Antiplatelets And Anticoagulant Therapy Flashcards
MOA OF heparin
Accelerates Antithrombin inhibition of factor Xa and IIa (thrombin)
Test used for monitoring of unfractionated heparin
APTT
Test used fpr monitoring of low molecular weigjt heparin
Anti Xa assay
Tx of overdose of unfractionated heparin
Protamine sulfate
Maximum effect of warfarin is attained after ….. Days
3 to 5 days
T or F
Warfarin crosses placenta and is teratogenic
True
Test used to monitor warfarin
PT
A patient has been taking warfarin for a while now, his INR is from 6-8 and there is minor bleeding
What is the management?
Stop warfarin for 24-48 hours.
• Recheck INR
• re-introduce drug at lower dosage and retest in 2-7 day
A patient is taking warfarin for a while now, his INR is >8 with minor bleeding
What is the management?
Stop warfarin for 48 hours and retest on third day before
restarting warfarin at lower dose.
• Consider Vitamin K
IV vitamin k takes…… Hrs to reach its therapeutic effect
6 hrs
A patient is taking warfarin for a while now, his INR is very high (life threatening, sight threatening, limb threatening)
What is the management?
Stop warfarin for 48 hours and retest on third day before
restarting warfarin at lower dose.
• Consider Vitamin K 2.5mg orally (Menadiol) or 1-2mg by slow
iv injection (Phytomenadione)
Tx of choice in Phlegmasia cerulea dolens
Catheter directed thrombolysis
Mention a direct thrombin inhibitor
Dabigatran
Mention 2 factor Xa inhibitors
Direct: Rivaroxaban, apixaban
Indirect: fondaparinux
Mention an ADP inhibitor (antiplatelets)
Clopidogrel
In heparin induced thrombocythemia, what is the patholpgy?
IgG against Heparin/PF4 complex detected after 5 days in serology
MOA of warfarin
Vit. K Antagonist
Half life of protein C,S
12 hrs
Half life of clotting factors 2,7,9,10
5 days
Antidote of Dabigatran
Idarucizumab
Antidote of apixaban (factor Xa inhibitors)
Andexanet
