Anticoagulants Flashcards

1
Q

what is the mechanism of warfarin

A

vitamin K antagonist

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2
Q

which clotting factors does warfarin prevent the activation of

A

II, VII, IX and X

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3
Q

does warfarin affect the intrinsic or extrinsic pathway

A

extrinsic

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4
Q

should warfarin be stopped before surgery

A

yes- it has a slow half life so needs to be stopped 3 days before surgery

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5
Q

give an example of a drug which will displace warfarin from being bound to albumin

A

NSAIDs

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6
Q

give some examples of drugs which will inhibit the hepatic metabolism of warfarin

A

amiodarone, quinolone, metronidazole

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7
Q

what drugs can reduce vitamin K in the gut to enhance warfarin

A

cephalosporin antibiotics

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8
Q

which drugs can inhibit warfarin

A

anti epileptics, rifampicin, St Johns Wort

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9
Q

how is warfarin monitored

A

by looking at the PT and INR

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10
Q

what are the side effects of warfarin

A

teratogenic, bruising, bleeding, risk of haemorrhage

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11
Q

when is warfarin used

A

in patient with AF, prosthetic heart valves or previous DVT/PE

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12
Q

how do you reverse the affects of warfarin in an overdose

A

give vitamin K but this is slow acting so give fresh frozen plasma for fast results

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13
Q

what is the mechanism of action of heparins

A

activate anti-thrombin III. this can then deactivate clotting factors

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14
Q

what clotting factors does LMWH deactivate

A

Xa only

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15
Q

what clotting factors does Fractionated heparin deactivate

A

Xa and thrombin

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16
Q

does heparin use need monitoring

A

only for fractionated not LMWH

17
Q

how do you monitor heparin

A

APTT

18
Q

what are the uses of LMWH

A
  • prevention of thrombosis-embolism in immobile patients or before surgery
  • as a loading dose for DVT/PE patients before warfarin
  • acute coronary syndrome
19
Q

what are the adverse effects of heparin

A

bruising
bleeding
osteoporosis
thrombocyotopenia

20
Q

how do you reverse the effects of heparin in an overdose

A

give protamine sulphate

21
Q

name 3 anti-platelet drugs

A

aspirin, dipyridamole, clopidogrel