Anticoagulant Treatment Flashcards
What is Heparin MOA
Activates antithrombin, which decrease action of IIa(thrombin) and factor Xa short half life
What is the clinical use of heparin
PE
Acute Coronary syndrome
MI
DVT
Pregnancy don’t cross placenta
What is the side effect of heparin
HIT
Bleeding
For rapid reversal of heparin what is the antidote
Protamine sulfate
Name direct thrombin inhibitors
- Bivalirudin
- Argatroban
- Dabigatran only oral agent
What is the MOA of Dabigatran?
Directly inhibits activity of free and clot associated thrombin
What is the clinical use of Bivalirudin?
Atrial fib
Venous thromboembolism
HIT
Does not require lab monitoring
What is the side effect of Argatroban
Bleeding
Dabigatran can be reverse with
Idarucizumab
What is the MOA of warfarin
Inhibits epoxide reductase, which interferes with gamma carboxylation of Vit K-dependent clotting factors II,VII,IX,X and Proteins C & S
In laboratory assay what labs would you order for warfarin
PT/INR
PT would be increase
Extrinsic pathway
What is the clinical use of warfarin
Thromboembolism prophylaxis
Prevent of stroke in atrial fib
Chronic anti coagulation
Not use in pregnant
What labs will you order for your patient on warfarin
PT/INR
What is the side effects of warfarin
Teratogenic
Bleeding
Skin/tissue necrosis
For the reversal for warfarin
Vit K, FFP or PCC
What are the names of the Direct factor Xa inhibitors
ApiXaban, rivaroXaban
What are the MOA of Apixaban
Binds to and directly inhibits factor Xa
What is the clinical use of Factor Xa inhibitor
Tx and prophylaxis for DVT and PE
Stroke prophylaxis in pt with atrial fib
What are the side effect of Apixaban, rivaroxabon
Bleeding
What are the MOA of Clopidogrel, prasugrel, ticagrelor, ticlopidine
Inhibits platelet clotting by irreversible blocking ADP(P2Y12) prevent expression of IIb/IIIa
What is ADP inhibitors Clinical use
Acute coronary syndrome
Coronary stenting
What is the side effect of clopidogel
Neutropenia
What is the name of this drug. It MOA is increase cAMP in platelets, resulting in inhibition of platelet aggregation and VD
Antiplatelet phosphodiesterase inhibitors
1. Cilostazol
2. Dipyridamole
What is the side effect of PDE5?
Nausea
H/A
Flushing
Hypotension
What is Abciximab S/E,MOA, and clinical usage
1.Bleeding & thromocyopenia is side effect
2. Use in unstable angina and PCI
3. Binds to the IIb/IIIa on platelets preventing clotting
4. Eptifibatide
5. Tirofiban