Parenteral DVT Anticoagulants Flashcards
Symptoms of a DVT?
Unilateral pain, swelling, redness, warmth in LE
What are the drugs that (-) factor Xa?
Heparin
LMWH (enoxaparin, delteparin, tinazeparin)
Fondaparinux
What are the drugs that (-) factor Xa?
Heparin
LMWH (enoxaparin, delteparin, tinazeparin)
Fondaparinux
Heparin can (-) both?
Factor Xa and Thrombin (indirectly)
What anticoagulant is prepared from lungs/intestines of cattle/pigs?
Heparin
Why can’t Heparin readily cross membranes/placenta?
It is super negatively charged
The half life for Heparin is relatively short and about how long?
1.5 hours
What are the contraindications for taking Heparin?
Thrombocytopenia, surgery involving brain, eye, or spinal cord
What are the possible adverse effects of taking Heparin?
BLEEDING - fatal/paralysis
Heparin induced thrombocytopenia
What is the antidote for Heparin or LMWH drugs and why?
Protamine - many positive charges that bond with negatively charged Heparin
What are the low molecular weight heparins (LMWH)?
Enoxaparin
Delteparin
Tinazeparin
What are the LMWHs?
Enoxaparin
Delteparin
Tinazeparin
MOA for LMWH?
(-) factor Xa
Why are LMWH like Enoxaparin easier to use than heparin?
Dosing is predictable and they have a longer half life
What is the 1st drug of choice for Parenteral Anticoagulation?
Enoxaparin (LMWH)
Adverse effects of the LMWHs?
Bleeding
Heparin induced thrombocytopenia
Neurologic/spinal cord injury
What is the antidote for the LMWHs?
Protamine
What is a synthetic pentasaccharide?
Fondaparinux
What is identical to antithrombin binding structure of heparin?
Fondaparinux
MOA for Fondaparinux?
(-) factor Xa
Fondaparinux is more effective than Enoxaprin (LMWH) but why is it not the first drug of choice?
Increased risk of bleeding
What can Fondaparinux be used in conjunction with?
Warfarin
How is Fondaparinux given and what is the half life?
SubQ daily dose with a longer half life (17-21 hours)
What are 2 Direct Thrombin Inhibitors?
Bivalirudin
Argatroban
