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Anticoagulants Lecture Flashcards

1
Q

what is a normal IV dose of heparin?

A

12 units/kg/hr (weight based continuous IV infusion)

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2
Q

what is the action of aspirin?

A

inhibits platelet aggregation by inhibiting enzymes for thromboxane A2 synthesis

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3
Q

where is warfarin metabolized?

A

liver

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4
Q

what is the normal lab value for INR for a patient on warfarin?

A

2.0-3.0 (can be higher for a pt with a mechanical valve)

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5
Q

what is the action for Pradaxa (dabigatran etexilate)?

A
  • direct thrombin inhibitor

- inhibits coagulation by inhibiting thrombin

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6
Q

what is a normal dose for aspirin?

A

81-325mg (81 is a normal low dose typically given with other drugs)

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7
Q

what is used to remove Pradaxa (dabigatran etexilate) from a patient’s system?

A

dialysis (can filter out 60%)

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8
Q

how long does aspirin last?

A

7 days (life span of a platelet that is why it should be stopped 1 week before surgery)

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9
Q

what is urticaria?

A

hives/allergic reaction on the skin

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10
Q

what is the normal dosing for Eliquis/Xarelto?

A
  • 1 a day for prevention

- 2 a day for treatment

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11
Q

what is the usual starting dose for warfarin?

A

5-10 mg

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12
Q

what is the generic name for Xarelto?

A

rivaroxaban

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13
Q

what are the two forms that heparin comes in?

A

IV and subcutaneous (there is no oral form because it can be digested)

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14
Q

what is the normal range for platelets?

A

150,000-400,000

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15
Q

what drug is used to prevent DVT post-op?

A

Eliquis/Xarelto

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16
Q

what are the advantages of Pradaxa (dabigatran etexilate)?

A
  • no blood work

- less risk for bleeding

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17
Q

what is Lovenox used for?

A
  • prophylaxis of DVT and ischemia

- pulmonary embolism and DVT

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18
Q

what is the action for Eliquis/Xarelto?

A
  • direct factor Xa inhibitor
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19
Q

what are the adverse effects for Eliquis/Xarelto?

A
  • brain hemorrhage

- GI bleeding

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20
Q

what anticoagulant can be used for open-heart surgery with bypass pump and dialysis

A

heparin can be used because of its short half-life ( Lovenox can’t be used)

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21
Q

what is HIT? (heparin-induced thrombocytopenia)

A

50% reduction of platelet count

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22
Q

what anticoagulant has no antidote?

A

Eliquis/Xarelto

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23
Q

what lab value should be monitored for drug toxicity? why? what are the values?

A

creatinine - shows kidney function

men: 0.74-1.35 mg/dL
women. : 0.59-1.04 mg/dL

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24
Q

what is DIC? (disseminated intravascular coagulation)

A

abnormal clumps of thickened blood (clots) form inside blood vessels
- these abnormal clots use up the blood’s clotting factors, which can lead to massive bleeding in other places

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25
Q

what is the trade name for warfarin?

A

Coumadin

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26
Q

what is a normal subcutaneous dose of heparin?

A

5,000 units

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27
Q

what is the antidote for heparin?

A

protamine sulfate (rarely used due to heparins short half-life)

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28
Q

what are the side effects of warfarin/coumadin?

A
  • risk for hemorrhage
  • nausea and vomiting
  • abdominal pain
  • alopecia
  • dizziness
  • joint and muscle pain
  • urticaria (hives)
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29
Q

what drug is used to treat DIC (disseminated intravascular coagulation)?

A

heparin

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30
Q

what anticoagulant can be given to pregnant women?

A

heparin

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31
Q

how long does it take warfarin to reach the therapeutic range?

A

1 week

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32
Q

what anticoagulant is typically given only in the hospital?

A

heparin

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33
Q

what lab should be taken for patients on heparin?

A

aPTT

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34
Q

what is the antidote for warfarin?

35
Q

what is the action of warfarin/coumadin?

A
  • inhibits synthesis of vitamin K

- inhibits clotting factors 10, 9, and 7

36
Q

what are the uses for Eliquis/Xarelto?

A
  • treatment of DVT or PE
  • prevention of DVT post-op
  • reduces the risk of CVA due to a-fib
37
Q

why is aspirin not used for pain management?

A

high dosages cause a risk for bleeding

38
Q

what is the dosing for Pradaxa (dabigatran etexilate)?

A

twice a day fixed doses

39
Q

what drug is an antiplatelet?

A

aspirin
GB
plavix

40
Q

the formula for kg to lbs

A

1 kg = 2.2 lbs

41
Q

what adverse reaction is common with aspirin?

