Anticoagulants/Antiplatelets

Question 1

What is the mechanism of action of coumadin/warfarin

Answer 1

Decreases hepatic synthesis of several clotting factors

Question 2

What is the antidote for coumadin

Answer 2

Vitamin K

Question 3

It may take up to ____ hrs for coumadin to exert its effect

Answer 3

72

Due to its mechanism of action and the half-life of clotting factors

Question 4

What is the mechanism of action of heparin/LMWH?

Answer 4

Increases the activity of antithrombin III, which results in breakdown of several clotting factors

Question 5

True or false:

Heparin/LMWH is the drug of choice for pregnant patients in need of anticoagulation

Answer 5

True

Question 6

What is the antidote for heparin/LMWH?

Answer 6

Protamine

Question 7

True or false:

Heparin/LMWH is safe to use in liver/renal insufficiency

Answer 7

False

Question 8

Name several factor Xa inhibitors

Answer 8

Xarelto (rivaroxaban)
Eliquis (apixaban)

Question 9

What is the mechanism of action of xarelto and eliquis

Answer 9

inhibits factor Xa

Xa is among the important final steps in the clotting cascade

Question 10

What is the antidote for the Xa inhibitors

Answer 10

NONE

trick question

Question 11

What are the black box warnings for the Xa inhibitors?

Answer 11

• Early termination of therapy may lead to thrombotic events
• High risk for epidural hematoma with spinal or epidural analgesia

Question 12

What is mechanism of action of aspirin?

Answer 12

Inhibits COX enzymes
(COX converts arachidonic acid into prostaglandins that increase platelet adherence and help form clots)

Question 13

What is the mechanism of action of Plavix/Clopidogrel?

Answer 13

P2y12 inhibitors (prevent platelets from responding to pro-clotting mediators)

Question 14

Anticoagulants should never be co-administered with what class of medications?

Answer 14

NSAID’s

Question 15

Anticoagulants should be stopped at least ________ days before a surgical procedure

Answer 15

5