Anticoagulants Flashcards
MOA of unfractionated heparin
Complex with AT and inhibits mainly factors Xa and IIa.
MOA of low mw heparin
Complex with AT and inhibits factors Xa and IIa-Monitored by anti-Xa
MOA of Fondaparinux
Complex with AT and inhibits factor Xa
MOA of argatroban
Directly Inhibits IIa, liver excretion, short t1/2
MOA of bivalirudin
Directly Inhibits IIa, renal excretion, short t1/2
MOA of hirudin
Directly Inhibits IIa, no cofactor, renal excretion, short t1/2
MOA of antithrombin concentrate
directly inhibits IIa
MOA of protamine sulfate
heparin antagonist
MOA of warfarin
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
MOA of Vitamin K
Cofactor in the synthesis of functional forms of factors II, VII, IX and X
MOA of
Oral Anti-Xa:
Rivaroxaban (R)
Apixaban (A)
Edoxaban (E)
Inhibits factor Xa
MOA of Oral Antithrombin Dabigatran
Inhibits thrombin
Route of Admin- unfractionated heparin
Mainly intravenous and also given subcutaneous
Route of Admin- LMW heparin and fondaparinux
Subcutaneous
Route of Admin- argatroban, bivalirudin, hirudin, antithrombin concentrate, protamine sulfate
IV
Indications - unfractionated heparin
Surgical Anticoagulation
Indications - LMW heparin
Prophylaxis and Treatment of DVT and ACS
Indications - fondaparinux
Management of DVT
Indications - argatroban, bivalirudin and hirudin
Anticoagulant management of heparin-induced thrombocytopenia patients
Indications - antithrombin concentration
DIC, sepsis, thrombophilia, hypercoagulable state
Indications - protamine sulfate
Antagonist for unfractionated heparin
Indications - warfarin
Prolonged treatment of DVT and Atrial fibrillation
Indications - Vitamin K
Hypoprothrombinemia, intestinal disorders and gastrectomy, reverses the effects of warfarin
Indications - Oral anti-Xa
Stroke prevention in patients with AF
R & A also approved for prophylaxis and treatment of DVT. R approved for ACS
Indications - Oral antithrombin dabigatran
Stroke prevention in patients with atrial fibrillation
Monitoring - warfarin
Prothrombin time/INR
Monitoring - Vitamin K
Not required
Monitoring - Oral Anti-Xa
Not required
Monitoring- Antithrombin Dabigatran
Not required
Monitoring - unfractionated heparin
Monitored by APTT (2-2.5 baseline therapeutic)
Only adverse effect of LMW heparin, fondaparinux, argatroban, bivalirudin, hirudin
Bleeding
Adverse effects: unfractionated heparin
Bleeding, HIT, osteoporosis, alopecia
Adverse effects: antithrombin concentrate
None
Adverse effects: protamine sulfate
Bradycardia, hypotension
Adverse effects: warfarin
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
Adverse effects: Vitamin K
Hemolysis
Adverse effects: Oral Anti-Xa
Bleeding, Liver damage
Adverse effects: Oral antithrombin dabigatran
Bleeding, liver toxicity,
Cleared by kidney could problems in patients with abnormal kidney function.