Unit: 5 - Monitoring Antithrombotic Therapies Flashcards
(86 cards)
Drugs that break down clots are also called?
Thrombolytic drugs
What os VTE?
Venous thromboembolic disease; includes DVT & PE
What is DVT?
Deep vein thrombosis
What is PE?
Pulmonary embolism
What is AMI?
Acute myocardial infarction (heart attack)
What is TIA?
Transient ischemic attack
What is PAO/PAD?
Peripheral artery occlusion or disease
What is NVAF?
Non-valvular atrial fibrillation
What are the 4 types of anticoagulant drugs we are studying?
Heparin, Coumadin/warfarin, anti-Xa, and DTI (direct thrombin inhibitors)
Coumadin is a vitamin K antagonist (VKA). T or F?
True
What enzyme does warfarin/Coumadin act on?
It suppresses vit K epoxide reductase
How is Coumadin metabolized?
It is metabolized by the CYP450 pathway, which is an enzyme found in the liver
How does knocking out the epoxide reductase enzyme suppress VK dependent coagulation factors?
It inhibits the carboxylation/decarboxylation cycle of VK, which makes VK dependent factors remain non-active due to their inability to bind Ca2+
What are the prophylactic uses for coumadin?
To prevent VTE and stroke and to help with other chronic medical conditions that may cause clotting
What are the therapuetic uses for Coumadin?
After DVT, PE, or AMI
What does an INR in the correct therapeutic range indicate about the patient?
The pt is metabolizing the drug properly, the dosage is correct, and the pt is not at risk for either clotting or bleeding.
What is the critical value for INR at DH?
Greater than 5
What is an alternative test to INR? Why might it be used instead?
Chromogenic FXa Assay (CFX); It is best to use when pt has LA, factor inhibitors, or factor deficiency
What is the therapeutic range for Coumadin at DH?
2-3
What does VK do to the effects of coumadin?
Reverses them
What is the first step to reverse a Coumadin OD?
Discontinue the Coumadin and administer oral or IV VK
What can also be administered for reversal of a Coumadin OD (2 options)? What coag factors does it contain?
Prothrombin complex concentrate (PCC) - FII, VII, IX, and X
Activated FVII
With severe bleeding, what should be administered to reverse a Coumadin OD?
FFP
What are the three types of heparin used?
UFH, LMWH, and Fondaparinux