Anticoagulants

Question 1

MOA of unfractionated heparin

Answer 1

Complex with AT and inhibits mainly factors Xa and IIa.

Question 2

MOA of low mw heparin

Answer 2

Complex with AT and inhibits factors Xa and IIa-Monitored by anti-Xa

Question 3

MOA of Fondaparinux

Answer 3

Complex with AT and inhibits factor Xa

Question 4

MOA of argatroban

Answer 4

Directly Inhibits IIa, liver excretion, short t1/2

Question 5

MOA of bivalirudin

Answer 5

Directly Inhibits IIa, renal excretion, short t1/2

Question 6

MOA of hirudin

Answer 6

Directly Inhibits IIa, no cofactor, renal excretion, short t1/2

Question 7

MOA of antithrombin concentrate

Answer 7

directly inhibits IIa

Question 8

MOA of protamine sulfate

Answer 8

heparin antagonist

Question 9

MOA of warfarin

Answer 9

Competitive antagonist of vitamin K. Suppresses the synthesis of functional forms of factors II, VII, IX and X by blocking enzyme epoxide reductase in liver

Question 10

MOA of Vitamin K

Answer 10

Cofactor in the synthesis of functional forms of factors II, VII, IX and X

Question 11

MOA of

Oral Anti-Xa:
Rivaroxaban (R)
Apixaban (A)
Edoxaban (E)

Answer 11

Inhibits factor Xa

Question 12

MOA of Oral Antithrombin Dabigatran

Answer 12

Inhibits thrombin

Question 13

Route of Admin- unfractionated heparin

Answer 13

Mainly intravenous and also given subcutaneous

Question 14

Route of Admin- LMW heparin and fondaparinux

Answer 14

Subcutaneous

Question 15

Route of Admin- argatroban, bivalirudin, hirudin, antithrombin concentrate, protamine sulfate

Answer 15

IV

Question 16

Indications - unfractionated heparin

Answer 16

Surgical Anticoagulation

Question 17

Indications - LMW heparin

Answer 17

Prophylaxis and Treatment of DVT and ACS

Question 18

Indications - fondaparinux

Answer 18

Management of DVT

Question 19

Indications - argatroban, bivalirudin and hirudin

Answer 19

Anticoagulant management of heparin-induced thrombocytopenia patients

Question 20

Indications - antithrombin concentration

Answer 20

DIC, sepsis, thrombophilia, hypercoagulable state

Question 21

Indications - protamine sulfate

Answer 21

Antagonist for unfractionated heparin

Question 22

Indications - warfarin

Answer 22

Prolonged treatment of DVT and Atrial fibrillation

Question 23

Indications - Vitamin K

Answer 23

Hypoprothrombinemia, intestinal disorders and gastrectomy, reverses the effects of warfarin

Question 24

Indications - Oral anti-Xa

Answer 24

Stroke prevention in patients with AF

R & A also approved for prophylaxis and treatment of DVT. R approved for ACS

Question 25

Indications - Oral antithrombin dabigatran

Answer 25

Stroke prevention in patients with atrial fibrillation

Question 26

Monitoring - warfarin

Answer 26

Prothrombin time/INR

Question 27

Monitoring - Vitamin K

Answer 27

Not required

Question 28

Monitoring - Oral Anti-Xa

Answer 28

Not required

Question 29

Monitoring- Antithrombin Dabigatran

Answer 29

Not required

Question 30

Monitoring - unfractionated heparin

Answer 30

Monitored by APTT (2-2.5 baseline therapeutic)

Question 31

Only adverse effect of LMW heparin, fondaparinux, argatroban, bivalirudin, hirudin

Answer 31

Bleeding

Question 32

Adverse effects: unfractionated heparin

Answer 32

Bleeding, HIT, osteoporosis, alopecia

Question 33

Adverse effects: antithrombin concentrate

Answer 33

None

Question 34

Adverse effects: protamine sulfate

Answer 34

Bradycardia, hypotension

Question 35

Adverse effects: warfarin

Answer 35

Bleeding, coumadin induced necrosis
Has interaction with several medications which can either potentiate the effects or inhibit the effects. Crosses placental barrier causing birth defects

Question 36

Adverse effects: Vitamin K

Answer 36

Hemolysis

Question 37

Adverse effects: Oral Anti-Xa

Answer 37

Bleeding, Liver damage

Question 38

Adverse effects: Oral antithrombin dabigatran

Answer 38

Bleeding, liver toxicity,

Cleared by kidney could problems in patients with abnormal kidney function.