Anticoagulant Medication Flashcards
Unfractionated Heparin (BIG Heparin) MOA
Enhances antithrombin thus inactivating clotting factors thrombin & factor Xa
Rapid active
Given IV or Suib-q
Unfractionated Heparin (BIG Heparin) Therapeutic Use
Preferred anticoagulant during pregnancy + is needed
DIC, PE, CV events, renal dialysis
Unfractionated Heparin (BIG Heparin) Specific Side Effects
Hemorrhage AND Heparin induced thrombocytopenia (HIT)
If Thrombocytopenia is present - D/C!!!!
Heparin antidote is?
Protamine sulfate + stopping heparin infusion
NORMAL aPTT (activated partial thomboplastin time)
Normal aPTT is 40 seconds
Therapeutic range 1.5 - 2x normal (60-80 seconds aPTT)
Low Molecular Weight (LMW) Heparin Therapeutic Medication prototype and uses
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
LMW Heparin Side Effects
Costs more
Bleeding occurance (less low than unfractionated)
HIT
fondaparaniux MOA + uses
sub-q anticoagulant -enhances antithrombin and inhibits Xa
Can be used in individuals who have had a heparin reaction
warfarin (Coumadin) MOA
Vitamin K oral antagonist
Blocks biosynthesis of factors VII, IX, & X and prothrombin II
warfarin (Coumadin) Therapeutic Use
NOT USEFUL IN EMERGENCIES
Long term prophylaxis of thrombosis
Prevention of venous thrombosis/thromboembolism
Prevention during A-fib
Warfarin Monitoring Tx
PT, INR
VERY narrow (small) therapeutic index
Warfarin Side Effects + Antidote
Hemorrhage (Vit K antidote)
Fetal hemorrhage
DO NOT USE during lactation
Direct Thrombin Inhibitors - dabigatran MOA
inhibits thrombin
considered an alternative to warfarin
NO need to monitor anticoagulation, few drug interactions
Direct Thrombin Inhibitors - dabigatran - Side Effect
GI disturbances - pts really do not like these so we look for another one
Direct Thrombin Inhibitors - dabigatran - Antidote?
idarucizumab
Direct Thrombin Inhibitors - Bivaliruden, argatroban
Given IV
Tx for thrombosis in HIT or in prevention of thrombosis
Factor Xa Inhibitors - rivaroxaban - MOA + Use
binds directly with factor Xa to cause inactivation
GIVEN PO - prevents DVT, PE Stroke in A-fib
Factor Xa Inhibitors - apixaban MOA + Use
Inhibits free and clot bound factor Xa
GIVEN PO - prevents stroke, emboli in a-fib
Factor Xa Inhibitors - rivaroxaban & apixaban - antidote
andexanet alfa