42
Q

what is the antidote for Eliquis/Xarelto?

A

there is none

43
Q

what is the half-life of warfarin?

A

multiple days to a week (a long half-life)

44
Q

what is the most common anticoagulant?

A

warfarin - coumadin

45
Q

what is a normal aPTT lab for someone not on heparin?

A

less than 35

46
Q

what are the only 2 FDA-approved uses for Pradaxa (dabigatran etexilate)?

A
  • DVT

- post-Afib

47
Q

what is the other name for Pradaxa?

A

dabigatran etexilate

48
Q

where is warfarin highly metabolized?

A

P450 system (competitive enzymes in the liver which makes complicated regimens for each pt)

49
Q

what is the route for Lovenox?

A

subcutaneously

50
Q

what form does Eliquis/Xarelto come in?

51
Q

what anticoagulant is typically taken at home?

52
Q

what is a normal aPTT lab for someone on heparin?

A

51 - 80 (should be 1.5-2 times normal)

53
Q

what form does Pradaxa (dabigatran etexilate) come in?

54
Q

what is the generic name for Eliquis?

55
Q

what drugs are used to treat PE or DVT?

A
  • heparin
  • Lovenox
  • warfarin
  • Eliquis/Xarelto
56
Q

when is warfarin mostly given?

A

the evenings

57
Q

can a pt be on warfarin and heparin at the same time?

A

yes until warfarin reaches its therapeutic range

58
Q

what is warfarin/coumadin used for?

A
  • DVT
  • PE
  • Afib
  • to decrease the risk of CVA/MI
  • prosthetic heart valve
59
Q

what is the usual maintenance dose for warfarin?

60
Q

what are the benefits of Lovenox?

A
  • aPTT doesn’t need to be monitored

- fixed dose based on weight

61
Q

what is Lovenox?

A

low molecular weight heparin

62
Q

What is the action of heparin?

A
  • binds with antithrombin III to inactivate clotting factors Xa
  • inhibits the production of thrombin
  • prevents thrombus formation
  • prevents the production of fibrin
63
Q

what is the half-life for heparin?

A

1.5-2 hours

64
Q

what is the drug for the category “thrombolytic drugs”?

A

altepase (tPA, activase)

65
Q

what is the ending for thrombolytic drugs?

A

“-ase”

66
Q

what is the high risk associated with thrombolytic drugs?

67
Q

what is the action of thrombolytic drugs?

A

dissolving established clot

68
Q

what is the only drug used for dissolving established clots?

A

TPA (alteplase)

69
Q

what is the route for TPA (alteplase)?

70
Q

what is the use for TPA (alteplase)?

A

acute MI, massive PE, acute stroke (ischemic not hemorrhagic)

71
Q

what is the goal for TPA (alteplase)?

A

administer quickly to prevent cell death

72
Q

what drug is an adenosine diphosphate receptor antagonist?

A

Clopidogrel (Plavix)

73
Q

when is Clopidogrel (Plavix) often used?

A

after stent surgery - to prevent stenosis of coronary stents (often also used to reduce risk of ischemic attack)

74
Q

what is the action of Clopidogrel (Plavix)?

A

inhibits platelet aggregation by blocking receptors on platelets

75
Q

what is thrombocytopenia?

A

low level of platelets due to medication side effects

76
Q

what are some adverse effects of Clopidogrel (Plavix)?

A
  • bleeding
  • thrombocytopenia
  • dyspepsia (abnormal stomach pain)
  • diarrhea
  • rash
77
Q

what is the common dose for Clopidogrel (Plavix)?

A

75 mg fix dose - monitor platelet count

78
Q

caution use of Clopidogrel (Plavix) with …

A
  • NSAIDs and coumadin - non-steroidal anti-inflammatory drugs
  • proton pump inhibitors
79
Q

what medication is Clopidogrel (Plavix) commonly used with?

80
Q

what kind of drug is GPIIb/IIIa antagonist?

A

antiplatelet (often referred to as super aspirins)

81
Q

what route is GPIIb/IIIa antagonist given?

82
Q

what is the only IV antiplatelet drug?

A

GPIIb/IIIa antagonist

83
Q

what is the use for GPIIb/IIIa antagonist?

A
  • acute coronary syndromes and coronary intervention
  • given during heart attack if pt can’t get to cath lab
  • also can be given after coronary artery intervention
84
Q

what drug would be given to a pt if they can’t get to the cath lab while having a heart attack?

A

GPIIb/IIIa antagonist

Pharm Exam 1 (4 decks)

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