Warfarin Anticoagulants

Question 1

Warfarin

Answer 1

MoA - Comp. antag. of vitamin K reductase –> inhibits vit K synthesis
- Suppresses synthesis of func forms of II, VII, IX, and X b/c lack of reduced Vit K prevents gamma-carboxylation of factors to func. form

Oral

Ind - Prolonged treatment of DVT or a.fib.

Adverse - bleeding, coumadin induced necrosis. Also interacts w/ several meds that potentiate its effects

Metab - hepatic

Highly protein bound

Test with PTT/INR

Question 2

Vitamin K

Answer 2

MoA - Cofactor in synthesis of II, VII, IX, and X

Oral

Ind - Hypoprothrombinemia, intestinal disorders/gastrectomy

Adverse - Hemolysis

Metab - Hepatic

Not really a drug, per se

Question 3

Rivaroxaban

Answer 3

MoA - Inhibits factor Xa

Oral

Ind - Stoke prevention in a. fib., prophylaxis/treatment of DVT

Adverse - Bleeding, liver toxicity

Metab - Renal (65%)

CYP3A4 inhibitor

Question 4

Apixaban

Answer 4

MoA - Inhibits factor Xa

Oral

Ind - Stoke prevention in a. fib., prophylaxis/treatment of DVT

Adverse - Bleeding, liver toxicity

Metab - Renal (25%)

CYP3A4 inhibitor

Question 5

Dabigatran

Answer 5

MoA - Inhibits thrombin

Oral

Ind - Stroke prevention in a. fib.

Adverse - Bleeding, liver toxicity

Metab - Renal (100%)

Proton pump inhibitor