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Hee-matte-ology > Anticoagulants > Flashcards

Anticoagulants Flashcards

1
Q

What is the function of heparin?

A

Potentiates anti-thrombin

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2
Q

What are 2 forms of heparin?

A

Unfractionated

Low molecular weight (LMWH)

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3
Q

How is unfractionated heparin monitored?

A

APTT

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4
Q

How is LMWH monitored?

A

Anti-Xa assay

Usually no monitoring required

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5
Q

What are the complications of heparin?

A

Bleeding
Heparin induced thrombocytopenia
Osteoporosis

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6
Q

How is heparin reversed?

A

Stop heparin

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7
Q

What is given in severe bleeding with heparin?

A

protamine sulphate

Reverses antithrombin effect

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8
Q

What anticoagulants are Coumarin/Inhibit vitamin K?

A

Warfarin
Phenidione
Acenocoumarin
Phenprocoumon

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9
Q

What is vitamin K?

A

fat soluble vitamin

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10
Q

Where is vitamin K absorbed?

A

Upper intestine

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11
Q

What is required for vitamin K absorption?

A

Bile salts

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12
Q

What is vitamin K needed for?

A

Carboxylation of clotting factors II,VII,IX and X

Protein C and protein S

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13
Q

Where are clotting factors 2,7,9 and 10 synthesized?

A

Liver

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14
Q

What is the function of warfarin/

A

Antagonises vitamin K so clotting factors are non functional

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15
Q

What is warfarin’s therapeutic window like?

A

narrow

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16
Q

What are the 3 steps to warfarin therapy?

A

Initiation
Stabilisation
Maintenance

17
Q

What time of day should warfarin be taken?

A

6pm

Same time everyday

18
Q

how is warfarin measured?

A

INR

19
Q

How is INR calculated?

A

Patient’s PT/Normal PT

20
Q

What is a major side effect of warfarin?

A

haemorrhage

21
Q

What might increase the bleeding risk of warfarin?

A

Intensity of treatment
Other clinical disorders
Other medications/DRUG interactions
Quality of management

22
Q

What are complications of bleeding?

A 
Skin bruising
Epistaxis
Haematuria
GI bleeding
Intracerebral
Drop in Hb => anaemia
23
Q

How is warfarin reversed/

A

Omit doses
Oral Vitamin K (6 hours)
Clotting factors (immediate)
Lab assessment of response

24
Q

What is a thrombin inhibitor?

A

Dabigatran

25
Q

What are some Xa inhibitors?

A

Edoxaban
Rivaroxiban
Apixaban

Hee-matte-ology (17 decks)

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