Topic 3

Question 1

NOAC drugs and their target

Answer 1

Dabigatran
A direct thrombin inhibitor. Prevents thrombin from generating. fibrin from fibrinogen.

Apixaban, Rivaroxaban.
Factor Xa inhibitors inhibit Thrombin generation from Prothrombin.

Question 2

NOAC drug risks

Answer 2

Xa inhibitors have no antidote, so they can’t be halted if there is an immediate emergency and surgery or something is required.

They also have kidney effects are are relatively contraindicated in kidney disease patients.

Question 3

Antiplatelet drugs and their targets

Answer 3

Thienopyridines.
Clopidogrel, Prasugrel Inhibit ADP receptor on platelets.

Dipyridamole.
Inhibits phosphodiesterase, increasing cAMP and cGMP, and lowering platelet response to ADP.

Aspirin.
Inhibits COX, lowering Thromboxane levels, preventing platelet aggregation. TXA2.

Antibodies against glycoprotein2b/3a

Heparin
Binds antithrombin A3, activating it, inhibiting thromin.
LMWH
Activates AT3, but in a way so that it only inhibits clotting factor Xa.

Fondaparinux
activates AT3.

Question 4

LDL target level

Answer 4

< 1.8 mMol

Question 5

Target HR

Answer 5

60/min and no angina

Question 6

Target Blood pressure

Answer 6

< 140/90,

above 110/70

Question 7

Target INR while on anticoagulants

Answer 7

2-3

Question 8

target waist circumference

Answer 8

females 90cm, males 103 cm

or ideally 80 and 90

Question 9

target HBA1c

Answer 9

<7%

Question 10

Target daily salt intake

Answer 10

<2.3g