Anticoagulant Medication

Question 1

Unfractionated Heparin (BIG Heparin) MOA

Answer 1

Enhances antithrombin thus inactivating clotting factors thrombin & factor Xa

Rapid active

Given IV or Suib-q

Question 2

Unfractionated Heparin (BIG Heparin) Therapeutic Use

Answer 2

Preferred anticoagulant during pregnancy + is needed
DIC, PE, CV events, renal dialysis

Question 3

Unfractionated Heparin (BIG Heparin) Specific Side Effects

Answer 3

Hemorrhage AND Heparin induced thrombocytopenia (HIT)

Question 4

Heparin antidote is?

Answer 4

Protamine sulfate

Question 5

Low Molecular Weight (LMW) Heparin Therapeutic Medication prototype and uses

Answer 5

enoxaparin (Lovenox)

Prevention of DVT after surgery - given sub-q

Dosage is based on body weight

Does not require monitoring - can go home on it

Question 6

LMW Heparin Side Effects

Answer 6

Costs more
Bleeding occurance (less low than unfractionated)
HIT

Question 7

fondaparaniux MOA + uses

Answer 7

sub-q anticoagulant -enhances antithrombin and inhibits Xa

Can be used in individuals who have had a heparin reaction

Question 8

warfarin (Coumadin) MOA

Answer 8

Vitamin K oral antagonist
Blocks biosynthesis of factors VII, IX, & X and prothrombin II

Question 9

warfarin (Coumadin) Therapeutic Use

Answer 9

NOT USEFUL IN EMERGENCIES

Long term prophylaxis of thrombosis
Prevention of venous thrombosis/thromboembolism
Pr evention during A-fib

Question 10

Warfarin Monitoring Tx

Answer 10

PT, INR

VERY narrow (small) therapeutic index

Question 11

Warfarin Side Effects

Answer 11

Hemorrhage (Vit K antidote)
Fetal hemorrhage
DO NOT USE during lactation

Question 12

Direct Thrombin Inhibitors - dabigatran MOA

Answer 12

inhibits thrombin
considered an alternative to warfarin
NO need to monitor anticoagulation, few drug interactions

Question 13

Direct Thrombin Inhibitors - dabigatran - Side Effect

Answer 13

GI disturbances - pts really do not like these so we look for another one

Question 14

Direct Thrombin Inhibitors - dabigatran - antidote?

Answer 14

idarucizumab

Question 15

Direct Thrombin Inhibitors - Bivaliruden, argatroban

Answer 15

Given IV
Tx for thrombosis in HIT or in prevention of thrombosis

Question 16

Factor Xa Inhibitors - rivaroxaban - MOA + Use

Answer 16

binds directly with factor Xa to cause inactivation

GIVEN PO - prevents DVT, PE Stroke in A-fib

Question 17

Factor Xa Inhibitors - apixaban MOA + Use

Answer 17

Inhibits free and clot bound factor Xa

GIVEN PO - prevents stroke, emboli in a-fib

Question 18

Factor Xa Inhibitors - rivaroxaban & apixaban - antidote

Answer 18

andexanet alfa