Anticoagulants

Question 1

Uses

Answer 1

Prevention and treatment of venous thrombus and embolism e.g.
DVT
PE
Post-op
Artificial heart valves 
AF

Question 2

Risks

Answer 2

Haemorrhage

Question 3

Drug names

Answer 3

Warfarin
Heparin (and LMWH) 
Rivaroxaban
Dabigatran
Fondaparinux

Question 4

Warfarin (mechanism)

Answer 4

Blocks vitamin K reductase
Vit K reductase converts oxidised K+ -> reduced K+ thus when this pathway is blocked, no reduced K+ is produced.
This renders factors II, VII, IX and X inactive
Slow onset of action
Long half life
Monitor INR regularly

Question 5

Warfarin (administration)

Answer 5

Oral

Question 6

Warfarin (overdose)

Answer 6

Managed with Vit K administration

Question 7

Heparin (mechanism)

Answer 7

Inactivates factor IIa and Xa

Binds to both ATIII and IIa to inactivate IIa
Binds to just ATIII to inactivate Xa

Question 8

Heparin (administration)

Answer 8

IV (immediate onset)

Subcutaneously

Question 9

LMWH (mechanism)

Answer 9

Preferred, except in renal failure

Inactivates factor Xa only.

Question 10

LMWH (administration)

Answer 10

Subcutaneously

Question 11

Rivaroxaban (mechanism and use)

Answer 11

Directly inhibits factor Xa

Preventative for venous thrombosis in patients undergoing hip and knee replacement

Question 12

Rivaroxaban (administration)

Answer 12

Oral

Question 13

Dabigatran (mechanism and use)

Answer 13

Directly inhibits factor IIa

Preventative for venous thrombosis in patients undergoing hip and knee replacement