Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiorespiratory > Haemostasis - Anti-Coagulant Therapy > Flashcards

Haemostasis - Anti-Coagulant Therapy Flashcards

1
Q

indications for anticoagulation

A

venous thrombosis
atrial fibrillation
mechanical prosthetic heart valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is heparin? what cells produce it?

A

GAG, produced by mast cells, anticoagulant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

actions of unfractionated heparin

A

enhancement of antithrombin [Inactivation of thrombin (Hep binds AT + Thrombin)
Inactivation of FXa (Hep binds AT only)
(Inactivation of FIXa, FXIa, FXIIa)]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

actions of low molecular weight heparin

A

Contain pentasaccharide sequence for binding AT

Predictable dose response in most cases so does not require monitoring (cf UFH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how is unfractionated heparin administered?

A

intravenous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how is low molecular weight heparin administered?

A

subcutaenous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

describe a graph showing the relationship between dose of UFH and LMWH to APPT

A

both curves

UFH steeper curve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are coumarins?

A

vitamin K antagonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

list an example of a coumarin

A

warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

mechanism of action of warfarin

A

inhibits vitamin K epoxide reductase > reduces production of functional coagulation factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

does warfarin administration require monitoring?

A

yes, due to narrow therapeutic index

many dietary, physiological and drug interactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

is the action of warfarin reversible?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how to reverse warfarin action slowly?

A

vitamin K administration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how to reverse warfarin action rapidly?

A

by infusion of coagulation factors:
Prothrombin Complex Concentrate- contains Factors II, VII, IX and X or
Fresh Frozen Plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

side effects of warfarin

A

bleeding
skin necrosis
purple toe syndrome
embryopathy - chondrodysplasia punctata

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

skin necrosis when taking warfarin

A

Severe Protein C deficiency
2-3 days after starting Warfarin
Thrombosis predominantly in adipose tissues

17
Q

purple toe syndrome when taking warfarin

A

Disrupted atheromatous plaques bleed

Cholesterol emboli lodge in extremities

18
Q

chondrodysplasia punctata when taking warfarin

A

Early fusion of epiphyses

Warfarin teratogenic in 1st trimester

19
Q

what is INR?

A

international normalised ratio

used to monitor patients on warfarin

20
Q

how to calculate INR?

A

patient prothrombin time to normal prothrombin time

21
Q

target INR is usually?

A

2-3

22
Q

describe the relationship between bleeding risk and INR on a graph

A

steep curve

as INR increases, so does bleeding risk

23
Q

resistance to warfarin

A

lack of patient complicance
diet, increased vitamin K intake
increased metabolism Cyt P450 (CYP2C9)
reduced binding (VKORC1)

24
Q

which DOACs act to inhibit factor Xa?

A

rivaroxaban
apixaban
edoxaban

25
Q

which DOACs act to inhibit factor IIa?

A

dabigatran

26
Q

comparison between warfarin and DOACs

A

W: slow onset, variable dosing, many interactions and food effect, requires monitoring, reversible with vit K, PCC
DOACs: rapid onset, fixed dosing, no food effect, few interactions, no monitoring, some renal dependence, antidote for dabigatran

27
Q

choice of anticoagulant for initial treatment of venous thrombosis

A

DOAC or LMWH for first few days followed by DOAC or warfarin

28
Q

choice of anticoagulant for long term treatment of venous thrombosis

A

DOAC or warfarin

29
Q

choice of anticoagulant for treatment atrial fibrillation

A

DOAC or warfarin

30
Q

choice of anticoagulant for mechanical prosthetic heart valve

A

Warfarin (DOACs not effective and should be avoided)

31
Q

choice of anticoagulant for prophylactic treatment following surgery

A

LMWH or DOAC

32
Q

choice of anticoagulant for prophylactic treatment during pregnancy

A

LMWH (DOACs not safe in pregnancy)

Cardiorespiratory (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions