Anticoagulants Flashcards
(31 cards)
Heparin MOA
accelerates the rate of ATII which neutralizes Xa
When can Heparin not be used?
for bound clots but is good during pregnancy
Side Effect of Heparin
HIT (Plus <100,000)
Lab for monitoring heparin levels?
ACT
IV Heparin stop time?
4-6 hours
SubQ Hep Stop time
12 hours
Protamine Sulfate MOA?
heparin antagonists and acts as a reversal agent
Names of Low Molecular Weight Heparins (LMWH)?
end in -aparin and sodium (Ex: Enoxaparin Sodium)
LMWH MOA?
inhibiting factor Xa and factor 11a (thrombin)
Monitoring for LMWH?
Anti Xa level
Considerations for LMWH?
must be renaly dosed
Fondparinux
High risk of spinal/epidural hematoma
Names of oral Xa inhibitors?
Have Xa in them (Ex) Apixaban, Edoxaban)
How long should Xa inhibitors be held?
1-2 days prior to surgery unless high risk and Dabigatran is up to four days
Oral Xa reversal
Andexxa
Argotroban MOA?
Direct thrombin inhibitor (IIa)
Lab value to monitor with argotroban?
aPTT
Examples of Direct thrombin inhibitors?
-Irudin (Ex) Bivalirudin
MOA od Direct thrombin inhibitors?
Bind irreversibly to the active catalytic and substrate-recognition sites of both circulating and clot-bound thrombin
What class is Dabigatran?
IIa direct thrombin inhibitor
Warfarins MOA?
indirect anticoagulant that alters the synthesis of blood coag factors II, VII, IX, and X (2,7,9,10) by interfering with the action of Vitamin K
Reversal agent for Warfarin?
Vitamin K and takes up to 24 hours to work
Names of thrombolytic agents?
-kinase or -eplase
MOA of Thrombolytic agents?
t-PA binds to fibrin and plasminogen and converts bound plasminogen to plasmin
