Parenteral anticoagulants Flashcards
Explain how heparin (unfractionated) differs from LMWH and outline which patients it might be useful to use in
1) Heparin initiates anticoagulation rapidly but has a short duration of action. LMWH have a longer duration of action (preferred for routine use)
2) Useful in patients at high risk of bleeding because its effect can be terminated rapidly by stopping the infusion
list the 3 LMWH
1) Dalteparin
2) Enoxaparin
3) Tinzaparin
Even though Heparin (unf) is as effective as LMWH, why is LMWH usually preferred for the prevention of VTE, PE and DVT
1) lower risk of heparin-induced thrombocytopenia
2) The duration of action is longer with LMWH so once-daily SC administration makes them convenient to use
3) Standard prophylactic regimen does not require anticoagulant monitoring
Apart from VTE, PE and DVT, what other conditions can LMWH be used in the management of?
1) Treatment of myocardial infarction,
2) unstable coronary artery disease
3) prevention of clotting in extracorporeal circuits
Which two LMWH are licensed for the extended treatment and prophylaxis of VTE in patients with solid tumours?
Dalteparin and tinzaparin (only 20 000 unit/mL syringe)- Recommended for a duration of 6 months
Danaparoid is a heparinoid , what are the two conditions it is indicated for use in?
1) Prevention of DVT in general or orthopaedic surgery
2) useful in patients with a history of heparin-induced thrombocytopenia
Bivalirudin, a hirudin analogue, is a thrombin inhibitor. what is it licenced to treat?
1) Unstable angina or non-ST-segment elevation MI in patients planned for urgent intervention
2) Anticoagulant for patients undergoing percutaneous coronary intervention
heparin flushes are used for maintaining patency of peripheral venous catheters. What is as effective as heparin flushes?
sodium chloride injection 0.9% flushes
1) Epoprosteno can be given to inhibit platelet aggregation during renal dialysis when heparins are unsuitable. Why should it be administered by continuous intravenous infusion.
2) what other condition is this drug indicated for?
1) Potent vasodilator that has a short half-life of approximately 3 minutes
2) Primary pulmonary hypertension resistant to other treatment
