Anticoagulants & Thrombolytics: Warfarin

Question 1

Vitamin K is a cofactor for the

Answer 1

enzymatic activation of clotting factors

Question 2

Vitamin K Promotes Gamma Carboxylation of

Answer 2

1. Coagulation factors II, VII, IX, X
2. Protein C
3. Protein S

Question 3

gamma carboxylation occurs at the glutamic acid residue on factors

Answer 3

II, VII, IX, and X

Question 4

Vitamin K epoxide reductase (VKOR) converts

Answer 4

vitamin K epoxide (inactive) into vitamin K (active)

Question 5

Protein C and Protein S are

Answer 5

Anticoagulant Factors

Question 6

Warfarin Inhibits

Answer 6

vitamin K epoxide reductase (VKOR)

Question 7

Inhibition of VKOR prevents

Answer 7

Activation of vitamin K

Question 8

___________ ______ is the first clotting factor to be reduced when starting warfarin

Answer 8

Factor VII

Question 9

Warfarin onset of action is

Answer 9

8-12 hours

Question 10

Warfarin is given by

Answer 10

Oral Administration (PO)

Question 11

Warfarin has a ________ half life

Answer 11

Long

Question 12

Monitor Warfarin activity with

Answer 12

Prothrombin Time

Question 13

Prothrombin Time (PT) is a measure of the function of the

Answer 13

extrinsic coagulation pathway

Question 14

_________ _____ is the main component of the extrinsic coagulation pathway

Answer 14

Factor VII

Question 15

The ____________ _______ _________is also used to measure warfarin activity and treatment of thrombosis

Answer 15

international normalized ratio (INR)

Question 16

Warfarin is used for

Answer 16

1. Long term anticoagulation in atrial fibrillation
2. DVT prophylaxis
3. Warfarin induced skin necrosis due to early hypercoagulable state

Question 17

Warfarin can cause

Answer 17

hemorrhage and abnormal bone formation in utero

Question 18

The anticoagulant protein C is reduced early in warfarin therapy, resulting in a

Answer 18

hypercoagulable state

Question 19

The __________ _____________ ______ is reduced early in warfarin therapy, resulting in a hypercoagulable state

Answer 19

anticoagulant protein C

Question 20

coadministration of _______ when starting warfarin therapy prevents the early hypercoagulable state (heparin bridge)

Answer 20

Heparin

Question 21

Warfarin anticoagulation can be reversed with

Answer 21

Vitamin K (delayed effect)

Question 22

_______ ___________ _________ provides coagulation factors for immediate reversal of warfarin anticoagulation

Answer 22

Fresh Frozen Plasma (FFP)

Question 23

Warfarin is a substrate of

Answer 23

Cytochrome P450