Anticoagulation

Question 1

Which drugs bind to AF?

Answer 1

UF, LMWH, fondaparinux

Question 2

What does AT do?

Answer 2

inactivates thrombin and other proteases involved in blood clotting, including factor Xa LMWHs inhibit factor Xa more specifically

Question 3

MOA of warfarin?

Answer 3

vitamin K antagonist

Question 4

What factors are involved in clotting?

Answer 4

factors II, VII, IX, X

Question 5

MOA of direct thrombin inhibitors?

Answer 5

block thrombin directly, decreasing amount of fibrin

Question 6

What is the choice for HIT?

Answer 6

argatroban

Question 7

What are factor Xa inhibitors?

Answer 7

apixaban, betrixaban, edoxaban, rivaroxaban

Question 8

MOa of UFH

Answer 8

binds to AT which then inactivates thrombin (factor IIa) and factor Xa and prevent conversion of fibrinogen to fibrin

Question 9

UFH prophylaxis of VTE?

Answer 9

5,000 units SC Q8-12H

Question 10

UFH treatment of VTE?

Answer 10

80 units/kg IV bolus and then 18 units/kg/hr infusion

Question 11

UFH treatment of ACS/STEMI

Answer 11

60 units/kg IV bolus and then 12 units/kg/hr

Question 12

What is the antidote for UHF and LMWH?

Answer 12

protamine 1 mg per 100 units

Question 13

LMWH prophylaxis of VTE?

Answer 13

30 mg SC Q12h or 40 mg daily

Question 14

LMWH treatment of UA/NSTEMI?

Answer 14

1 mg/kg Q 12H or 1.5 mg/kg SC daily

Question 15

LMWH treatment of STEMI?

Answer 15

30 mg IV bolus and 1 mg/kg SC

Question 16

Which medications can increase bleeding risk with UFH and LMWH?

Answer 16

anticoagulants, antiplatelet, herbals, NSAIDs, SSRI, SNRI, thrombolytics

Question 17

What is HIT?

Answer 17

immune mediated IGG drug reaction that is associated with a high risk of venous and arterial thrombosis

Question 18

HIT can lead to?

Answer 18

further platelet activation and causes a release of PF 4 and other pro coagulant micro-particles (prothrombotic state)

Question 19

When does HIT usually start?

Answer 19

5-14 days and platelet drop 50%

Question 20

HIT treatment?

Answer 20

Stop all forms of heparin and LMWH and warfarin and admin vitamin K –> argatroban –> do not start warfarin until platelet have recovered to at least 150,000

Question 21

Bivallrudin is preferred in ?

Answer 21

urgent cardiac surgery or PCI

Question 22

MOA of fondaparinux?

Answer 22

injectable synthetic pentasaccharide that selectively inhibits factor Xa via antithrombin AT

Question 23

When to give apixaben 2.5 mg BID?

Answer 23

2 of the following: >80 yrs, <60 kg, SCr> 1.5

Question 24

Eliquis

Answer 24

apixaban

Question 25

the treatment dose for eliquis?

Answer 25

10 mg PO BId for 7 days and then 5 mg po BID

Question 26

Bevyxxa

Answer 26

betrixaban

Question 27

Savaysa

Answer 27

edoxaban

Question 28

when to not use edoxaban?

Answer 28

Crcl> 95 and use parenteral anticoagulation for 5-10 days

Question 29

Xarelto

Answer 29

rivaroxaban

Question 30

Arixtra

Answer 30

fondaparinux

Question 31

Pradaxa

Answer 31

dabigatran

Question 32

antidote of pradaxa

Answer 32

praxbind

Question 33

Angiomax

Answer 33

bivalirudin

Question 34

Iprivask

Answer 34

desirudin

Question 35

Coumadin, Jantoven

Answer 35

warfarin

Question 36

Praxbind

Answer 36

idarucizumab

Question 37

Meohyton

Answer 37

vitamin K