anticoagulant and antiplatelet drugs

Question 1

mechanism of action of heparin

Answer 1

potentiates antithrombin

Question 2

monitoring of heparin

Answer 2

APTT for unfractionated
anti-Xa assay for LMWH but usually no monitoring

Question 3

heparin complications

Answer 3

bleeding
heparin induced thrombocytopenia (with thrombosis)- monitor FBC
osteoporosis with long term use

Question 4

heparin reversal

Answer 4

stop the heparin
in severe bleeding:
- protamine sulphate

Question 5

coumarin anticoagulants

Answer 5

warfarin
phenindione
acenocoumarin
phenprocoumon

Question 6

mechanism of action of coumarin anticoagulants

Answer 6

inhibition of vit K

Question 7

vitamin K dependent factors

Answer 7

factors II (prothrombin), VII, IX, X

Question 8

monitoring for warfarin

Answer 8

INR

Question 9

bleeding complications of warfarin

Answer 9

mild: skin bruising, epistaxis, haematuria
severe: GI, intracerebral, significant drop in Hb

Question 10

warfarin reversal

Answer 10

omit warfarin dose
administer oral vit K
administer clotting factors

Question 11

dabigatran

Answer 11

thrombin inhibitor

Question 12

Xa inhibitors

Answer 12

edoxaban
rivaroxaaban
apixaban

Question 13

reversal of dabigatran

Answer 13

idarucisumab
- monoclonal antibody fragement