anticoag/ platelets Flashcards
which factors does unfractionated heparin block?
Unfractionated heparin forms a complex with antithrombin III in the inactivation of
mostly factor Xa and II
but also 9,11 and 12
which enzyme does warfarin inhibit?
epoxide reductase
when is warfarin pro-thombotic?
initially - often covered with LMWH
in those with mild-moderate hepatic function
what is the mechanism of apixaban , rivaroxaban and dabigatran ?
Rivaroxaban and apixaban are factor Xa inhibitors
whereas dabigatran is a direct thrombin (factor IIa) inhibitor.
what is Andexanet alfa?
recombinant modified human factor Xa (FXa) protein used as a specific reversal of rivaroxaban and apixaban
when is aspirin given based on QRISK score?
anyone with QRISK >20% (10 year CVS risk score)
or specific patients 10-20% e.g. diabetics
what are rules of clopidogrel after drug elluting stent and bare metal stent
BMS - 1 month
DES - 6 months
which commonly used drug should be avoided with clopidogrel?
omeprazole
which patient group should you avoid prasugrel in?
> 75 yrs
<60kg
which antibiotics/fungal/virals should be avoided in ticagrelor?
clarithromycin
ketonazole
how many days pre-op should clopidogrel be stopped?
7 days
how many days should the following be stopped for neuroaxial blocks?
tirofiban - hrs
clopi - 7 days
ticagrelor - 5 days
abciximab - 2 days
aspirin - continue
what is gold standard for assessing platelet function?
Optical light aggregometry
what binds GP IIb/IIIa?
fibrinogen, wVF
Tirofiban, abciximab
for an epidural, when can this be performed after the last LMWH dose?
12 hours
