Exam 5 Anticoagulants

Question 1

Which drug(s) are classified as antiplatelets?

Answer 1

1. Aspirin

2. Clopidogrel (Plavix)

Question 2

Which drug(s) are classified as anticoagulants?

Answer 2

1. Heparin
2. Enoxaparin (Lovenox) (I.V./s.c.)
3. Warfarin (Coumadin) (p.o.)
4. Rivaroxaban (Xarelto)
5. Apixaban (Eliquis) (p.o.)
6. Dabigatran (Pradaxa) (p.o.)

Question 3

Which drug(s) are classified as thrombolytic/fibrinolytic drugs?

Answer 3

Alteplase (t-PA) (I.V.)

Question 4

Aspirin

Answer 4

Action: Decrease platelet aggregation
Use: Prevent arterial thrombosis

Question 5

Clopidogrel (Plavix)

Answer 5

Action: Decrease platelet aggregation by irreversibly inhibiting P2Y12 receptor; an adenosine diphosphate (ADP) receptor on platelet cell membranes
Use: Prevent arterial thrombosis
Adverse Effects: Bleeding

Question 6

Heparin

Answer 6

Action: Inactivation of clotting factors. Inhibits the effects of thrombin on fibrinogen, blocking its conversion to fibrin. The heparin-anti-thrombin complex also inhibits other clotting factors
Use: Prevent venous thrombosis. Treat acute coronary syndrome. A-fib, DVTs, pulmonary embolism and cardiopulmonary bypass.
Side Effects: Bleeding
Antidote for heparin overdose: Protamine sulfate

Question 7

Enoxaparin (Lovenox)

Answer 7

Action: Inactivation of clotting factors
Use: Prevent venous thrombosis. Treat acute coronary syndrome

Low molecular weight heparin. More cost effective

Question 8

Warfarin (Coumadin)

Answer 8

Action: Inhibition of regeneration of vitamin K/synthesis of clotting factors. It stops the blood from clotting within the blood vessels and is used to stop existing clots from getting bigger
Use: Primary and secondary prevention of deep-vein thrombosis (DVT), pulmonary embolism (PE) in patients with atrial fibrillation (AF) and prosthetic heart valve. Prevention of MI and stroke in high risk patients
Side Effects: Bleeding and bruising
Diet Effects: Vitamin K-rich food, fish

Question 9

Rivaroxaban (Xarelto)

Answer 9

Action: Direct Factor Xa inhibitor
Use: Primary and secondary prevention of deep-vein thrombosis (DVT), pulmonary embolism (PE) in patients with atrial fibrillation (AF) and prosthetic heart valve. Prevention of MI and stroke in high risk patients

Require no monitoring and have a rapid onset of action and shorter half-life than warfarin

Question 10

Apixaban (Eliquis)

Answer 10

Action: Direct Factor Xa inhibitor
Use: Primary and secondary prevention of deep-vein thrombosis (DVT), pulmonary embolism (PE) in patients with atrial fibrillation (AF) and prosthetic heart valve. Prevention of MI and stroke in high risk patients

Require no monitoring and have a rapid onset of action and shorter half-life than warfarin

Question 11

Dabigatran (Pradaxa)

Answer 11

Action: Direct thrombin inhibitor
Use: Primary and secondary prevention of deep-vein thrombosis (DVT), pulmonary embolism (PE) in patients with atrial fibrillation (AF) and prosthetic heart valve. Prevention of MI and stroke in high risk patients

Require no monitoring and have a rapid onset of action and shorter half-life than warfarin

Question 12

Alteplase (t-PA)

Answer 12

Action: Fibrinolysis/Breakdown of thrombi. Serine protease for breakdown of blood clots found on endothelial cells.
Use: Treat embolic or thrombotic stroke. Intravitreal tPA injection can be an effective treatment for submacular hemorrhage.
Side Effects: Bleeding/cerebral hemorrhage. Contraindicated in hemorrhagic stroke and head trauma.