Anticoagulant drugs Flashcards
What are some examples of coumarins and phenindione?
warfarin, acenocoumarin, phenidione
What do coumarins do to vitamin K
antagonise it
How long does warfarin take
48-72 hours (wars take long)
What should be used for immediate effect
Heparins
What are warfarin colours
0.5mg - white
1mg - Brown
3mg - Blue
5mg - Pink
What juices should be avoided with warfarin
Cranberry and pomegranate (increases INR)
What does alcohol do to effect of warfarin
Decreases effect
What is the MHRA warning with Warfarin?
Calciphylaxis (painful rash)
Increased risk of bleeding when used with miconazole
How long should warfarin be stopped before surgery
5 days
Should warfarin be used at the same time daily
Yes
How should Warfarin be expressed
In mg, not tablets
Are coumarins and warfarin teratogenic?
Yes
What can be given in pregnancy
LMWH, enoxaparin, heparin
What are INR targets
3.5 - recurrent DVT and mechanical prosthetic valve
2.5 - everything else
INR overview
What two medicines give higher risk of bleeding
Clopidogrel and warfarin
(aspirin and warfarin)
What is the advantage of unfractionated heparin
Rapid working but short duration of action
Does LMWH or unfractionated have longer duration of action
LMWH
Why is heparin preferred in patients with high risk of bleeding?
Effects can be terminated quickly by stopping infusion
What are some examples of LMWH
Tinzaparin, Dalteparin, Enoxaparin
Give some examples of antiplatelets
Aspirin, Clopidogrel, Prasguel, dipyridamole
Is there any benefit in using Aspirin in primary prevention of CV disease in patients without diabetes?
No
When is aspirin used in CV disease
Secondary prevention
What can you give alongside aspirin to reduce bleeding risk
PPI
