Anticoagulants

Question 1

What does a thrombus in the venous circulation consist of…

Why are anticoagulants no good for arterial curculation

Answer 1

Fibrin web enmeshed with platelets and red cells

…in the arterial circulation thrombus is mainly platelets and little fibrin

Question 2

Which has a longer duration of action… LMWH or UFH

Answer 2

LMWH

Question 3

What is the advantage of UFH

Answer 3

Shorter duration of action so use in high risk as effect rapidly terminated by stopping transfusion

Question 4

LWWH : name three

Answer 4

Dalteparin
Enoxaparin
Tinzaparin

Question 5

Why are LMWH preferred for prevention of DVT (3)

Answer 5

No monitoring
Lower risk of heparin induced thrombocytopenia
Once daily admin is usually fine

Question 6

What is a role of LMWH in cancer

Answer 6

Dalteparin and Tinzaparin licenced for extended prophylaxis of DVT in patients with solid tumours (6 months)

Question 7

Role of her paring in maintaining the patently of peripheral venous catheters?

Answer 7

Apparently sodium 0.9% is as effective

For arterial and central catheters the role is unclear
According to the BNF…

Question 8

Fondaparinux mode of action

Answer 8

Synthethic pentasacarride that inhibits activated factor X

Question 9

Asinine contraindicated under what age? Except….

Answer 9

16

When specifically indicated such as kwasaki syndrome or high risk of stroke

Question 10

Interactions with aspirin (4)

Answer 10

NSAIDs -s/e
SSRI & venlafaxine- bleed
Methotrexate - reduced renal excretion of methotrexate
Acetozolamide (diuretic)

Question 11

Symptoms of aspirin overdose

Answer 11

Tinnitus 
Hyperventilation
Deafness 
Vasodilation
Sweating