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3MB Haematology > Anticoagulant drugs > Flashcards

Anticoagulant drugs Flashcards

1
Q

Outline the coagulation cascade

A
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2
Q

What is another name for thrombin?

A

Activated factor II

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3
Q

What are the multiple pro-coagulative functions of thrombin?

A
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4
Q

Give examples of direct factor inhibitors

A

Direct thrombin inhibitors
Direct factor Xa inhibitors

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5
Q

Function of direct thrombin inhibitors

A

Bind thrombin in circulation and already attached to a clot

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6
Q

Function of factor Xa inhibitor

A

Greater effect on anticoagulation. Higher in the coagulation cascade

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7
Q

Lab parameters of direct thrombin inhibitors

A

Prolongs thrombin
Less effect on PT and aPTT

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8
Q

Lab parameters of factor Xa inhibitor

A

Prolongs PT and aPTT
No effect on thrombin

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9
Q

Direct thrombin inhibitors are especially useful when heparin causes an adverse reaction called..

A

HIT, or heparin induced thrombocytopenia

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10
Q

Side effects of direct thrombin inhibitors

A

GI symptoms like dyspepsia and gastritis
Bleeding when taken in excess

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11
Q

Direct thrombin inhibitors should not be discontinued suddenly as it leads to…

A

Increased thrombosis and risk of strokes

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12
Q

Give examples of direct thrombin inhibitors

A

Dabigatran etexilate and dabigatran

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13
Q

Give examples of direct factor Xa inhibitors

A

Apixaban, edoxaban and rivaroxaban

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14
Q

Side effects of direct factor Xa inhibitors

A

Bleeding

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15
Q

When are direct thrombin inhibitors used?

A

Replacement of heparin in HIT

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16
Q

When are direct factor Xa inhibitors used?

A

Alternative to Warfarin

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17
Q

Differentiate between unfractionated and fractionated heparin

A

Un: HMWH + LMWH
Frac: LMWH

18
Q

Only LMWH/HMWH have an effect on thrombin

A

HMWH - in order to increase antithrombin III’s activity against thrombin, the thrombin needs to bind to the long tail of the heparin

19
Q

What is used to measure the efficacy of heparin?

A

aPTT - longe than average

20
Q

If heparin aPTT is greater than 100 then the patient must be suffering from..

A

Internal bleeding

21
Q

Antithrombin also binds to active ________, which is a pivotal coagulation protein that converts ________ into ________

A

Antithrombin also binds to active factor X, which is a pivotal coagulation protein that converts prothrombin into thrombin

22
Q

Function of heparin

A

Decreases activity of clotting factors thrombin and Xa by binding to antithrombin 3 and increasing its activity

23
Q

Unfractioned heparin inhibits..

A

Factor Xa & thrombin

24
Q

Fractioned heparin inhibits..

A

Factor Xa

25
Q

Producing coagulation factors ____________ requires an enzyme that uses vitamin K

A

II, VII, IX, and X

26
Q

Function of Warfarin

A

Blocks vitamin K from getting recycled and as a result factors II, VII, IX, and X don’t get activated

27
Q

How is PT measures?

A

Using INR

28
Q

Warfarin prevents disorders that cause blood clots. Give examples of this

A

DVT
Prosthetic heart valves
A-fib

29
Q

T or F: Warfarin is C.I in pregnancy

A

True

30
Q

What does warfarin inhibit?

A

Protein C and S
II, VII, IX, X

31
Q

Heparin enhances the activity of another anticoagulation protein found in the body called..

A

Antithrombin III

32
Q
A
33
Q

Side effects of heparin

A

Bleeding
HIT
Osteoporosis

34
Q

Monitoring of heparin

A

APTT for unfractioned
Usually no monitoring for LMWH

35
Q

Reversal for heparin

A

Stop the heparin

If severe bleeding:
Protamine sulphate- reverses antithrombin effect
Complete reversal for unfractionated
Partial reversal for LMWH

36
Q

Where is vitamin K absorbed?

A

Upper intestine - bile salts for absorption

37
Q

Where is vitamin K synthesised?

A

Liver

38
Q

Warfarin reversal

A
39
Q
A
40
Q

Label where Heparin acts

A
41
Q

Label where Warfarin acts

A
42
Q

Label where DOAs act

A

3MB Haematology (23 decks)

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