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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
what is the trade name for warfarin?
Coumadin
26
what is a normal subcutaneous dose of heparin?
5,000 units
27
what is the antidote for heparin?
protamine sulfate (rarely used due to heparins short half-life)
28
what are the side effects of warfarin/coumadin?
- risk for hemorrhage - nausea and vomiting - abdominal pain - alopecia - dizziness - joint and muscle pain - urticaria (hives)
29
what drug is used to treat DIC (disseminated intravascular coagulation)?
heparin
30
what anticoagulant can be given to pregnant women?
heparin
31
how long does it take warfarin to reach the therapeutic range?
1 week
32
what anticoagulant is typically given only in the hospital?
heparin
33
what lab should be taken for patients on heparin?
aPTT
34
what is the antidote for warfarin?
vitamin K
35
what is the action of warfarin/coumadin?
- inhibits synthesis of vitamin K | - inhibits clotting factors 10, 9, and 7
36
what are the uses for Eliquis/Xarelto?
- treatment of DVT or PE - prevention of DVT post-op - reduces the risk of CVA due to a-fib
37
why is aspirin not used for pain management?
high dosages cause a risk for bleeding
38
what is the dosing for Pradaxa (dabigatran etexilate)?
twice a day fixed doses
39
what drug is an antiplatelet?
aspirin GB plavix
40
the formula for kg to lbs
1 kg = 2.2 lbs
41
what adverse reaction is common with aspirin?
GI upset
42
what is the antidote for Eliquis/Xarelto?
there is none
43
what is the half-life of warfarin?
multiple days to a week (a long half-life)
44
what is the most common anticoagulant?
warfarin - coumadin
45
what is a normal aPTT lab for someone not on heparin?
less than 35
46
what are the only 2 FDA-approved uses for Pradaxa (dabigatran etexilate)?
- DVT | - post-Afib
47
what is the other name for Pradaxa?
dabigatran etexilate
48
where is warfarin highly metabolized?
P450 system (competitive enzymes in the liver which makes complicated regimens for each pt)
49
what is the route for Lovenox?
subcutaneously
50
what form does Eliquis/Xarelto come in?
oral
51
what anticoagulant is typically taken at home?
warfarin
52
what is a normal aPTT lab for someone on heparin?
51 - 80 (should be 1.5-2 times normal)
53
what form does Pradaxa (dabigatran etexilate) come in?
oral
54
what is the generic name for Eliquis?
apixaban
55
what drugs are used to treat PE or DVT?
- heparin - Lovenox - warfarin - Eliquis/Xarelto
56
when is warfarin mostly given?
the evenings
57
can a pt be on warfarin and heparin at the same time?
yes until warfarin reaches its therapeutic range
58
what is warfarin/coumadin used for?
- DVT - PE - Afib - to decrease the risk of CVA/MI - prosthetic heart valve
59
what is the usual maintenance dose for warfarin?
2-10 mg
60
what are the benefits of Lovenox?
- aPTT doesn't need to be monitored | - fixed dose based on weight
61
what is Lovenox?
low molecular weight heparin
62
What is the action of heparin?
- binds with antithrombin III to inactivate clotting factors Xa - inhibits the production of thrombin - prevents thrombus formation - prevents the production of fibrin
63
what is the half-life for heparin?
1.5-2 hours
64
what is the drug for the category "thrombolytic drugs"?
altepase (tPA, activase)
65
what is the ending for thrombolytic drugs?
"-ase"
66
what is the high risk associated with thrombolytic drugs?
bleeding
67
what is the action of thrombolytic drugs?
dissolving established clot
68
what is the only drug used for dissolving established clots?
TPA (alteplase)
69
what is the route for TPA (alteplase)?
IV
70
what is the use for TPA (alteplase)?
acute MI, massive PE, acute stroke (ischemic not hemorrhagic)
71
what is the goal for TPA (alteplase)?
administer quickly to prevent cell death
72
what drug is an adenosine diphosphate receptor antagonist?
Clopidogrel (Plavix)
73
when is Clopidogrel (Plavix) often used?
after stent surgery - to prevent stenosis of coronary stents (often also used to reduce risk of ischemic attack)
74
what is the action of Clopidogrel (Plavix)?
inhibits platelet aggregation by blocking receptors on platelets
75
what is thrombocytopenia?
low level of platelets due to medication side effects
76
what are some adverse effects of Clopidogrel (Plavix)?
- bleeding - thrombocytopenia - dyspepsia (abnormal stomach pain) - diarrhea - rash
77
what is the common dose for Clopidogrel (Plavix)?
75 mg fix dose - monitor platelet count
78
caution use of Clopidogrel (Plavix) with ...
- NSAIDs and coumadin - non-steroidal anti-inflammatory drugs - proton pump inhibitors
79
what medication is Clopidogrel (Plavix) commonly used with?
aspirin
80
what kind of drug is GPIIb/IIIa antagonist?
antiplatelet (often referred to as super aspirins)
81
what route is GPIIb/IIIa antagonist given?
IV
82
what is the only IV antiplatelet drug?
GPIIb/IIIa antagonist
83
what is the use for GPIIb/IIIa antagonist?
- 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
what drug would be given to a pt if they can't get to the cath lab while having a heart attack?
GPIIb/IIIa antagonist

Pharm Exam 1 (4 decks)

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