Pharmacology - Anti-coagulant drugs Flashcards by Jenna Dymond

what is the common product of both pathways of the coagulation cascade?

a. XIIa
b. Xa
c. X
d. II

b.Xa

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abnormal/ damaged surface leads to which branch of the coagulation cascade being activated?

a. intrinsic
b. extrinsic
c. final common

a.intrinsic

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trauma/tissue damage leads to which branch of the coagulation cascade being activated?

a. intrinsic
b. extrinsic
c. final common

b.extrinsic

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which pathway of the coagulation cascades involves some components derived from outside of the blood?

a. intrinsic
b. extrinsic
c. final common

b.extrinsic

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unfractionated and low molecular weight are two types of which drug?

a. anti platelet
b. anti coagulant
c. heparin
d. warfarin
e. NOACS

c.heparin

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which of these drugs is a coumarin?

a. heparin
b. warfarin
c. streptokinase
d. alteplase

b.warfarin

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where is heparin normally released from?

a. liver
b. kidney
c. intact blood vessel endothelium
d. damaged blood vessel endothelium

c.intact blood vessel endothelium

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which type of drug is best at preventing thrombus formation in veins?

a. anti platelet agents
b. anti coagulants
c. fibrinolytics

b.anti coagulants

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the family of glycosaminoglycans of variable chain length 3-330 kDa are known as..

a. low moleuclar weight heparin
b. unfractionated heparin

b.unfractionated heparin

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true or false low molecular weight heparin is longer acting and has a more predictable anticoagulant effect?

a. true
b. false

a.true

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enoxaparin sodium is an example of which type of drug?

a. coumarin
b. heparin
c. UFH
d. LMWH

d.LMWH

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what does heparin bind to in order to activate it?

a. Xa
b. IIa - thrombin
c. ATIII

c. ATIII

anti thrombin III

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what does the UFH-ATIII complex inactivate by binding to it?

a. IIa and Xa
b. II and Xa
c. I and Ia
d. II and IIa

a. IIa and Xa

thrombin and Xa

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the main effect of LMWH is to inactivate which component of the coagulation cascade?

a. VIII
b. Xa
c. IIa
d. II

b.Xa

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which of these factors does not take part in the extrinsic pathway?

a. tissue factor
b. VIIIa
c. XIIa

c.XIIa

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which of these factors does not take part in the intrinsic pathway?

a. XIIa
b. XIa
c. IXa
d. VIIa

d.VIIa

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how if UFH given?

a. IV
b. IM
c. subcutaneous
d. oral

a.IV

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how if LMWH given?

a. IV
b. IM
c. subcutaneous
d. oral

c.subcutaneous

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which of these drugs is immediately active and has a half life of 40-90 mins?

a. UFH
b. LMWH

a.UFH

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which of these drugs requires 1x / 2x daily dose ?

a,UFH
b,LMWH
c.heparin
d.warfarin

b,LMWH

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how is LMWH excreted?

a. hepatic
b. renal

b.renal

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caution/dose adjustment should be made when giving which drug to a patient with renal failure?

a. UFH
b. warfarin
c. heparins
d. LMWH
e. NOACS

d.LMWH

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what is used in treatment of thromboembolic disease in pregnancy?

a. heparin
b. warfarin
c. NOACS

a.heparin

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what is used in treatment of pleural effusion initially together with warfarin?

a. heparin
b. DOACS
c. NOACS

a.heparin

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what is used in treatment of deep vein thrombosis initially together with warfarin? a. heparin b. DOACS c. NOACS

a.heparin

what drug is used in prevention of thromboembolic disease especially before surgery in high risk patients? a. warfarin b. heparin c. dipyridamole d. NOACS

b.heparin

which of these drugs is used in haemodyalisis? a. warfarin b. heparin c. NOACS d. DOACS

b.heparin

what is the main side effect of heparin? a. hyperkalaemia b. reduced aldosterone secretion c. osteoporosis and alopecia d. haemorrhage e. hypersensitivity reactions

d. haemorrhage

which drug should be avoided in bleeding disorders and gastric ulcers? a,heparin b. warfarin c. NOACS d. DOACS

a,heparin

protamine sulphate is a chemical antagonist for which anticoagulant drug? a. warfarin b. heparin c. NOAC d. DOACS e. ezetimibe

