PCC prothrombin complex concentrate (factor II)

Question 3

why does warfarin need a bridge therapy drug?

Answer 3

• needs bridge therapy because it only stops new vitamin K dependent zymogens from forming so there is the current storage

Question 4

warfarin is contraindicated in

Answer 4

pregnant women

Question 5

warfarin side effects

Answer 5

bleeding

Question 6

How do you monitor warfarin?

Answer 6

weekly INR/PT and then monthly

Question 7

What is warfarin used to treat?

Answer 7

1. prevention of stroke in a fib patients
2. prevention of thrombosis in mechanical hearts and valves
3. VTE

Question 8

heparin’s mechanism of action

Answer 8

binds antithrombin to inactivate factor X and thrombin

Question 9

un-fractionalized heparin must be administered

Answer 9

in the hospital

Question 10

heparins antidote

Answer 10

sulfate protamine

Question 11

low molecular weight heparin

Answer 11

enoxaparin and lovenox

Question 12

how do you monitor heparin

Answer 12

aPTT and anti-Xa levels

Question 13

how do you monitor enoxaparin (lovenox)?

Answer 13

anti-Xa levels

Question 14

mechanism of action for enoxaparin (lovenox)?

Answer 14

deactivates Xa via binding to

Question 15

what anti-coagulations are degraded by the kidney?

Answer 15

enoxaparin (lovenox) and fondaparinux

Question 16

argatroban is hepatically/renally metabolized?

Answer 16

hepatically

Question 17

low molecular weight heparin is used for

Answer 17

pregnant women and patients with cancer

Question 18

can oral anticoagulants be used for patients who have mechanical hearts or valves?

Answer 18

NO

Question 19

what is a pro of oral anticoagulants?

Answer 19

decreased intracranial bleeds

Question 20

what is the antidote for low molecular weight heparin?

Answer 20

there is no antidote

Question 21

which anticoagulants require antithrombin binding for activation?

Answer 21

heparin and low molecular weight heparin like enoxaparin (lovenox) and fondaparinux

Question 22

argatroban binds directly to

Answer 22

thrombin

Question 23

dabigatran mechanism of action

Answer 23

orally; binds prothrombin

Question 24

how is argatroban administered

Answer 24

IV

Question 25

what is the antidote to dabigatran?

Answer 25

idarucisumab

Question 26

idarucisumab

Answer 26

fab fragment that binds and inactivates dapigatran

Question 27

rivaroxaban, apixaban, and edoxaban

Answer 27

are all Xa inactivators