Anticoagulants

Question 1

Dabigatran Etexilate (Pradax)

Answer 1

Group:Anticoagulant
Mechanism:Direct thrombin (factor IIa) inhibitor.
Indication:Prevent stroke, blood clots
Side Effects:Bleeding
Considerations:Doesn’t require frequent monitoring, drug interactions

Question 2

Enoxaparin (low dose of Heparin) Lovenox)

Answer 2

Group:Anticoagulant
Mechanism:Activates antithrombin III, inhibiting coagulation factors
Indication:Thromboembolic disorders, maintain patency of IV catheters, DVT, PE
Side Effects:Bleeding, tissue irritation, anemia, thrombocytopenia, fever
Considerations:Given SQ and no lab monitoring

Question 3

Heparin

Answer 3

Group:Anticoagulant
Mechanism:Binds to the enzyme inhibitor antithrombin III
Indication:Thromboembolic disorders, maintain patency of IV catheters
Side Effects:Bleeding, tissue irritation, anemia, thrombocytopenia, fever
Considerations:Monitor partial thromboplastin time (PTT) 1.5-2.5 x, antidote: protamine sulfate, short acting

Question 4

Rivaroxaban (Xarelto)

Answer 4

Group:Anticoagulant
Mechanism:Inhibitor of Xa factor
Indication:Prevent strokes, heart valve, DVT
Side Effects:Bleeding
Considerations:Don’t abruptly stop, drug interactions

Question 5

Warfarin (Coumadin)

Answer 5

Group:Anticoagulant
Mechanism:Depleting active vitamin K1
Indication:Pulmonary emboli, deep vein thrombosis, MI, atrial dysrhythmias, post cardiac valve replacement
Side Effects:Hemorrhage, diarrhea, rash, fever
Considerations:Monitor prothrombin time (PT) 1.5-2.5x, antidote: vitamin K. Avoid foods high in vitamin K.