Coagulation Drugs Flashcards
What drug activity is dependent on Antithrombin II?
Heparin
Heparin mainly affect w/ steps of the coagulation cascade?
Xa & Thrombin
Also effects: IXa, XIa, XIIa (aPTT pathway)
What drug accelerates the activity of ATII x 1000?
Heparin
What anti-coagulant is used before surgery, during operations, in IV catheters, for in-patient anticoagulation bridging?
Heparin
What form of heparin is used in IV?
High Molecular weight
What form of Heparin in used in subQ injections?
Low Molecular weight
Are the effects of Heparin immediate or delayed?
Immediate
Is the PTT or PT pathway the therapeutic target of Heparin?
PTT
What drug can you give to stop Heparin induced hemorrhage?
Protamine sulfate
heParin –> Protamine, share a P
What autoimmune reaction can occur as a result of Heparin use?
Heparin induced Thrombocytopenia (HIT)
Pt is never able to be on Heparin again
Caution with Heparin use in pts w/ what dysfunction (2)
Renal
Hepatic
Heparin is contraindicated in what pts? (4)
- Actively bleeding
- Hemophilia/other blood clotting disorders
- Hypersensitivity (previous HIT)
- During/after surgery on the brain, spinal cord, eye
Enoxaprin HMW or LMW heparin?
LMW
What synthetic pentasaccharide acts on factor Xa?
Fondaparinux
Do Enoxaprin and Fondaparinux have any effect on Thrombin?
No, only inhibitory action is on factor Xa
What is the DOC for subQ anti-coagulation therapy?
LMW drugs: Enoxaprin and Fondaparinux
Is HMW or LMW Heparin safe in pregnanct, outpatient bridging, once/day dosing?
LMW drugs: Enoxaprin and Fondaparinux
Will LMW Heparin (Enoxaprin and Fondaparinux) increase or lower the incidence of HIT?
Lower
Will protamine also work as a reversal agent on Enoxaprin and Fondaparinux?
Won’t completely reverse Enoxaprin
No effect on Fondaparinux
Dabigatran (Pradaxa) is from what class of anticoagulants?
Direct Oral thrombin inhibitors
Do you monitor Dabigatran with PTT?
No b/c predictable anticoagulant effects
Dabigatran is contraindicated in pts w/ what?
mechanical heart valves