Antiplatelets (HRDs), Heparin, LMWH, Tranexamic acid Flashcards
Tranexamic acid 500mg tabs POM
Indications
Local Fibrinolysis, Menorrhagia, Hereditary angioedema, Epistaxis (nose bleed).
Helps blood to clot and used for nose bleeds and heavy periods.
DOSE:
Fibrinolysis - 1-1.5g BD/TDS - Adult
Menorrhagia - 1g TDS for 4 days and start when periods starts MAX 4g/day - Adult
Epistaxis - 1g TDS 7 days
AEs: Diarrhoea (reduce dose), NV
Monitoring
Regular LFT in long use for Hereditary angioedema.
Tranexamic acid P - Menorrhagia
GPHC Q
Tranexamic acid controls/reduces bleeding.
Adult dose: 1g TDS for 4 days
- 18 and above can buy.
- Take WITH/Without food.
Increased risk of DVT with contraceptive pill (EXAM Q)
Contraindication
Epilepsy, DVT, PE, Irregular periods, renal issues, pregnancy.
RED FLAGs
Colour vison change or visual impairment - STOP drug
Signs of DVT/PE. (DVT - Swollen, red & warm to touch legs, PE - SOB, Sharp pain in the chest).
Coughing blood/ Coughing
Anaphylactic reactions.
Parenteral Anticoagulants
HEPARIN:
- Fast acting but short duration
- Known as standard or Heparin to separate them from LMWH.
- LMWH preferred for routine use BUT UFH can be used in those with high risk of bleeding BC AEs are terminated rapidly due to short duration
- SAFE in pregnancy
LMWH:
Dalteparin, enoxaparin, tinzaparin
- Used in Prophylaxis/Treatment of DVT, PE & MI.
- Preferred over heparin - BC they effective and have reduced risk of Heparin induced thrombocytopenia (HIT)
- Duration longer than heparin and is OD SC = more convenient.
- Dalteparin and Tinzaparin licensed for extra treatment/prophylaxis in VT with solid tumours. (20k only)
Antiplatelet
Aspirin, clopidogrel, dipyridamole (3 most common), prasugrel, ticagrelor
Glycoprotein IIb/IIIa inhibitors: abciximab (moa), tirofiban, eptifibatide.
- Decrease platelet aggregation so inhibit thrombus formation in arterial circulation.
Aspirin now only FOR SECONDARY prevention. No longer primary - has no benefit.
- Give PPI if PTs at high risk of bleeding.
- Aspirin + Clopidogrel increases bleeding risk.
CLOPIDOGREL:
- Prevention of atherothrombotic event (ACS, IS)
DYPYRIDAMOLE:
- Prophylaxis if thromboembolism with prosthetic heart valves.
- MR preps used for 2ndry prevention of IS/TIA (200mgBD +food)
IMPORTANT PRESCRIBING INFO:
- MR caps need to be given in OG container any extra caps should be discarded 6 weeks after opening.