ANTICOAGULANTS + ANTIPLATELETS Flashcards
Injectable anticoagulants
heparins
oral anticoagulants
coumarin
non-coumarin
antiplatelet meds
aspirin/ clopidogrel
heparin delivery? how long is it active for and what does it inhibit?
infusion
active for few mins
inhibits antithrombin 3
lower molecular weight heparin delivery?
subcutaneous injection
indications for anticoagulants
AF
DVT
heart valve disease
mechanical heart valves
thrombophilIa
most common anticoagulants
warfarin
apixaban
warfarin onset
3 days
warfarin mode of action
inhibits vit K clotting factors 2 7 9 10
measuring warfarin
INR between 2-3
pt taking warfarin undergoing invasive dental procedure
INR and FBC blood test within 72 hours
INR less than 4
treat early in day and week
drugs that increase INR
amiodarone
antibiotics
alcohol with liver disease
NSAIDs
drugs that reduce INR
carbamazepine, barbiturates
cholestryamine
griseofulvin
alcohol without liver disease
for pt taking warfarin do not prescribe
Aspirin
NSAIDs
azole antifungals
apixaban
new oral anticoagulant
apixaban onset
1 hour
apixaban duration
lost within a day
pt on apixaban with invasive dental tx
treat early in day and week
miss delay morning dose
restart dose immediately after
drugs to avoid when taking apixaban
NSAIDS
carbamazepine
standard antiplatelets
low dose aspirin 75mg
clopidogrel
dipyridamole
antiplatelets for advanced cardiac therapy
prasugrel + aspirin
abciximab
eptifibate + aspirin
ticagrelor
tirofiban
what to avoid with antiplatelets
additional NSAIDs
carbamazepine/ omeprazole
clopidogrel interactions
erythromycin/ fluconazole reduce efficacy
Ticagrelor interactions
clarithromycin may increase effect
