Anticoagulants Flashcards

1
Q

Indications for anticoagulants

A
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2
Q

Parenteral anticoagulants

A
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3
Q

MOA of anticoagulants

A
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4
Q

Three phases of coagulation

A
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5
Q

MOA of heparin

A
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6
Q

Coagulation cascade

A
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7
Q

Effects of thrombin

A
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8
Q

Effects of antithrombin III

A
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9
Q

Fractionated vs. unfractionated heparin

A
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10
Q

HMWH has effect on _________ and factor X

A
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11
Q

Low molecular weight heparins

A

Enoxaparin, dalteparin, tinzaparin

Administered SubQ with more predictable bioavailability
Longer half life and less need to monitor (unless child or obese)
Cleared by the kidneys and low risk of HIT

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12
Q

Indications and use for heparin and warfarin

A

Binds to endothelium and to plamsa proteins
Levels of heparin-binding proteins vary from person to person so there is an upredictable anticoagulant response
Monitoring and titration required

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13
Q

How is heparin monitored, and what is the reversal?

A
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14
Q

Major adverse effect of heparin

A

Heparin-induced thrombocytopenia

Risk of clots because of antibody production that creates a prothrombotic environment, incidence is ~5%

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15
Q

Low molecular weight heparin indications

A
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16
Q

LMWH boxed warning

A

Spinal/epidural hematoma that could lead to paralysis

17
Q

Risks of Fondaparinux

18
Q

Indication for Argatroban

A

Treatment for heparin-induced thrombocytopenia

19
Q

Indication for Bivalirudin

A

IV infusion used as alternative to heparin in patients undergoing PCI

20
Q

Direct oral anticoagulants
Direct thrombin inhibitor/Factor Xa inhibitors

21
Q

Indications for oral anticoagulants

22
Q

MOA of warfarin

23
Q

Impact of genotype on S-warfarin clearance

24
Q

How long does warfarin typically take effect?

A

About 7 days

25
How is warfarin managed, and what is the recommended INR level to be at?
INR
26
Warfarin dosing and monitoring
27
Factors that correlate with warfarin dose
28
Warfarin adverse effects
Hypercoaguable state
29
What is warfarin purple toe syndrome
30
Reversal for warfarin
31
How do the novel anticoagulants compare with warfarin
32
Dabigatran clearance and absorption
80% renally cleared Requires an acidic environment for absorption
33
Consideration when taking Rivaroxaban?
Take it with food
34
Boxed warning of the novel oral anticoagulants
Increased risk of thrombotic events/stroke in clinical trials
35
Antidotes for novel oral anticoagulants