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Anticoagulants Flashcards

1
Q

MOA of unfractionated heparin (UFH)?

A

Binds ATIII causing inactivation of factor IIa and Xa

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2
Q

MOA of low molecular weight heparin(LMWH)?

A

Binds ATIII causing inactivation of factor Xa

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3
Q

MOA of warfarin?

A

Inhibit sliver synthesis of vitamin K dependent factors (II, VII, IX, X)

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4
Q

MOA of dibigatran?

A

Direct thrombin (IIa) inhibitor

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5
Q

MOA of rivaroxaban and apixaban?

A

Direct factor Xa inhibitor

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6
Q

Onset of action of UFH?

A

rapid

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7
Q

Onset of action of LMWH?

A

3-5 hours

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8
Q

Onset of action of warfarin?

A

hours-days

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9
Q

Onset of action of dabigatran?

A

peak 1-2 hours

2-3 days to steady state

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10
Q

Onset of action of rivaroxaban and apixaban?

A

peak action 2.5-4 hours

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11
Q

Elimination route of UFH?

A

Cleared by reticuloendothelial system

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12
Q

Elimination route of LMWH?

A

Renal clearance (decrease dose in renal failure)

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13
Q

Elimination route of warfarin?

A

Hepatic metabolism, CYP2C9

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14
Q

Elimination route of dabigatran?

A

Primary renal (remember to renal dose)

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15
Q

Elimination route for rivaroxaban and apixaban?

A

Hepatic CYP3A

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16
Q

Monitoring lab test for UFH?

A

aPTT

anti-factor Xa prn

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17
Q

Monitoring lab test for LMWH?

A

not needed

anti-factor Xa prn

18
Q

Monitoring lab test for warfarin?

19
Q

Monitoring for dabigatran, rivaroxaban, and apixaban?

A

No routine monitoring

20
Q

Adverse effects of UFH?

A

Bleeding, thrombocytopenia

21
Q

Adverse effects of LMWH?

A

Bleeding, thrombocytopenia

22
Q

Adverse effects of warfarin?

A

Bleeding, skin necrosis

23
Q

Adverse effects of dabigatran?

A

Bleeding, gastritis symptoms

24
Q

Adverse effects of rivaroxaban and apixaban?

25
Q

What two anticoagulants are safe in pregnancy?

A

UFH and LMWH

26
Q

DDIs with all anticoagulants?

A

NSAIDs - they increase bleeding risk

27
Q

DDIs with UFH and LMWH?

A

Antiplatelet agents.

28
Q

DDIs with warfarin?

A

CYP450 inhibitors
CYP450 inducers
Dietary vit K

29
Q

DDIs with Dabigatran, rivaroxaban, and apixaban?

A

P glycoprotein inducers (rifampin, dronedarone) decrease effect
P glycoprotein inhibitors increase effect
CYP3A4 inhibitors effect rivaroxaban

30
Q

Overdose treatment for UFH?

31
Q

Overdose treatment for LMWH?

32
Q

Overdose treatment for warfarin?

A

Phytonadione (Vit K1)

FFP

33
Q

Overdose treatment for dabigatran?

A

Idarucizumab

34
Q

Overdose treatment for rivaroxaban, apixaban?

A

Andexanet alfa (rXa)

35
Q

Uses for UFH?

36
Q

Uses for LMWH?

37
Q

Uses for warfarin?

A

A-fib, VTE prophylaxis

38
Q

Uses for Dabigatran?

39
Q

Uses for rivaroxaban?

A

A fib, DVT-PE prevention after total hip or total knee

40
Q

Uses for Rivaroxaban?

A

A fib, DVT-PE prevention after total knee or total hip

41
Q

Uses for apixaban?

Cam's Cards (103 decks)

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