b.heparin

which of these reverses the action of heparin ? a. vitamin K b. protamine sulfate

b.protamine sulfate

thrombocytopenia is relatively common when taking heparin. what is thrombocytopenia? a. reduced rbc b. reduced platelets c. increased destruction of rbc d. reduced blood vol e. increased platelet count

b.reduced platelets

a 50% drop in platelet count 5-10 days after treatment onset accompanied by a rash and thrombosis? a. immune mediated HIT b. thrombocytopenia c. haemolysis

a. immune mediated HIT

what needs to be routinely monitored in patient taking heparin? a. fbc and heparin platelet antibodies b. platelet count and fbc c. platelet count and heparin platelet count

c. platelet count and heparin platelet count

what is heparin dose adjusted according to? a. bleeding time b. activated partial thromboplastin time c. clotting time

b. activated partial thromboplastin time

how is UFH given intially? a. IM b. IV c. IV bolus d. oral

c.IV bolus

which pathways are tested by activated partial thromboplastin time? a. intrinsic and extrinsic b. intrinsic and final common c. final common d. extrinsic and final common

b. intrinsic and final common no tissue factor activity

which type of heparin does not effect APTT? a. LMWH b. UFH

a.LMWH

which of these clotting factors is not affected by warfarin? a. Xa b. II c. VII d. IX e. X

a.Xa

what enzyme is inhibited by warfarin? a. cox 1 b. cox 2 c. vit k epoxide reductase d. phosphodiesterase

c. vit k epoxide reductase stops regenration of reduced vit k for clotting factor synthesis

in order for clotting factor precursors for X, IX, VII and II to be converted to complete clotting factors what happens to vit K? a. reduced vit k converted to oxidised vit k b. oxidised vit K reduced to reduced vit k

a.reduced vit k converted to oxidised vit k

what does vit k epoxide reductase do? a. oxidise vit K b. reduce vit K

b.reduce vit K

how long is the onset for the anti coagulant effect of warfarin? a. immediate b. 2-5 days c. 10 days d. 3 days

b.3 days covered by LMWH time for already formed active factors to be degraded

what is given to cover the delayed onset of warfarin? a. LMWH b. UFH c. NOACS

a.LMWH

what is the duration of action of warfarin? a. 2-5 days b. 3-4 days c. 7-10 days

a.2-5 days

which of these drugs is used in prophylaxis and treatment of thromboembolic disease as first line? a. heparin b. warfarin c. DOACS

b.warfarin

which of these drugs is used as prophylaxis in atrial fibrillation to reduce stroke risk? a. warfarin b. heparin c. NOACS b. DOACS

a. warfarin

which drug is used as prophylaxis with prosthetic heart valves in order to prevent valve emboli a. heparin b. warfarin c. NOACS b. DOACS

b. warfarin

what measurement is used to inform dose of warfarin? a. APTT b. PT c. bleeding time d. clotting time

b.PT prothrombin time

the international normalised ratio is the ratio of a patients PT to a control sample a. true b. false

a.true

what INR should be aimed for for a patient on warfarin with DVT/PE/AF? a. 3.5 b. 2.5

b.2.5

what INR should be aimed for for a patient on warfarin with mechanical valves? a. 3.5 b. 2.5

a.3.5

how long is a loading dose of warfarin given? a. 1-3 days b. 2-3 days c. 5-7 days d. 4 days

a.1-3 days

before a loading dose is given of warfarin what should be measured? a. PT b. APTT c. bleeding time

a.PT

what is the main adverse effect of warfarin ? a. haemorrhage b. unexplained Hb fall c. GI upset d. teratogen e. alopecia

a.haemorrhage

in which of these cases should warfarin be avoided a. obese b. hypertensive c. elderly d. pregnant

d.pregnant

what is the reversal agent for warfarin if major bleeding occurs? a. protamine sulphate b. vitamin K

b.vitamin K

how is vit k asministered? a. IV b. IM c. IV bolus d. oral

d.oral or slow IV

wha can be given if major bleeding on warfarin? a. RBC b. FFP c. Thromin

b.FFP or prothrombin complex concentrate

if patient has an INR of < 8 and no bleeding what should be done? a. vit k administered b. warfarin withdrawal c. Prothrombin complex concentrate given d. increased warfarin dose given

