Anticoagulant drugs Flashcards

1
Q

indications for anticoagulant drugs

A
  • venous thrombosis
  • atrial fibrillation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

naturally occurring anticoagulants

A

anti-thrombin
protein C and protein S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how is heparin given

A

IV or subcutaneous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how quickly does heparin work

A

immediate effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

heparin potentiates _______

A

antithrombin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the 2 forms of heparin

A

unfractionated

low molecular weight (LMWH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

heparin monitoring for unfractionated

A

activated partial thromboplastin time (APTT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

does LMWH require monitoring

A

usually no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

heparin complications

A

Bleeding

Heparin induced thrombocytopenia (with thrombosis) HITT - monitor FBC in patients on heparin

Osteoporosis with long term use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

if on heparin and platelets drop, what are we thinking about

A

Heparin induced thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what’s the longest we would ever use heparin for

A

9 months (pregnancy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

which has a shorter half life - LMWH or unfractionated heparin

A

unfractionated - out the system in about half an hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

heparin summary

A

immediate effect
given IM or subcut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

why must heparin be given too in the first week of warfarin

A

warfarin takes more time to take effect?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

warfarin mechanism of action

A

competitively inhibits the vitamin K epoxide reductase complex 1 (VKORC1), an essential enzyme for activating the vitamin K available in the body

acts by inhibiting the gamma-carboxylation of glutamic acid residues in the clotting proteins II (prothrombin), VII, IX, and X.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what coagulation factors does warfarin target

A

II, VII, IX, and X.

17
Q

what is the most sensitive monitoring test for warfarin

A

prothrombin time

18
Q

what is INR

A

International Normalised Ratio
a mathematical correction of prothrombin time

19
Q

what factors may influence bleeding risk on warfarin

A
  • Intensity of anticoagulation
  • Concomitant clinical disorders
  • Concomitant use of other medications
  • BEWARE DRUG INTERACTIONS
  • Quality of management
20
Q

mild bleeding complications of anticoagulation

A

skin bruising
epistaxis
haematuria

21
Q

severe complications of anticoagulation

A

gastro-intestinal
intracerebral
significant drop in Hb

22
Q

how can effect of warfarin be reversed

A

give vitamin K
administer clotting factors

23
Q

management of bleeding
- how fast does vit K work?
- how fast does clotting factors work?

A

vitamin K - 6 hours
Clotting factors - immediate

24
Q

what INR is high risk of future bleeding

A

INR >8

25
Q

Xa inhibitors examples

A

Edoxaban
Rivaroxaban
Apixaban

26
Q

how are Xa inhibitors administered

A

oral

27
Q

is monitoring required for Xa inhibitors

A

no

28
Q

direct thrombin inhibitor example

A

dabigatran