SCDEP - Anticoag/ Antiplatelet Flashcards
What is anti platelet?
Medication that interferes w/ platelet aggregation bu inhibiting steps in platelet aggregation
Examples of anti-platelets?
Aspirin
Clopidogrel
How does aspirin work?
COX1 inhibitor
Binds irreversibly - inactivate COX within platelet, last life time of platelet
How does clopidogrel work?
ADP mediated platelet inhibition
What are anticoagulants?
Inhibit factors required in coagulation cascade
Prevent fibrinogen being converted fibrin
Examples anticoagulants?
Warfarin
DOAC
Heparin
How to monitor warfarin?
INR
How to monitor heparin?
APTT
How can antiplatatlets be given?
IV
Subcutaneous
Oral
Give example DOAC?
Direct oral anti-coagulants
Apixaban, rivaroxban, dabigatran
Mechanism of apixaban/ rivaroxaban?
Inhibit factor Xa in clotting cascade
Mechanism of dabigatran?
Direct thrombin inhibitor
Adv DOACs?
Standard dose, no monitoring needed
Fewer interactions
Half life DOACs?
6-15 hours
How manage pt on apixaban or dabigatran?
Will take 2 doses a day
XLA - miss morning dose
Take usual evening dose
How manage pt on rivaroxban/ edoxaban?
Will take 1 dose a day
If morning dose, miss and take 4 hours post haemostasis
If evening dose - no miss dose, take as usual
What is warfarin?
Vitamin K antagonist
Metabolised cytochrome P450 in liver
How is warfarin measured?
INR
What need INR to XLA?
Less 4
How manage pt on warfarin?
Check INR
Pack and suture
POIG: no alcohol, no rinsing, what to do if bleed
Issue w/ warfarin?
Lots of interactions
Care w/ prescribe ab: amoxicillin, metronidazole, azithromycin
Care w/ aspirin/NSAIDs
What is tranexamic acid?
Anti-fibrinolytic
Inhibit breakdown fibrin clot
What medical disorder put pt increased risk of bleeding?
Renal failure
Liver disease
Bleeding disorders
What medications put pt increased risk of bleeding?
Anticoag/ antiplatelet
SSRIs
Cytotoxics
Immunosuppressants
How manage pt on anti-platelets?
Tx w/o interruption of medication
