Anticoags Flashcards
(22 cards)
What is the primary focus of anticoagulation?
Anticoagulation involves preventing blood clot formation.
What is the Coagulation Cascade?
A series of biochemical events that lead to blood clotting.
Each clotting factor is a serine protease, an enzyme that speeds up the breakdown of another protein
What are common targets for anticoagulation drugs?
- Factor Xa
- Thrombin
- Vitamin K
What is the mechanism of action of Warfarin?
Warfarin inhibits Vitamin K epoxide reductase, interfering with clotting factor synthesis.
2,7,9, 10
What is the mechanism of action of DOACs?
DOACs directly inhibit specific clotting factors, such as Factor Xa or Thrombin.
What are the pharmacokinetics of DOACs?
- Rapid absorption
- Variable half-lives
- Renal excretion
What is a significant concern with drug-drug interactions in anticoagulation?
Interactions can alter the effectiveness or safety of anticoagulants.
How is DOAC dosing determined in atrial fibrillation? (Apixaban)
Dosing is based on
Reduce if 2/3 factors present:
renal function SCr>1.5
weight <60kg
patient characteristics >80yrs
What is the mechanism of action of Heparin?
Heparin enhances the activity of antithrombin III, inhibiting thrombin and Factor Xa.
What are key points in anticoagulant therapy?
- Monitoring is essential
- Patient adherence is critical
- Individualized treatment plans
What is antiplatelet therapy?
A treatment that prevents platelet aggregation to reduce thrombus formation.
What is the mechanism of thrombus formation?
Involves platelet activation and coagulation cascade activation.
What is the mechanism of action of antiplatelet agents?
They inhibit platelet activation and aggregation.
What are common targets for antiplatelet drugs?
- Cyclooxygenase (COX)
- P2Y12 receptors
- Glycoprotein IIb/IIIa
What do P2Y12 inhibitors do?
They block the P2Y12 receptor on platelets, preventing activation.
-plavix- only about 30% platelet inhibition
-ticagrelor 70-80% inhibition
What is the mechanism of action of Glycoprotein IIb/IIIa inhibitors?
They block the Glycoprotein IIb/IIIa receptors, inhibiting platelet aggregation.
What is the mechanism of action of fibrinolytics?
They convert plasminogen to plasmin, leading to clot breakdown.
What are contraindications to fibrinolytic therapy?
- Active bleeding
- Recent surgery
- Severe hypertension
What is the purpose of DOAC laboratory monitoring?
To ensure therapeutic levels and assess renal function.
Why do we use bivalirudin?
Not for conservative therapy!!
Go to when patients develop HIT***
Aspirin MOA
Inhibits synthesis of thromboxane A2, via irreversible acetylation of COX-1
Drug specific recs with Prasugrel and Ticagrelor
Prasugrel- contraindicated in CVA/TIA
Ticagrelor- can cause Dyspnea and bradycardia
