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Cardio > anticoags > Flashcards

anticoags Flashcards

1
Q

what factors does warfarin inhibit

A

2,7,,9,10

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2
Q

action of warfarin

A

blocks an enzyme so stops vitamin k from getting recycled and so factors 2,7,9,10 dont get activated

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3
Q

effect of inhibitng fator 7

A

extrinsic pathway wont function

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4
Q

why might intrinsicpathway not function

A

due to no activated factor 9

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5
Q

effect of no factor 2

A

common pathway wont function

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6
Q

what factor is affected first with warfarin

A

7 as it has a short half life

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7
Q

what is wararin contraindictaed in

A

pregnancy

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8
Q

how is the efficacy of warfarin monitored

A

pr time

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9
Q

target PT for warfarin

A

2-3

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10
Q

what drugs might interact with warfarin causing it to accumulate

A

trimethoprim
omeprazole
metronidazole
amiodarone

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11
Q

how is warfarin taken

A

orally q

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12
Q

side effect of warfarin

A

uncontrollable bleeding in gi tract

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13
Q

what might lower the INR with warfarin

A

phenytoin and carbamezapine as they increase the enzyme whcih breaks it down

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14
Q

what to use if warfarin has caused acute bleeding

A

fresh frozen plasma

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15
Q

action of heparin

A

indirectly inhibits thrombin and factor 10a by binding to antithrombin 3

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16
Q

main target of antithrombin 3

A

thrombin

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17
Q

active factor 2

A

thrmbin
factor 2a

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18
Q

what converts prothrombin to thrombin

A

active factor 10

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19
Q

what does antithrombin inhibit

A

factors 7,9,11,12

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20
Q

unfractioned heparin

A

inhibits factor xa and thrombi

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21
Q

fractioned heparin

A

inibits xa

22
Q

is LMWH fracioned

A

yes

23
Q

assoc of lmwh

A

low half life

24
Q

what is similar to lmwh

A

fondaprinaux

25
Q

when is heparin used

A

in acute settings, acute dot, post op preventiotn for dvvt and pe

26
Q

side effects of heparin

A

osteoporosis

27
Q

preferred anticoag for chronic

A

warfarin/ DOAC

28
Q

heparin and pregnancy

A

doesnt cross placenta so safe

29
Q

what does heparin inhibt

A

common and intrinsic pathway

30
Q

what interacts with heparin making it less efficient

A

tetracyclines
antihistamines
nicotine

31
Q

adp receptor inhibitor

A

clopidogrel; antiplatelet

32
Q

what is clopidogrel used with in ACS

A

aspirin

33
Q

direct facot Xa inhibitord

A

apixaban
edoxaban
rivaroxaban

34
Q

how are factor xa inhitor taken

A

orally

35
Q

what are factor xa inibotors used for

A

prevetion od dvt, pe, afib

36
Q

are factor xa inhibs rapid onset

A

yes

37
Q

what are direct thrombin inhibtors used in conjunction with

A

antiplatelet like aspirin/ clopidogrel

38
Q

example of direct thrombin inhibotor

A

dabigatran

39
Q

why might bleeding occur when taking factor xa inhibs

A

its metabolysed by cytohcrome p450 and so drugs like metornidazole, trimethoprim, amiodaorne inhibit this enzyme

40
Q

what might antiplatelets cause

A

gastric ulcers and bleeding

41
Q

function of antiplatelets

A

orimary haemostasis inhibitors

42
Q

action of antiplatelets

A

blocks syntheisis of thromboxane a2 which activates platelets

43
Q

what do antiplatelets inhibit

A

indiredctly inhibit cox 1 and 2 by acetylation

44
Q

action of thrombolytics

A

bind to plasminogen to form plasmin and degrading ibrin clot

45
Q

what is used to convert plasminogen to plasmin

A

TPA

46
Q

Thrombolytic drig

A

alteplase iV

47
Q
A
48
Q

action of alteplase

A

binds to fibrinproteins on clot then binds to plasminogen

49
Q

when is thrombolytics prescirbwd

A

short term acutely

50
Q

when must thrombolysis be given

A

within 12hrs of symptom onset

51
Q

when is thrombyolyics contraindicated

A

in major bleeding, acute bleeding. trauma, pre surgery

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