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IBI Test 3 > B3-087 Anticoagulant Therapies > Flashcards

B3-087 Anticoagulant Therapies Flashcards

1
Q

heparins

[3]

A

unfractionated heparin

Low molecular weight heparins:
-enoxaparin
-dalteparin

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2
Q

direct thrombin inhibitors

[3]

A

argatroban
bivalirudin
dabigatran

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3
Q

Factor Xa inhibitors

[4]

A

fondaparinux
rivaroxaban
apixaban
edoxaban

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4
Q

vitamin K antagonist

A

warfarin

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5
Q

antiplatelets

[5]

A

aspirin
prasugrel
ticlopidine
clopidogrel
dipyridamole

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6
Q

forms complex with antithrombin and neutralizes thrombin

prevents growth of clot but does not dissolve

A

unfractionated heparin

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7
Q

IIa and Xa are most sensitive to complex

A

unfractionated heparin

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8
Q

indications:
unstable angina and ACS
prophylaxis and treatment of DVT
maintenance

A

unfractionated heparin

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9
Q

unfractionated heparin is ….. in renal impairment

A

preferred

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10
Q

adverse effects:
bleeding, bruising
induced thrombocytopenia

A

unfractionated heparin

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11
Q

when using unfractionated heparin, do a

A

baseline CBC, at 24 hours, then every other day

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12
Q

contraindication: unfractionated heparin

A

history of HIT

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13
Q

reversible with protamine sulfate

A

unfractionated heparin

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14
Q

indications:
prophylaxis and treatment of DVT/PE

A

enoxaparin

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15
Q

indications:
prophylaxis and treatment of DVT/PE in cancer

A

dalteparin

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16
Q

preferred anticoagulant in pregnancy

A

enoxaparin

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17
Q

renal adjustment needed when creatine clearance less than 30mL/min

A

enoxaparin

give 30 mg instead of 40

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18
Q

parenteral direct thrombin inhibitors

[2]

A

argatroban
bavalirudin

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19
Q

oral direct thrombin inhibitor

A

dabigatran

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20
Q

target factor IIa (thrombin)

[3]

A

argatroban
bivalirudin
dabigatran

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21
Q

indications:
adults with HIT
PCI patients with HIT

[2]

A

argatroban
bivalirudin

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22
Q

direct thrombin inhibitor requiring hepatic adjustment

A

argatroban

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23
Q

special considerations when switching to Warfarin (alters INR)

A

argatroban

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24
Q

indications:
prevention and treatment of thromboembolism
stroke prevention in nonvalvular atrial fibrillation
post operative thromboprophylaxis after hip replacements

A

dabigatran

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25
VTE treatment requires 5-10 days of parenteral agent prior to starting
dabigatran
26
contraindication: mechanical heart valve replacement
dabigatran
27
dose adjustments with P-glycoprotein inducers and inhibitors
dabigatran
28
separate from antacids
dabigatran
29
P-gp inducers
barbituates carbamazepine phenytoin rifampin ritonavir St. Johns Wort
30
p-gb inducers
amiodarone ketoconazole carvedilol lopinavir conivaptan macrolides cyclosporines non-dihydropyridine CCB dronedarone itraconazole quinindine ritonavir
31
parenteral Factor Xa inhibitor
fondaparinux
32
oral Factor Xa inhibitors | [3]
rivaroxaban apixaban edoxaban
33
2nd preferred agent in pregnancy if patient has history of HIT
fondaparinux
34
contraindication: mechanical heart valve
Factor Xa inhibitors
35
doses >10mg must be taken with food | increases absorption
rivaroxaban
36
VTE treatment requires 5-10 days of paenteral agent prior to starting
edoxaban and dabigatran
37
VTE treatment utilizes weight based dosing
edoxaban
38
targets factors II, VII, IX, X and proteins C and S
warfarin
39
narrow therapeutic window
warfarin
40
VTE treatment requires administration of parenteral agent plus warfarin for 5 days and until INR>2
warfarin
41
many dietary and drug interactions | vitamin K, alcohol
warfarin
42
ask about CBD used
warfarin
43
reversal agents: fresh frozen plasma prothrombin complex concentrate
warfarin
44
measure of patients coagulation status
INR
45
high INR
increased risk of bleed
46
low INR
increased risk of clot
47
INR>10 without bleeding
hold warfarin until INR falls into therapeutic range
48
INR 4.5-10 without bleeding
hold warfaring temporarily (1-2 doses) | consider dosage reduction
49
INR <4.5 without bleeding
hold 1 dose of warfarin | consider dosage reduction
50
INR goal range: DVT or PE atrial fibrillation or flutter bioprosthetic valve mechanical aortic valve
2-3
51
INR goal range: mechanical mitral valve
2.5-3.5
52
targets COX1
aspirin
53
indications: acute coronary syndrome CABG or stroke prevention
aspirin
54
inhibits the binding of ADP to its platelet P2Y12 receptors | [3]
prasugrel ticlopidine clopidogrel
55
targets phosphodiesterase III
dipyridamole
56
monitor for GI ulceration
aspirin
57
inhibitors reduce active metabolite concentrations
clopidogrel
58
<60kg reduce maintenance dosage
prasugrel
59
contraindicated in patiets with stroke history and TIA
prasugrel
60
not recommended for patients >75 years old
prasugrel
61
BBW for hematologic toxicities (aplastic anemia, TTP)
ticlopidine
62
BID dosing, frequent CBCs
ticlopidine
63
binds to fibrin in clot and converts entrapped plasminogen to active plasmin
altepase
64
hold all antiplatelets and anticoagulation for
at least 24 hrs post tPA
65
is warfarin teratogenic
yes
66
LMWH are preferred for
outpatient therapy
67
do heparins cross the placental barrier
no
68
indirectly blocks thromboxane production
aspirin
69
warfarin inhibits factors
II VII IX X C S
70
only orally administered direct thrombin inhibitors
dabigatran
71
what is administred to immediately lower INR
plasma | **contains functional clotting factors**
72
lowers INR over several days
d/c warfarin or vitamin K
73
plasma contains
functional, calcium responsive clotting factors | lowers INR immediately
74
plasma contains
functional, calcium responsive clotting factors | lowers INR immediately
75
inhibits CYP2C9
clopidogrel | ticlopidine may be prescribed if potential interactions are problematic
76
alteplase is a
thrombolytic
77
heparin is administered
IV
78
requires PT/PTT monitoring
heparin
79
oral anticoagulant
rivaroxaban
80
all antiplatelet drugs can be administered
orally
81
enoxaparin is administered
subq
82
does exonaparin require PT/PTT monitoring?
no

IBI Test 3 (20 decks)

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