Anticoagulants

Question 1

Dalteparin, enoxaparin, fondaparinux

Answer 1

LWMH
E and D- inhibit 10a by enhancing AT3.
F inhibit 10a by binding to AT3

Question 2

Heparin

Answer 2

Unfractionated. Bind to AT3 to increase activity to inhibit 10a and 2a

Question 3

Reversal agent

Answer 3

Protamine sulphate- forms inactive complex with heparin and dissociated it with AT3.

Question 4

Warfarin

Answer 4

Vit K antagonist, stops activation of 2,7,9,10 clotting factors by inhibiting reduction of Vit K by VKOR

Question 5

Apixaban, rivaroxaban and dabigatran

Answer 5

DOACs
A/R- inhibit free 10a and that bound to AT3.
D- thrombin inhibitor

Question 6

S/E Herparins

Answer 6

HIT, bruising, bleeding, osteoporosis

Question 7

Contraindications with heparin

Answer 7

ACEi due to both inhibiting aldosterone= K rising risk.

Question 8

Warfarin contraindications

Answer 8

Pregnancy, crosses placenta so avoid in 3rd trimester. Amiodarone, clopidogrel, ETOH

Question 9

CYP2C9 inducers

Answer 9

phenytoin, rifampicin, st John’s wort

Question 10

CYP2C9 inhibitors

Answer 10

Amiodarone, clopidogrel, st John’s wort.

Question 11

Dabigatran contraindications

Answer 11

Low creat clearance, also affected by CPY activators and inhibitors