anticoagulants Flashcards

1
Q

what are some common anticoagulants?

A

heparin and warfarin

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2
Q

what are some new anticoagulants?

A

danaparoid **

and lepirudin

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3
Q

what are anticoagulants used for?

A

to prevent or manage thrombophlebitis, DVT, and PE

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4
Q

what is the main adverse effect of anticoags?

A

bleeding

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5
Q

heparin combines with ___ to inactivate which clotting factors?

A

antithrombin III

clotting factors IX, X, XI, and XII

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6
Q

heparin inactivates and inhibits what?

A

Inhibits conversion of prothrombin to thrombin
Inactivates thrombin, preventing conversion of fibrinogen to fibrin
Inhibits factor XIII, V and VIII and platelet aggregation

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7
Q

what drug is as effective as heparin?

A

LMWH

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8
Q

what does LMWH do?

A

prevention or management of thromboembolic disorder associated with surgery or iscehmimc complications of unstable angina and MI

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9
Q

do LMWH require close monitoring of blood coat tests?

A

no**

less thrombocytopenia than heparin

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10
Q

what is the most commonly used oral anticoagulants?

A

warfarin

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11
Q

what does warfarin do?

A

prevent synthesis of vic k-dep clotting factors I, VII, IX< and X

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12
Q

when do the effects of warfarin occur?

A

**3-5 days after oral use

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13
Q

indications of warfarin?

A

prevention or management of DVT, PE, and embolization associated with afib and prosthetic heart valves

used after MI

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14
Q

how soon should someone go off warfarin if they are going for surgery?

A

2-5 days bc thats the duration after discontinued

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15
Q

arterial thrombi are composed primarily of what?

A

plaelets

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16
Q

anti platelet drugs act by a variety of mechanisms to ___

A

inhibit platelet activation, adhesion, aggregation or procoagulant activity

17
Q

MOA of aspirin ??

A

prevents formation of thromboxane A2 and thromboxane A2 aggregation. Activity persists for life of platelet (7-10 days)

18
Q

MOA of NSAIDS?

A

inhibits cyclooxyrgenase reversibility. lasts until drugs are eliminated from circulation

19
Q

MOA of ticlopidine? classification?

A

adenosine diphosphate receptor antagonist. it inhibits platelet aggregation by preventing ADP-induced binding between platelets and fibrinogen. last lifetime of paltelet

20
Q

MOA of clopidogrel (placid)

A

similar effects as ticlopidine with fewer or less severe adverse effects

21
Q

MOA of abiciximab? classification?

A

glycoprotein IIb/IIIa Receptor antagonists?

prevents binding of fibrinogen, von Willebranf factor and other molecules to GP IIb IIIa receptors on activated platelets

22
Q

MOA of epitifibaride and tirofiban

A

prevent activation of GP IIb/IIIa receptors on the platelet surface and subsequent binding of fibrinogen and von Willebrand factor to platelets

23
Q

classification of cilostazol?

A

phosphodiesterase inhibitor. inhibits that from metabolizing cAMP, thereby increasing cAMP which inhibits platelet aggregation and produces vasodilation

mgmt of intermittent claudication

24
Q

what do thrombolytic agents do?

A

dissolve thrombi
stimulate conversion of plasminogen to plasmin

mom of acute, severe thromboembolic disease such as MI, PE, and iliofemoral thrombosis

goal is to reestablish blood flow and prevent or limit tissue damage
dissolve clots in arterial or venous catheters

25
Q

examples of thrombolytic agents? ***

A

Alteplase* (clot buster for strokes), reteplase, and tenecteplase* are tissue plasminogen activators used in acute MI. Bind to fibrin and dissolve clot

26
Q

different types of strokes? (%)

A

%85 ischeic

%15 hemorrhagic

27
Q

drugs used to stop bleeding? if on warfarin? if on heparin? and LMWH?

A

Aminocaproic acid and tranexamic acid stop bleeding caused by overdoses of thrombolytic agents
Aprotinin inhibits plasmin and kallikrein, inhibiting fibrinolysis, inhibits breakdown of blood clotting factors
Protamine sulfate is antidote for heparin and LMWH
Vitamin K is antidote for warfarin overdose
** ^

28
Q

vitamin C >500 mg/d may lower what lab value?

A

INR

29
Q

> 400IU/d of vitamin e may inc effects of what drug

A

warfarin

30
Q

what herbs may inc warfarin effects?

A

**alfalfa, celery, clove, feverfew, garlic, ginger, ginkgo, ginseng, and licorice