anticoagulants

Question 1

warfarin

Answer 1

vit k antagonist
inhibit vit K reductase

Can be reversed with vitamin K1 administration.
antidote:Stop therapy, Vitamin K given IV or orally

INR needs to be measured.2-3 range on warfarin

Interacts (increased bleeding) with St John’s Wort.

Adverse effects of warfarin
Bleeding (common)

Contraindications
Bleeding disorders etc
Alcoholism

Question 2

heparin

Answer 2

Binds to antithrombin III and activates it.
antithrombin 3 inhibits 2a, 9a, 10a, 11a, 12a

Can be reversed with protamine sulfate

IV for heparin, SC for LMWH

enoxaparin, dalteparin- LMWH

LMWH does not need aPTT monitoring.whereas unfractionated heparin does

LMWH-increase inactivation by AT III of Factor Xa,
not thrombin

Question 3

Rivaroxaban

Apixaban

Answer 3

Direct Factor Xa inhibitor
Not reversible
No INR monitoring necessary

Question 4

Dabigatran

Answer 4

Thrombin inhibitor
Not reversible
No INR monitoring necessary

Question 5

aspirin

Answer 5

(impair platelet aggregation)
Irreversible inactivation of cyclooxygenase (COX)

low dose aspirin is anti platelet

Question 6

Clopidogrel

Answer 6

(inhibit platelet binding/adhesion)

Inhibits ADP binding to platelets

Question 7

Alteplase

Answer 7

helps break up clots

Recombinant form of tissue plasminogen activator

Question 8

streptokinase

Answer 8

Binds to and activates plasminogen
can only be used once

helps break up clots