Anticoagulants + Anti-Platelets

Question 1

Indications for anticoagulant drugs =

Answer 1

Venous thrombosis
Atrial fibrillation

Question 2

Which clotting process do anticoagulants target?

Answer 2

Formation of the fibrin clot

Question 3

Naturally occurring anticoagulants

Answer 3

1. Antithrombin (serine protease inhibitor)
2. Proteins C and S (act upon clotting factors V/Xa and VIII/Xa)

Question 4

Heparin MOA

Answer 4

Potentiates antithrombin

(immediate effect)

Question 5

How to monitor unfractionated heparin

Answer 5

Activated partial thromboplastin time (APTT)

Question 6

Heparin complications

Answer 6

Bleeding
HITT (Heparin-induced Thrombocytopaenia with Thrombosis) - make sure to monitor FBCs
Osteoporosis (long term use)

Question 7

Severe bleeding with heparin - how to reverse it ?

Answer 7

Protamine sulphate

Question 8

Class + MOA of warfarin ?

Answer 8

Coumarin anticoagulants

Inhibits Vitamin K

Question 9

Vitamin K clotting factors

Answer 9

2,7,9,10

Question 10

What is required to absorb Vitamin K ?

Answer 10

Bile salts

Question 11

How to reverse warfarin ?

Answer 11

Oral Vitamin K (works in 6 hours)
+ clotting factors (works immediately)

Question 12

MOA of dabigatran

Answer 12

Thrombin inhibitor

(type of DOAC)

Question 13

Precise MOA of rivaroxaban/apixaban

Answer 13

Factor Xa inhibitor

Question 14

Aspirin MOA

Answer 14

Inhibits cyclo-oxygenase which is necessary to produce Thromboxane A2

Question 15

MOA of clopidogrel and prasugrel

Answer 15

ADP receptor antagonists

Question 16

MOA of dipyridamole

Answer 16

Phosphodiesterase inhibitor - increases production of cAMP which inhibits platelet aggregation