EDIT Antiarrythmics & Anticoagulants

Question 1

Anticoagulants ______ coagulation of the blood. Examples:

Answer 1

-delay/prevent
-ex: antiplatelet, antifibrinolytic

Question 2

Define thrombus and embolus?

Answer 2

-Thrombus: blood clot
-Embolus: blood clot that moves through vessels

Question 3

3 Classes of coagulation modifiers (+what they do):

Answer 3

-anti-platelet, prevent clotting
-anti-coagulant (-in/-ans), thin out blood
-thrombolytic (-ase), bust up clots

Question 4

Aspirin class, MOA

Answer 4

-class/MOA: antiplatelet (prevents clots, binds to COX-1 and COX-2)

Question 5

Clopidogrel (use, MOA, side effects)

Answer 5

-MOA: ADP receptor blocker, anti platelet
-side effects: bleeding
interactions w/ Ca channel blockers, NSAIDs

Question 6

Eptifibatide and tirofiban (MOA/use, side effects/considerations)

Answer 6

-MOA: glycoprotein inhibitor, antiplatelet
-side effects: thrombocytopenia, bleeding

Question 7

Heparin (MOA, use, side effects–considerations/antidote?)

Answer 7

-MOA: anti factors IIA, IX, and X –> anticoagulant
-side effects: HIT (heparin induced thrombosis), bleeding
-consider: check aPTT, protamine sulfate is antidote

Question 8

Enoxaparin (lovenox) and dalteparin MOA, side effects + considerations

Answer 8

-MOA: LMWH (factor X)
-Side effects: bleeding, anemia, bruising, nothing life threatening
-Check: HCT, HgB, platelets–bleeding

Question 9

Warfarin MOA, use, side effects, considerations/antidote

Answer 9

-MOA: inhibits vit K dependent clotting factors
-Use: in afib, prevent clotting in heart
-Side effects: bleeding, muscle pain
-Consider: antidote = Vit K, (watch for too much vit K intake) interacts with erythromycin/sulfa/amiodarone, check INR (therapeutically, 2-3.5)

Question 10

Rivaroxaban and apixaban (class/MOA, considerations, reversal agent)

Answer 10

-anticoagulant
-MOA: inhibits clotting factor Xa
-considerations: don’t stop abruptly, dose carefully, in
-reversal agent: andexanet alfa

Question 11

Dabigatran MOA, use, side effects/interactions/considerations–antidote?

Answer 11

-MOA: thrombin inhibitor (anticoagulant)
-prodrug activated in liver
-use: in Afib patients
-Side effects: bleeding, GI bleeding,
-interacts w/ St John’s wort, azoles, HIV protease inhibitors
-Consider: dose is dependent on kidney function, antidote is Praxbind (idarucizumab)

Question 12

Argatroban MOA, use, side effects/considerations

Answer 12

-MOA: thrombin inhibitor (anticoagulant)
-Contraindicated for severe hepatic dysfunction (use lower dose)

Question 13

If someone is bleeding from gums, while shaving, from IV site, or has blood in urine/stool, they may be on:

Answer 13

heparin (or anti coagulants)

Question 13

Thrombolytic drugs are the only anti-clotting drugs that do what?

Answer 13

Lyse clots that are already formed

Question 14

Thrombolytic drug examples, MOA, side effects

Answer 14

-alteplase
-reteplase
-streptokinase
-MOA: activates plasminogen
-Side Effs: ecchymoses, bleeding, toxicity

Question 15

NO-NOs w/ anti coagulants

Answer 15

Grapefruit juice, cranberry juice, ginko/ginger/st John’s wort, green tea (vit K)

Question 16

Don’t take what on heparin?

Answer 16

Potassium (salt-replacements in diet foods)

Question 17

Anticoagulants have what effect on blood clots?

Answer 17

NO effect

Question 18

Amiodarone MOA, use, side effects/considerations

Answer 18

-use: ventricular arrhythmias
-MOA: blocks Potassium channels
-Side effects: hypotension, bradycardia, photosensitivity, respiratory issues: Blue Man syndrome, pulmonary fibrosis, pulmonary toxicity
-Considerations: cardiac/respiratory assessment, check potassium levels

Question 19

A patient w/ Afib and an dysrhythmia may be ordered to undergo cardioversion (T/F)

Answer 19

F

Question 20

Thrombolytic drugs have a _____ half life, and can be very ______.

Answer 20

-half-life
-toxic–no antidote!

Question 21

Prasugral and ticagrelor are newer types of what class of medication?

Answer 21

Antiplatelet ADP receptor blockers

Question 22

What anticoagulant and HF drug does Amiodarone interact with?

Answer 22

-warfarin
-digoxin