Antithrombotic Drugs Flashcards
venous thrombi define
fibrin and trapped RBC with FEW PLATELETS
arterial thrombi
platelet aggregates with small fibrin
anticoag, antiplatelet or both
afib
yes both PO
anticoag, antiplatelet or both
primary/secondary prevention ACS
only platelet PO
anticoag, antiplatelet or both
unstable angina/NSTEMI
+/- IV anticoag
Yes antiplatelet PO
anticoag, antiplatelet or both
acute MI (STEMI)
yes both
anticoag IV
antiplatelet PO
anticoag, antiplatelet or both
PCI
yes both IV
anticoag, antiplatelet or both
VTE treatment or prevent
only anticoag
Platelet and coag cascade
1) wall defect
2) adhesion based on Gp1A/1B
3) release of ADP/TXA2 to activate expression of Gp2b/3a for aggregation
Half life of heparin is ____
dose dependent (zero order)
___ infusion preferred for heparin
continuous infusion
LMW heparins have ___ durations (___ dosing)
longer duration
once-twice daily dosing
LMW heparins have ___ renal elimination kinetics
first order
LMW heparins can be dosed on
mg/kg if normal renal function
non-vitamin K oral anticoags
1) dabigatran
2) rivaroxaban
3) apixaban
4) edoxaban
lab test for intrinsic pathways
aptt
lab test for extrinsic pathway
PT–> INR
incr vitamin K, ____ effect of warfarin
decr
NOAC preferred over warfarin for ____
nonvalvular Afib
concerns with warfarin relative to NOAC (4)
1) variability in dosage requirements
2) dietary restrictions related to vit K
3) need for close monitoring to maintain INR
4) DDI
warfarin should be used with
Afib assoc with
1) mech/bioprosth valve
2) mitral repair or mitral stenosis
warfarin is reasonable choice for (4)
1) unlikely to comply with BID dosing (dabigatrain) and once daily NOAC not availabl
2) chronic kidney disease
3) cost is concern
