Anticoagulant drugs

Question 1

What are some examples of coumarins and phenindione?

Answer 1

warfarin, acenocoumarin, phenidione

Question 2

What do coumarins do to vitamin K

Answer 2

antagonise it

Question 3

How long does warfarin take

Answer 3

48-72 hours (wars take long)

Question 4

What should be used for immediate effect

Answer 4

Heparins

Question 5

What are warfarin colours

Answer 5

0.5mg - white
1mg - Brown
3mg - Blue
5mg - Pink

Question 6

What juices should be avoided with warfarin

Answer 6

Cranberry and pomegranate (increases INR)

Question 7

What does alcohol do to effect of warfarin

Answer 7

Decreases effect

Question 8

What is the MHRA warning with Warfarin?

Answer 8

Calciphylaxis (painful rash)

Increased risk of bleeding when used with miconazole

Question 9

How long should warfarin be stopped before surgery

Answer 9

5 days

Question 10

Should warfarin be used at the same time daily

Answer 10

Yes

Question 11

How should Warfarin be expressed

Answer 11

In mg, not tablets

Question 12

Are coumarins and warfarin teratogenic?

Answer 12

Yes

Question 13

What can be given in pregnancy

Answer 13

LMWH, enoxaparin, heparin

Question 14

What are INR targets

Answer 14

3.5 - recurrent DVT and mechanical prosthetic valve

2.5 - everything else

Question 15

INR overview

Answer 15

Question 16

What two medicines give higher risk of bleeding

Answer 16

Clopidogrel and warfarin

(aspirin and warfarin)

Question 17

What is the advantage of unfractionated heparin

Answer 17

Rapid working but short duration of action

Question 18

Does LMWH or unfractionated have longer duration of action

Answer 18

LMWH

Question 19

Why is heparin preferred in patients with high risk of bleeding?

Answer 19

Effects can be terminated quickly by stopping infusion

Question 20

What are some examples of LMWH

Answer 20

Tinzaparin, Dalteparin, Enoxaparin

Question 21

Give some examples of antiplatelets

Answer 21

Aspirin, Clopidogrel, Prasguel, dipyridamole

Question 22

Is there any benefit in using Aspirin in primary prevention of CV disease in patients without diabetes?

Answer 22

No

Question 23

When is aspirin used in CV disease

Answer 23

Secondary prevention

Question 24

What can you give alongside aspirin to reduce bleeding risk

Answer 24

PPI

Question 25

How long after the dipyridamole MR tablets should be discarded

Answer 25

6 weeks

Question 26

What is given in non valvular AF

Answer 26

Doacs

Question 27

What is given in valvular AF

Answer 27

Warfarin

Question 28

What should you monitor in DOACS

Answer 28

Kidneys

Question 29

What are all doacs contraindicated in

Answer 29

Antiphospholipid syndrome

Question 30

Should you give aspirin to under 16s

Answer 30

No - Rye’s syndrome risk

Question 31

What is the dosing interval for DOACS

Answer 31

RE (OD)

AD (BD)

Question 32

What if you give antiplatelets with anticoagulants

Answer 32

Increased bleeding risk

Question 33

What is you give antiplatelets with diuretics

Answer 33

Increase risk of renal failure

Question 34

Clopidogrel and omeprazole

Answer 34

Serious interaction

Question 35

What egfr should dabigatran be avoided in

Answer 35

Below 30

Question 36

What egfr should REA be avoided in

Answer 36

Below 15

Question 37

Cautionary labels for rivaroxaban

Answer 37

Take with or after meals (21)

Question 38

Cautionary label for Edoxaban

Answer 38

Read additional info given with this medication (10)

Question 39

Cautionary label for Apixaban

Answer 39

Read additional info given with this medicine (10)

Question 40

Cautionary label for dabigatran

Answer 40

Read additional info given with this medicine (10)

Do not crush, chew - swallow whole (25)

Question 41

DOAC overview

Answer 41