AntiCoag

Question 1

Common pathway

Answer 1

10-> 2 -> 1, CF5 to 10

Question 2

Extrinsic pathway

Answer 2

tissue dmg -> 7(CoFac TF) ->10 (CoFac 5)

Question 3

intrinsic pathway

Answer 3

surface dmg -> 12 -> 11 -> 9 (CoFac 8)

Question 4

Dabigatran

Answer 4

thrombin inhibitor (FII)
Oral BID
RENAL
12-17hr HL

Question 5

Bivalirudin

Answer 5

thrombin inhibitor (FII)
IV continuos
PROTEOLYTIC
25min HL

Question 6

Argatroban

Answer 6

thrombin inhibitor (FII)
IV continuous
Hepatic elim
40-50mins

Question 7

Rivaroxaban

Answer 7

F10a Inhibitors
Oral QD/BID
Hep mostly (some renal)
5-9 HL

Question 8

Apixaban

Answer 8

F10a Inhibitors
Oral BID
Hep mostly (some renal)
12hr HL

Question 9

Edoxaban

Answer 9

F10a Inhibitors
Oral QD
Renal hepatic elim
LESS EFFECTIVE WITH CRCL> 95
10-14 HL

Question 10

UFH

Answer 10

ATIII boosters (binds to Xa and IIa)
causes HIT
no renal bc eaten by macrophages
LONG USE = osteopenia
monitor with PTT

Question 11

Enoxaparin and dalteparin

Answer 11

17 chain used for Xa only
can’t monitor with PTT
HIT bit lower
less reversal effect
needs renal adjustment
LONGER HL

Question 12

Warfarin

Answer 12

VKOR blocker to stop the reuptake of K
7(4-6), C(8), 9(24), S(30), 10(48), II(72)
7 is INR!!!!!!
VKORC1 and CYP2C9
CYP inducers decrease INR and increase clotting
CYP inhibitors increase INR Increase bleeding
anticoagulant and platelets (increase bleeding)
Antibiotics