DRUGS USED IN COAGULATION DISORDER II

Question 1

this is a heparin syndrome that is life threatening that develops antibodies to platelet factor 4 and increases the risk of thrombosis?

Answer 1

heparin induced thrombocytopenia

Question 2

antidote for LMWH?

Answer 2

protamine

Question 3

how is heparin monitored?

Answer 3

aPPT

platelet count

Question 4

antidote for heparin?

Answer 4

protamine sulfate

Question 5

how does warfarin exist?

Answer 5

racemic mixture, S-warfarin is 4x more potent than R-warfarin

Question 6

anticoagulant used in patients with heparin induced thrombocytopenia?

Answer 6

thrombin inhibitors

Question 7

T/F, from an absorption POV, dabigatran etexilate mesylate is a prodrug?

should the capsule be opened?

is it dialyzable?

Answer 7

T

NO!! increases bioavailability by 75%

yes

Question 8

what is the drug interaction of dabigatran etexilate***

Answer 8

elimination is sensitive to inducers and inhibitors of P-gp, and avoid in patients with mechanical heart valves

Question 9

what are the factor Xa inhibitors?

Answer 9

rivaroxaban

apixaban

Question 10

rivroxaban bioavalibility is increased how?

antidote?

drug interactions?

missed dose?

Answer 10

with food

andexanet alpha

strong CY{3A4 and P-gp inducer or inhibitor**

ASAP and d/c before any surgical procedure

Question 11

apixaban is what percent excreted? what is the rest metabolized by? and what type of substrate is it?

Answer 11

25%
CYP3A4
P-gp substrate

Question 12

what are the thrombolytics?

Answer 12

alteplase

streptokinase

Question 13

antidote for:

heparin

warfarin

oral factor Xa

oral direct thrombin inhibitor, dabigatran

Answer 13

protamine

vit K, fresh frozen plasma, PCCs

andexanet alpha, PCCs

isarucizumab

Question 14

dabigatran binding affinity? what binds to this

Answer 14

350x greater than thrombin with effect in minutes

Fab, monoclonal