b. warfarin withdrawal

patient has INR>8 with no/minor bleeding what is the most appropriate course of action ? a. withdraw warfarin b. give vit k c. give base and withdraw warfarin d. give protamine sulfate

c. give base and withdraw warfarin

which of these is not a contraindication for warfarin? a. bacterial endocarditis b. active bleeding c. peptic ulcer d. uncontrolled sever hypertension e. atrial fibrillation

e. atrial fibrillation

which of these drugs has varying effect based on diet, disease, genetic variation and interactions? a. heparin b. LMWH c. warfarin d. NOACS

c. warfarin

which of these diseases does not contribute to variation in warfarin effect? a. liver disease b. congestive heart failure c. small bowel disease d. pulmonary oedema

d. pulmonary oedema

genetic variation in the vitamin k epoxide reductase enzyme ay affect the efficacy of which of these drugs? a. LMWH b. UFH c. warfarin d. NOACS e. DOACS

c.warfarin

genetic variation in the CYTOCHROME P450-2C9 affect the efficacy of which of these drugs? a. LMWH b. UFH c. warfarin d. NOACS e. DOACS

c.warfarin

Which of these drugs would decrease the effect of warfarin? a.antibiotics b.azole antifungals c/cimetidine d. anti epileptics e.acute diet and alcohol changes

d. anti epileptics

most antibiotics, azole antifungals and which of these drugs increases the effect of warfarin? a. cimetidine b. rifampicin c. barbituates d. carbamazepine

a.cimetidine

which of these antibiotics decrease the effect of warfarin? a. metronidazole b. rifampicin c. doxycycline d. erythromycin

b.rifampicin

antiepileptics, rifampicin, chronic changes in diet and alcohol and which group of drugs decrease the effect of warfarin? a. azole antifungals b. cimetidine c. barbituates

c.barbituates

what is inhibited by rivaroxaban? a. Xa b. IIa c. II d. X

a.Xa rivaroXaban direct Xa inhibitor

what is inhibited by dabigatran? a. Xa b. IIa c. II d. X

b. IIa dabigATran - Anti Thrombin

true or false DOACS have a reduced risk of haemorrhage and shorter duration in comparison to warfarin and heparin? a. true b. false

a.true

what drug is given in order to prevent DVT/PE after orthopaedic surgery? a. warfarin b. heparin c. DOACS

c.DOACS

in non valvular atrial fibrillation what is given in order to prevent stroke? a. warfarin b. heparin c. DOACS

c. DOACS

what is the main side effect of DOACS? a. haemorrhage b. GI upset c. thrombocytopenia d. dyspepsia

b.GI upset

true or false INR is needed for DOACS? a. true b. false

b.false

before which drug treatment is U and E, LFT,FBP and a coagulation profile done? a. warfarin b. IV bolus heparin c. DOACS

c. DOACS

What is monitored 3 months into DOAC treatment? a. U and E, FBP ,LFT, coagulation profile b. U and E, FBP, LFT c. adherence, adverse reactions and efficacy

c.adherence, adverse reactions and efficacy

What is monitored 6 months into DOAC treatment? a. U and E, FBP ,LFT, coagulation profile b. U and E, FBP, LFT c. adherence, adverse reactions and efficacy

b. U and E, FBP, LFT

azole antifungals, NSAIDS, aspirin, clarithromycin, SSRIS, verapamil, rifampicin and carbamazepine shouls not be given with? a. warfarin b. heparin c. DOACS

c.DOACS

How are DOACS administered? a. orally b. IV c. IM

a.orally

which of these is a reversal agent for dabigatran?] a. vit k b. protamine sulphate c. idarucizumab d. andexanet alfa

c.idarucizumab

how is idarucizu,ab given? a. orally b. IV c. IM

b.IV

true or false no adjustment of dose is required for dabigatran based on renal function, age or weight a. true b. false

a.true

which of these is a reversal agent for Xa inhibitors? a. vit k b. protamine sulphate c. idarucizumab d. andexanet alfa

d.andexanet alfa

when is andexanet alfa given? a. minor bleeding b. life threatening bleeding

b.life threatening bleeding xa inhibitor reversal agent

Which DOACS can be used in pregnancy, artifical heart valves, liver disease or malignancy? a. dabigitran b. rivaroxaban c. apixaban d. none

d.none