Anticoagulant

Question 1

mechanism of action of heparin

Answer 1

potentiates antithrombin

Question 2

how can heparin be given

Answer 2

IV or SC

Question 3

how quickly does heparin act

Answer 3

immediately

Question 4

how is heparin monitored

Answer 4

APTT for unfractionated

Anti Xa assay for LMWH - but usually no monitoring required

Question 5

complications of heparin

Answer 5

bleeding
heparin induced thrombocytopenia - monitor FBC
osteoporosis with longterm use

Question 6

describe how to reverse heparin

Answer 6

stop heparin usually all require - short half life

if severe sever bleed
-protamine sulfate

Question 7

what is warfarin

Answer 7

coumarin -rat poisoning

Question 8

mechanism of warfarin

Answer 8

vit k antagonist

Question 9

clotting factors which are vit k dependant

Answer 9

2, 7, 9, 10

Question 10

where are clotting factors made

Answer 10

liver

Question 11

action of vit K

Answer 11

carboxylation of glutamic acid residues in factos 2 7 9 and 10 protein C and S

Question 12

how is warfarin reversed?

Answer 12

step up scale depending on clinical senario and INR

no action - omit warfarin dose - give vit K - give prothrombin complex or FFP

Question 13

how long does it take for vit k to take affect when reversing warfarin

Answer 13

6 hours

Question 14

dabigatran

Answer 14

thrombin inhibitor

Question 15

rivaroxiban

apixiban

Answer 15

factor Xa inhibitors