Anticoaulants

Question 1

anticoagulant types

Answer 1

1- heparin family

2- warfarin family

Question 2

Heparin mechanism of action

Answer 2

Aimin to increase APPT >1.5 normal

Question 3

types of heparin and use

Answer 3

• unfractionated in massive pulmonary embolism

Question 4

unfractionated Heparin side effects

Answer 4

• Anaphylaxis
• HIT, thrombocytopenia
• Osteoporosis
• Bleeding

Safety marging of heparin require close monitoring of PTT

Question 5

unfractionated Heparin advantae

Answer 5

• presence of antidote, protamine sulphate, quick actin

- Don’t affect fetus

Question 6

LMWH advantage

Answer 6

No these effects, which are with unfractionated

• Anaphylaxis
• HIT, thrombocytopenia
• Osteoporosis
• Bleeding

No monitoring

Question 7

LMWH follow up

Answer 7

Anti factor X

specific for LMWH toxixcity

Question 8

LMWH side effect

Answer 8

no Antidote

Question 9

LMWH toxicity MX

Answer 9

FFP

Question 10

Dose of LMWH

Answer 10

• according to indication to BMI
• Therapeutic doe only in following other wise prophylactic dose is recommended dose
  1- DVT
  2- Thromboembolic complication

Prop hylactic dose: 1 mg/k, once daily
Therapeutic dose: 1.5 mg /k twice daily (some 2mg/k)

Question 11

antidote of warfarin

Answer 11

vitamin K

Question 12

warfarin mechanism of action

Answer 12

anti vitamin K

Question 13

Warfarin indication

Answer 13

• oral for permanent valve replacement
• Recurrent thromboembolism
• Thromobophillia + family Hx

Question 14

warfarin monitoring

Answer 14

INR:
> 1.5: risk of bleeding
cardiac issues: maintain 2.5 - 3.5 depends on (mitral or aortic)

Question 15

warfarin discussion

Answer 15

cardiac patient with prenancy

Question 16

when to stop warfarin and LMWH surgery

Answer 16

warfarin: 5 days before surery
Therapeutic LMWH: 24 hours before
prophylactic, LMWH 12 hours before