B / 2 : Anticoagulant Drugs

Question 1

Anticoagulant drugs (6)

Answer 1

1. Heparin
2. Dalteparin
3. Fondaparinux
4. Dabigatran-etexilate
5. Warfarin
6. Rivaroxaban

Question 2

Heparin
- MOA
- Effect
- Indication
- SE
- ROA

Answer 2

• Activates antithrombin III
• Antithrombin III activation : inactivation of thrombin and factor Xa
• DVT, embolism, angina, anticoagulant in pregnancy
• Bleeding, osteoporosis (chronic use)
• Only parenteral

Question 3

What is dalteparin?

Answer 3

Low molecular weight heparin

Question 4

Dalteparin
- MOA
- Effect
- Indication
- ROA

Answer 4

• Analog of antithrombin III binding SU of heparin
• Same as heparin, but more selective factor Xa inhibition
• Preferred in pregnancy (does not cross placenta)
• Subcutaneous injection

Question 5

Fondaparinux
- MOA
- Effect
- Indication
- SE
- ROA

Answer 5

• Analog of antithrombin III binding SU of heparin
• More effective for Xa inhibition
• For DVT and pregnancy
• Bleeding
• Only parenteral

Question 6

Dabigatran-etexilate
- MOA
- Effect
- Indication
- Extra
- ROA

Answer 6

• Direct thrombin inhibitor
• Prevents clot formation
• Chronic therapy for atrial fibrillation, DVT, PE
• Prodrug
• Oral

Question 7

What is a commonly used coumarin?

Answer 7

Warfarin

Question 8

Warfarin
- MOA
- Effect
- Indication
- Contraindication
- Extra
- ROA

Answer 8

• Block Vitamin K epoxide reductase
• Prevents carboxylation of coagulation factors : inactivation
• Continuation of heparin therapy, prophylaxis for embolism, atrial fibrillation
• Pregnancy
• Delayed effect (8-12h)
• Oral (good absorption)

Question 9

Rivaroxaban
- MOA
- Effect
- Indication
- ROA

Answer 9

• Direct factor Xa inhibitor
• Prevents clot formation
• Prophylaxis of DVT, PE + reduces risk of stroke
• Oral