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Flashcards in Anticoagulant Therapy Deck (29):
1

List four types of Anticoagulant Therapy.

Standard unfractionated heparin (UFH)
Low molecular weight heparin (LMWH); Coumadin drugs, Thrombolytic agents (clot busters)

2

Standard unfractionated (UFH): Mechanism of Action

Heparin by itself is NOT and anticoagulant
must complex with AT and AT is called the "heparin Co-factor"

3

Standard unfractionated (UFH): indication for therapy

treatment of thrombosis to precent propagation

4

Standard unfractionated (UFH): Administration

IV or subcutaneously (SQ)

5

Standard unfractionated (UFH): Monitoring

APTT: (target for therapy, prophylaxis, daily plt counts to detect HIT)

6

Standard unfractionated (UFH): Overdose

treat with protamine sulfate

7

Low molecular weight heparin (LMWH): Mechanism of Action

Increases the inhibitor effect of AT on thrombin and Xa. Mainly Xa

8

This is also known as Lovenox

Low molecular weight heparin (LMWH):

9

Low molecular weight heparin (LMWH): administration

SQ

10

Low molecular weight heparin (LMWH): Indication for therapy

Treatment of thrombosis to prevent propagation; not as commonly used but great for those needing to go home on heparin

11

Low molecular weight heparin (LMWH): Monitoring

anti-Xa heparin assay (APTT is insensitive)

12

Why is monitoring Low molecular weight heparin (LMWH) necessary?

For infants, children, obese or underweight patients, those with renal disease, or unexpected bleeding

13

which brand is most common for long term anticoagulant therapy?

Coumadin

14

Which brand is oldest brand name for long term anticoagulant therapy?

Warfarin

15

Coumadin: Mechanism of Action

Coumadin blocks the action of vitamin K which si needed for the synthesis of the vitamin K dependent factors. There fore, slowing thrombin formation

16

What are the Vitamin K dependent factors?

Prothrombin Group (II, VII, IX, X)

17

Coumadin: Administration

Oral

18

Coumadin: Delayed reaction or Immediate reaction?

Delayed reaction (3-5 days)

19

Coumadin: Indication for therapy

Treatment of thrombosis to prevent propagation; prevention of thromboembolic disease in thrombophilia, mechanical heart valves, and high risk surgery.

20

Coumadin: Monitoring

PT and INR

21

Coumadin: Overdose

Treat by giving vitamin K and FFP if major bleeding

22

Standard Unfractionated Heparin (UFH) has delayed or immediate reaction

Immediate reaction

23

List sources of Vitamin K

Diet: green leafy vegetables, fish , and liver
Normal gut flora: E.coli, B.fragilis

24

Three situations in which Vitamin K deficiency may occur.

Poor diet, long term antibiotic therapy, newborns

25

Vitamin K makes the Prothrombin factors functional by___

By adding a 2nd carboxyl group on the gamma carbon. In Vita K deficiency or in the presence of a Vita K antagonist, these factors are released from the liver without the gamma-carboxylation rendering them nonfunctional

26

Thrombolytic Agents (clot blusters): mechanism of action

Indiscriminately induce in vivo fibrinolysis by activating plasminogen to plasmin; not only get rid of bad clots but good clots too

27

Types of Thrombolytic agents

Tissue plasminogen activator (TPA), streptokinase, urokinase

28

Why is TPA considered the best/safest clot bluster?

because it will NOT activate circulating (free) plasminogen ..only fibrin bound

29

The use of Therapeutic drug TPA

Life threatening thromboses
Must be given within 4-6 hours of onset