Flashcards in Anticoagulants Deck (11):
1
aspirin
decreases thrombus risk in CAD and post- MI patients
inhibits COX/PLT aggregation
SE:asthma
2
thienopyridines
clopidogrel (Plavix)
ticlopidine (Ticlid)
these drugs block ADP receptors on platelets, to inhibit platelet aggregation
Role:
-aspirin intolerance
-history of MI or stroke
-PVD
-post-vascular intervention
Complications:
GI bleed
hemorrhage
3
Glycoprotein IIB/IIIa inhibitors
abciximab
tirofiban
eptifibatide
mechanism: inhibit platelet aggregation by binding to GPIIb/IIIa receptor
Role:
-unstable angina
-following coronary vessel intervention
-non-STEMI, in patients who are being managed medically
complications: hemorrhage
4
Adenosine re-uptake inhibitors
Dipyridamole (Aggrenox)
Role:
recent stroke
artificial heart valve replacement (with warfarin), but this is second line usually clopidogrel is used instead
Adverse effects:
HA
5
Heparin
Makes antithrombin more active
antithrombin inactivates thrombin and other coagulation factors, shutting down the body's ability to make more fibrin clots
Role:
post-op DVT prophylaxis
dialysis (heparin flush)
flush IV catheter
decreases post- MI thrombus risk
safer than warfarin during pregnancy
monitor with PTT
Side effect:
thrombocytopenia, heparin- induced
a state of hypercoagulability despite thrombocytopenia (low platelets)
In HIT, antibodies form that end up aggregating activated platelets and taking them out of circulation.
6
Low molecular weight heparins
enoxaparin
dalteparin
bind to factor Xa
prevent clot formation
used like heparin, but easier to administer because given sQ 2x qD instead of continuously, with weight-based dosing
can monitor with anti-factor Xa
Safest during preg
do not require monitoring with PTT
7
Direct thrombin inhibitors
argatroban
bivalidurin
role: anticoagulation in HIT
Fondaparinux acts by activating thrombin, and it can also be used to treat HIT (indirect thrombin inhibitor)
8
Direct factor Xa inhibitors
Riveroxaban
Apixiban
can be given orally
role: afib
post-op DVT prophylaxis
Direct thrombin inhibitors
9
Warfarin
inhibits Vit K dependent activation of factors 10,9,7,2,protein S, protein C
role:
hypercoagulable syndromes
atrial fibrillation
artificial heart valves
DVT/PE
adverse effects:
hemorrhage
drug interactions
teratogeniic
monitor with PT/INR
manage OD
vitamin K (2-3 days), FFP
bridge with heparin
10
Streptokinase mechanism
cleaves fibrin clots
11