Anticoagulants

Question 1

Apixaban brand name

Factor XA-Inhibitors

Answer 1

Eliquis

Question 2

Xarelto generic name

Factor XA-Inhibitors

Answer 2

Rivaroxaban

Question 3

Indication

factor xa inhibitors (eliquis, xarelto)

Answer 3

atrial fibrillation, venous thromboembolism, venous thromboembolism prophylaxis

Question 4

MOA

factor xa inhibitors (eliquis, xarelto)

Answer 4

selective inhibitor of factor Xa which decreases thrombin generation and thrombus development

Question 5

major contraindication

factor xa inhibitors (eliquis, xarelto)

Answer 5

active bleeding

Question 6

Black Box Warnings

factor xa inhibitors (eliquis, xarelto)

Answer 6

• premature discontinuation increases risk of thrombotic events
• increased risk of spinal hematoma with spinal puncture or neuraxial anesthesia

Question 7

common ADRs

factor xa inhibitors (eliquis, xarelto)

Answer 7

minor bleeding including epistaxis, heavy menstrual bleeding, gingival hemorrhage

Question 8

rare ADRs

factor xa inhibitors (eliquis, xarelto)

Answer 8

severe bleeding

Question 9

key counseling points

factor xa inhibitors (eliquis, xarelto)

Answer 9

• do not stop taking this medication w/o talking to doctor
• severe bleeding can occur. common to bruise easily or take longer for minor cute to stop bleeding
• call doctor if dark tarry stool, you cough up blood or have a bleeding cut that won’t stop
• avoid taking with NSAIDs

Question 10

brand name

direct thrombin inhibitors

Answer 10

pradaxa

Question 11

generic name

direct thrombin inhibitors

Answer 11

dabigatran

Question 12

indication

pradaxa (direct thrombin inhibitors)

Answer 12

atrial fibrillation, venous thromboembolism, venous thromboembolism prophylaxis

Question 13

MOA

pradaxa (direct thrombin inhibitors)

Answer 13

competitive, reversible, direct thrombin inhibitor which blocks the conversion of fibrinogen into fibrin during the coagulation cascade and prevents development of a thrombus

Question 14

major contraindications

pradaxa (direct thrombin inhibitors)

Answer 14

• active bleeding
• prosthetic heart valve

Question 15

black box warnings

pradaxa (direct thrombin inhibitors)

Answer 15

• premature discontinuation increases risk of thrombotic events
• increased risk of spinal hematoma with spinal puncture or neuraxial anesthesia

Question 16

common ADRs

pradaxa (direct thrombin inhibitors)

Answer 16

• minor bleeding including epistaxis, heavy menstrual bleeding, gingival hemorrhage
• dyspepsia

Question 17

rare ADRs

pradaxa (direct thrombin inhibitors)

Answer 17

severe bleeding

Question 18

key counseling points

pradaxa (direct thrombin inhibitors)

Answer 18

• do not stop taking this medication w/o talking to doctor
• severe bleeding can occur. common to bruise easily or take longer for minor cute to stop bleeding
• call doctor if dark tarry stool, you cough up blood or have a bleeding cut that won’t stop
• avoid taking with NSAIDs

Question 19

brand name

low molecular weight heparin

Answer 19

lovenox

Question 20

generic name

low molecular weight heparin

Answer 20

enoxaparin

Question 21

indication

lovenox (low molecular weight heparin)

Answer 21

atrial fibrillation, venous thromboembolism, venous thromboembolism prophylaxis

Question 22

MOA

lovenox (low molecular weight heparin)

Answer 22

potentiates antithrombin leading to decreased transformstion from prothrombin to thrombin and inactivates factor Xa

Question 23

major contraindication

lovenox (low molecular weight heparin)

Answer 23

• active bleeding
• hypersensitivity to pork products

Question 24

black box warnings

lovenox (low molecular weight heparin)

Answer 24

increased risk of spinal hematoma with spinal puncture or neuraxial anesthesia

Question 25

common ADRs

lovenox (low molecular weight heparin)

Answer 25

minor bleeding including epistaxis, heavy menstrual bleeding, gingival hemorrhage

Question 26

rare ADRs

lovenox (low molecular weight heparin)

Answer 26

• heparin induces thrombocytopenia
• hyperkalemia
• major bleeding

Question 27

key counseling points

lovenox (low molecular weight heparin)

Answer 27

• severe bleeding can occur. common to bruise easily or take longer for minor cute to stop bleeding
• call doctor if dark tarry stool, you cough up blood or have a bleeding cut that won’t stop
• avoid taking with NSAIDs

Question 28

brand name

vitamin k antagonist

Answer 28

coumadin, jantoven

Question 29

generic name

viamin k antagonist

Answer 29

warfarin

Question 30

indication

warfarin (vitamin k antagonist)

Answer 30

Atrial fibrillation, venous thromboembolism, prosthetic heart valve

Question 31

MOA

warfarin (vitamin k antagonist)

Answer 31

Prevents the conversion of vitamin K back to its active form from vitamin K epoxide. This impairs formation of the vitamin K–dependent clotting factors II,VII, IX, and X (prothrombin) and proteins C and S (physiologic anticoagulants)

Question 32

major contraindications

warfarin (vitamin k antagonist)

Answer 32

pregnancy

Question 33

black box warnings

warfarin (vitamin k antagonist)

Answer 33

major and life threatening bleeding risk

Question 34

common ADRs

warfarin (vitamin k antagonist)

Answer 34

Minor bleeding including epistaxis, heavy menstrual bleeding, gingival hemorrhage

Question 35

rare ADRs

warfarin (vitamin k antagonist)

Answer 35

• major bleeding
• tissue necrosis

Question 36

key counseling points

warfarin (vitamin k antagonist)

Answer 36

• regular INR checks required
• severe bleeding can occur. common to bruise easily or take longer for minor cute to stop bleeding
• call doctor if dark tarry stool, you cough up blood or have a bleeding cut that won’t stop
• avoid taking with NSAIDs