anticoagulants

Question 1

What are serious side effects of heparin?

Answer 1

Bleeding complications and heparin-induced thrombocytopenia (HIT)

HIT causes arterial and venous thromboembolism due to an antibody-mediated aggregation of platelets.

Question 2

What does heparin-induced thrombocytopenia (HIT) cause?

Answer 2

Arterial and venous thromboembolism
HIT is characterized by an antibody-mediated aggregation of platelets.

Question 3

What platelet count indicates heparin-induced thrombocytopenia (HIT)?

Answer 3

A drop in platelet count < 100,000 platelets/μL or decrease of > 50% compared to baseline

Question 4

What should be done if heparin-induced thrombocytopenia (HIT) is suspected?

Answer 4

Discontinue all heparins and begin nonheparin anticoagulation (usually argatroban)

Question 5

unfractionated heparin is monitored by

Answer 5

activated partial thromboplastin time (aPTT) , platelet count (including baseline before treatment is started)

Question 6

clearance of UFH is by

Answer 6

hepatic (preferred agent for patients with renal insufficiency)

Question 7

LMWH agents include

Answer 7

enoxaparin, dalteparin, tinzaparin, nadroparin, certoparin

Question 8

clearance of LMWH is by

Answer 8

renal (contraindicated for patients with renal insufficiency)

Question 9

synthetic heparin agents

Answer 9

fondaparinux

Question 10

direct thrombin inhibitor agents

Answer 10

argatroban, bivalirudin, desirudin, dabigatran

Question 11

half life of heparin

Answer 11

anticoagulant effect quickly ceases once administration is stopped

Question 12

LMWH and synthetic heparin half life

Answer 12

Long half-life: 2–4 times longer than unfractionated heparin

Question 13

VTE in pregnancy

Answer 13

Physiological hypercoagulability (e.g., due to increased levels of clotting factors) leads to increased risk of thrombosis.
UFH and LMWH can be used during pregnancy: neither cross the placenta nor are they transferred through breast milk
LMWH has fewer side effects.