Anticoagulant/Antiplatelet/Thrombolytic Drugs

Question 1

When are anticoagulants used?

Answer 1

Prevention of venous thrombosis and embolism

In patients with artificial heart valves and AF

Question 2

How does warfarin affect the coagulation cascade?

Answer 2

Competes with vitamin K to render factors II, VII, IX and X inactive

Question 3

Warfarin has a low TI and many side effects. True/false?

Answer 3

True

Question 4

How is an overdose of warfarin treated?

Answer 4

Administration of vitamin K

Question 5

How does heparin affect the coagulation cascade?

Answer 5

Binds to antithrombin III to cause inactivation of factors Xa and IIa

Question 6

Are LMWHs now preferred to heparin?

Answer 6

Yes

Question 7

Give two examples of LMWHs

Answer 7

Enoxaparin

Dalteparin

Question 8

What is the difference between LMWH and heparin?

Answer 8

LMWH only inhibits factor Xa

Question 9

Give a side effect of heparin/LMWH

Answer 9

Haemorrhage

Question 10

Heparin is administered SC and LMWH is administered IV. True/false?

Answer 10

False - other way around!

Question 11

What drug is a new inhibitor of factor Xa?

Answer 11

Rivaroxaban

Question 12

How is rivaroxaban administered?

Answer 12

Orally

Question 13

When are antiplatelets used?

Answer 13

Treatment of arterial thrombosis

Question 14

How does aspirin prevent platelet formation?

Answer 14

Blocks COX to prevent TXA2 synthesis

Question 15

How does clopidogrel prevent platelet formation?

Answer 15

Inhibits the P2Y12 receptor

Question 16

When are thrombolytics used?

Answer 16

Acute MI
Strokes
PE (rarely)

Question 17

Give examples of thrombolytics

Answer 17

Streptokinase
Alteplase
Duteplase

Question 18

How do thrombolytics cause clot lysis?

Answer 18

Activate plasminogen to plasmin