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Pharmacology > Anticuagulation > Flashcards

Anticuagulation Flashcards

1
Q

What is the MOA of aspirin

A

irreversible inhibition of cyclooxegenase

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2
Q

what is the onset of aspirin

A

1-4 hours

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3
Q

what is the lifespan of a platelet?

A

10 days

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4
Q

what is the maximal effective dose of aspirin for preventative reasons?

A

160mg daily. every disease has an amount that is recommended

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5
Q

what is the purpose of dipyridamole?

A

secondary prevention of TIA and stroke

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6
Q

what is the MOA of dipyridamole:

A

inhibit cAMP inhibiting platelets and leading to vasodilation

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7
Q

how is dipyridamole usually administered?

A

in combination with low dose aspirin

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8
Q

what are symptoms of dipyridamole toxicity

A

Headache, and bleeding

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9
Q

what is the only anti-platelet agent that reversibly binds to platelets?

A

ticagrelor

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10
Q

how is clopidogrel usually dosed?

A

with a loading dose then maintainence dose.

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11
Q

how soon does clopidogrel start to work

A

after repeated dosing.

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12
Q

how long is clopidogrel effective for

A

up to 7 days of last dose

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13
Q

are antiplatelet drugs safe for renal patients

A

generally yes. especially clopidogrel

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14
Q

how long does it take to get to steady state for clopidogrel?

A

3-7 days

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15
Q

what drugs can attenuate the effects of clopidogrel?

A

macrolids, atorvastatin, and simvastatin

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16
Q

aside from bleeding, what is another risk/sign of toxicity in clopidogrel

A

thrombocytopenic purpura TTP

17
Q

at what point in clopidogrel dosing can TTP occur?

A

within the first weak of treatment as you start getting to steady state

18
Q

which drug has more bleeding risk and effectiveness? clopidogrel of prasugrel

A

prasugrel

19
Q

what are the ADEs of prasugrel?

A

bleeding, abnormal LFTs, thrombocytopenia, anemia

20
Q

why is ticagrelor uncommon in primary practice?

A

it has short duration of action, is recersible and has many CYP3A4 interactions

21
Q

which antiplatelet drug causes dyspnea?

A

ticagrelor

22
Q

what clotting factor is inhibited with low molecular weight heparin?

A

factor Xa

23
Q

what are the two LMWHs

A

lovenox/enoxaparin, Fragmin (dalteparin)

24
Q

what factors should be considered when determining the dose of LMWH drugs?

A

weight, renal function indication (prophylaxis or treatment

25
Q

what is fondaparinux

A

anticoagulant drug injection. it is a synthetic factor Xa drug

26
Q

what patients have increased bleeding risk for fondaparinux

A

patients over the age of 75 & renally impaired patients due to increased terminal half life

27
Q

is fonduparanix appropirate for pregnancy?

A

no due to lack of data

28
Q

what populations is fondaparinux contraindicated for

A

CrCl <30, pregnant women, patients over 50kg for prevention

29
Q

what are the dosing differences between LMWH and fondaparinux?

A

LMWH is generally given twice daily but fondaparinux is usually once daily due to a longer half life

30
Q

how long does it take to get warfarin to peak drug concentrations

A

1-3 days

31
Q

at initial warfarin dosing when do you test INR

A

after the initial 2-3 days of therapy

32
Q

how often to you check INR for stable warfarin dosing?

A

every 4 weeks

33
Q

what are warfarin ADEs?

A

skin necrosis, bleeding, and teratogenic effects

34
Q

what drugs increase bleeding with warfain

A

2nd and 3rd generation cephalosporins , penicillin

35
Q

how do DOAC and warfarin differ in halflife?

A

DOACs have much shorted half lives than warfarin

36
Q

which DOACs do not have notable CYP interractions?

A

Dabigatran and edoxaban

37
Q

which DOACs require no bridge therapy?

A

apixaban and rivaroxaban

38
Q

what kind of safety monitoring (labs) are required for DOACs?

A

renal functioning and CBC

Pharmacology (5 decks)

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