Anticoagulation

Question 0

Fondaparinux

Answer 0

-for anticoagualtion
MOA
-indirect Xa inhibitor

Question 1

Heparin

Answer 1

-for anticoagulation
MOA
-heparin (UHF) binds to antithrombin and speeds up rxn
ADE
-heparin induced thrombocytopenia (HIT)
Contraindications
-heparin/LMWH reversal: protamine
-protamine alone has anticoagulant effect
-if protamine is given w/ heparin, a salt is formed which results in loss of anticoagulant activity
-*safe for pregnant women

Question 2

Low molecular wight heparin

LMWH

Answer 2

-for anticoagulation
-Enoxaprin, Dalteprin
MOA
-primarily Xa rxns; some IIA
Contraindications
-heparin/LMWH reversal: protamine
-protamine alone has anticoagulant effect
-if protamine is given w/ heparin, a salt is formed which results in loss of anticoagulant activity
-*safe for pregnant women

Question 3

Warfarin

Answer 3

-for anticoagulation
MOA
-inhibits production of Vit K-dependent clotting factors II, VII, IX, and X (as well as anticoagulant proteins C and S)
ADE
-warfarin skin necrosis
Contraindication
-do not use with pregnant women
Warfarin Rescue!
-Vit K=PHYTONADIONE
-fresh frozen plasma
-recombinant factor VIIa (novoseven)
-prothrombin complex concentrate