Parenteral ACs

Question 1

Onset and duration of action of heparin

Answer 1

Heparin initiates anticoagulation rapidly but has a short duration of action. This is for UFH heparin, aka standard or heparin.

Question 2

Standard heparin aka

Answer 2

‘standard’ or heparin (unfractionated)

Question 3

Duration of action of LMWEH

Answer 3

Longer duration of action than heparin (UFH).

Question 4

What is preferred for routine use

Answer 4

LMWH

Question 5

What to use in pt at high risk of bleeding and why

Answer 5

UFH can be used in those at high risk of bleeding because its effect can be terminated rapidly by stopping the infusion.

Question 6

examples of LMWH

Answer 6

Low molecular weight heparins (dalteparin sodium, enoxaparin sodium, and tinzaparin sodium)

Question 7

What is preferred for prevention and treatment of VTE and why?

Answer 7

LMWH (e.g. dalteparin, enoxaparin etc)
They are as effective as UFH and they have a lower risk of heparin-induced thrombocytopenia

Question 8

Name the heparinoid and what is it indicated for

Answer 8

Danaparoid sodium is a heparinoid used for prophylaxis of DVT in patients undergoing general or orthopaedic surgery. Providing there is no evidence of cross-reactivity, it also has a role in patients who develop heparin-induced thrombocytopenia.

Question 9

MOA

Answer 9

Heparin acts as an anticoagulant by binding to antithrombin III, which enhances the inhibition of several clotting factors, notably factor Xa and thrombin (factor IIa). This mechanism significantly reduces thrombin formation, leading to an anticoagulant effect that prevents clot formation and extension.