anticoagulants Flashcards

1
Q

Heparin (Chemistry)

A

Sulfated glycosaminoglycan

a. unfractionated
b. low –MW

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2
Q

Warfarin (Chemistry)

A

Coumarin

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3
Q

Heparin (ROA)

A

Parenteral (IV or SC)

Not IM - produce hematoma

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4
Q

Warfarin (ROA)

A

Oral, IV

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5
Q

Heparin (Uses)

A

Post MI
Prevention of DVT and PE

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6
Q

Warfarin (Uses)

A

Prevention of DVT and PE
Atrial fibrillation
Atificial heart valves

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7
Q

Heparin (Mechanism)

A

Activates antithrombin

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8
Q

Warfarin (Mechanism)

A

Inhibits Vit. K synthesis

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9
Q

Heparin (Target)

A

1.5 - 2.5x control

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10
Q

Warfarin (Target)

A

INR 2-3

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11
Q

Heparin Side Effects

A

Bleeding
Allergy
Thrombocytopenia

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12
Q

Warfarin Side Effects

A

Bleeding
Teratogenic

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13
Q

Heparin Monitoring

A

Activated partial thromboplastin time

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14
Q

Warfarin Monitoring

A

Prothrombin time (expressed as INR)

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15
Q

Heparin Antidote

A

Protamine sulfate (1mg/100 units)

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16
Q

Warfarin Antidote

A

Vitamin K

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17
Q

Unfractionated heparin MW

A

5,000-30,000 Daltons

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18
Q

Low molecular weight heparins (LMWH)

A

Enoxaparin
Dalteparin
Tinzaparin

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19
Q
  • Longer half life
  • Less bleeding, routine aPTT unnecessary
A

Low Molecular Weight Heparins (LWMH)

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20
Q

Mixture of sulfated glycosaminoglycosan
(heparin, dermatan, chondroitin)

A

Danaparoid Na

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21
Q

Danaparoid Na is a mixture of sulfated glycosaminoglycosan:

A

Heparin
Dermatan
Chondroitin

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22
Q

Note: Heparin is a preferred drug given to a pregnant woman, It does not cross the placenta.

A
23
Q

Heparin and Related Agents

A
  • Unfractionated Heparin
  • Low Molecular Weight Heparins
  • Danaparoid Na
  • Fondaparinux Na
24
Q

Coumarin Derivatives

A
  • Warfarin sodium
  • Dicumarol
25
Q

It dissolves clot

  • converts plasminogen—-plasmin (fibrinolytic)
A

Thrombolytics (Enzymes)

26
Q

Types of Thrombolytics

A
  • Streptokinase
  • Tissue Plasminogen Activators
27
Q

It is a protein from streptococci

A

Streptokinase

28
Q

Uses of Streptokinase

A
  • MI, DLVT (deep venous thrombosis) , PE (pulmonary embolism)
29
Q

Side Effects of Streptokinase

A

Hemorrhage
Allergy

30
Q

Examples of Tissue Plasminogen Activators

A

Alteplase
Reteplase
Streptokinase

31
Q

Uses of TPA

A
  • MI, DLVT, PE
32
Q

It only binds to plasminogen bound to fibrin

A

Tissue Plasminogen Activators

33
Q

Side Effect of TPA

A

Hemorrhage

34
Q

It inhibits platelet aggregation and prolongs bleeding time

A

Antiplatelets

35
Q

Uses of Antiplatelets

A

Prevention of MI, Stroke

36
Q

It prevents thromboxane synthesis by inhibiting cyclooxygenase

A

Aspirin

37
Q

Uses of Aspirin

A

Prevention of MI, Stroke

38
Q

Side Effects of Aspirin

A

GI Ulcer
Bleeding

39
Q

It blocks ADP(adenosine diphosphate) receptor in the platelet cell membrane

A

Thienopyridines

40
Q

Uses of Thienopyridines

A

Prevention of MI, Stroke

41
Q

Side Effects of Clopidogrel

A

Nausea
Vomiting
Diarrhea
Hemorrhage

42
Q

Side Effects of Ticlopidine

A

Neutropenia

43
Q

It inhibits adenosine reuptake—-decrease platelet aggregation

It inhibits phosphodiesterase—–Inc. cGMP—vasodilation

A

Dipyridamole

44
Q

It is for patients undergoing percutaneous coronary intervention (angioplasty)

A

Glycoprotein IIb/ IIIa inhibitors

45
Q

Examples of Glycoprotein IIb/ IIIa inhibitors

A

Abciximab
Eptifibatide
Tirofiban

46
Q

Side Effects of Glycoprotein Inhibitors

A

Bleeding

47
Q

Glycoprotein IIB/IIA Inhibitors Use

A

To decrease the incidence of hemorrhage

48
Q

Vitamin K and its synthetic derivatives

A

Vitamin K1 (phytonadione) - fat soluble
Vitamin k3 (menadione) - fat soluble
Vitamin K4 (menadiol) -water soluble

49
Q

Vitamin K MOA

A

Promotes the synthesis of Factors II, VII ,IX and XI

50
Q

Factor II

A

Prothrombin

51
Q

Factor VII

A

Proconvertin

52
Q

Factor IX

A

Plasma Thromboplastin Component

53
Q

Factor XI

A

Stuart Factor

54
Q

It is the drug of choice for the treatment of anticoagulant overdose and HDN (hemorrhagic disease of newborn) because it has the same degree of activity with the naturally occurring vitamin and have better margin of safety.

A

Vitamin K1 (Phytonadione)