Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pre-reg Exam 2021 > Anticoagulants/antiplatelets > Flashcards

Anticoagulants/antiplatelets Flashcards

(50 cards)

Start Studying
1
Q

What is the mechanism of action of heparin?

A

Unfractionated heparin activates antithrombin

LMWH inactivates factor Xa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When is unfractionated heparin preferred over LMWH?

A

If there’s a high risk of bleeding

In renal impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is there a lower risk of when using LMWH?

A

Osteoporosis

Heparin induced thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Is LMWH or unfractionated heparin preferred in pregnancy?

A

LMWH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What needs to be measured when using unfractionated heparin?

A

APTT

Activated partial thromboplastin time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the side effects of heparin?

A

Haemorrhage
Hyperkalaemia
Osteoporosis
Heparin induced thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What do you do if haemorrhage occurs when using heparin?

A

Withdraw heparin

Protamine is antidote if required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When using heparin what increases the risk of hyperkalaemia?

A

Diabetes mellitus

CKD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why do heparins cause hyperkalaemia?

A

Inhibits aldosterone secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When do you monitor potassium levels in heparin use?

A

Before use and if > 7 days use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the clinical signs of heparin induced thrombocytopenia?

A

5-10 days after use

30% reduction in platelets

Skin allergy

Thrombosis

Monitor before treatment and if > 4 days use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the LMWH?

A

Tinzaparin
Enoxaparin
Dalteparin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which has a longer duration of action LMWH or heparin?

A

LMWH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the mechanism of action of warfarin?

A

Antagonise action of vitamin K in blood clotting

Takes 48-72 hours to work

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the colours and strengths of warfarin pills?

A

White - 0.5mg

Brown - 1mg

Blue - 3mg

Pink - 5mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the initial dose of warfarin?

A

5mg and monitor every 1-2 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the maintenance dose of warfarin?

A

3-9mg at same time each day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How often do you monitor INR when stable?

A

Every 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the duration of treatment for an isolated calf DVT with warfarin?

A

6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the duration of treatment for a provoked VTE with warfarin?

A

3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What constitutes a provoked VTE?

Study These Flashcards
A

COCs

Pregnancy

Leg plaster cast

22
Q

How long is the treatment with warfarin for unprovoked VTE? (A. Fib)

Study These Flashcards
A

At least 3 months/long term

23
Q

What is the target INR for recurrent VTE in patients receiving anticoagulant and INR > 2?

24
Q

When is the target INR 2.5?

Study These Flashcards
A

VTE
MI
Cardioversion
Bioprosthetic mitral valve

25
What is the MHRA advice for warfarin from January 2017?
Risk of interaction with direct acting antivirals to treat chronic hepatitis C, changing the INR and affecting the efficacy of warfarin Monitor INR closely
26
What is the MHRA advice for warfarin from September 2017?
OTC oral miconazole gel contraindicated in patients taking warfarin. Closely monitor if miconazole prescribed Miconazole is a potent enzyme inhibitor, increases anticoagulant effect of warfarin
27
What are the counselling points for warfarin?
Yellow treatment booklet Anticoagulant alert card Stop and seek immediate medical attention if any sign of bleeding
28
What are the side effects of warfarin?
Bleeding | Calciphylaxis
29
What is the antidote to warfarin?
Vitamin K - phytomenadione
30
What is the MHRA advice for warfarin from July 2016?
Reports of calciphylaxis. Report painful skin rash Consider stopping if calciphylaxis diagnosed Risk factor - end stage renal disease
31
What do you do when a patient is on warfarin and has a major bleed?
Stop warfarin IV phytomenadione Dried prothrombin complex or fresh frozen plasma
32
When the INR is 5-8 or >8 and there is minor bleeding what is the most appropriate action?
Omit warfarin IV phytomenadione Repeat if INR still high after 24 hours Restart warfarin when INR < 5
33
What is the most appropriate action when INR > 8 but no bleeding?
Omit warfarin Oral phytomenadione Repeat if INR still high after 24 hours Restart warfarin when INR < 5
34
What is the most appropriate action when INR 5-8 but no bleeding?
Withhold 1-2 doses Reduce maintenance dose Measure INR after 2-3 days
35
What are the interactions for warfarin that increase its anticoagulant effect?
``` Amiodarone Bezafibrate Chloramphenicol Cimetidine Ciprofloxacin Clarithromycin/erythromycin Cranberry juice Disulfiram Fluconazole Statins Itraconazole Metronidazole Miconazole Tamoxifen Tetracyclines ```
36
What are the interactions for warfarin that increase the risk of bleeding?
``` NSAIDs Aspirin SSRIs Dipyridamole Fluvoxamine Mefenamic acid Venlafaxine ```
37
What are the interactions with warfarin that decrease its anticoagulant effect?
``` St Johns Wort Rifampicin Enteral feeds Carbamazepine Alcohol ```
38
What are the interactions that alter the effect of warfarin?
Penicillins
39
When do you stop warfarin before elective surgery?
5 days before Oral phytomenadione if INR > 1.5 Restart on evening or next day
40
When do you stop warfarin if having emergency surgery?
Delay surgery by 6-12 hours No delay give IV phytomenadione and dried prothrombin complex
41
If patient is having surgery, is on warfarin and has a high risk of VTE, what is the most appropriate treatment?
Bridge with LMWH and stop 24 hours before surgery
42
If a patient is on warfarin, goes in for surgery and has a high risk of bleeding what is the most appropriate action?
Start LMWH 48 hours after surgery
43
How do DOACs work?
Inhibits specific clotting factors I.e. thrombin or factor Xa
44
What are the DOACs?
Dabigatran Apixaban Edoxaban Rivaroxaban
45
What are the advantages of DOACS?
Rarely causes bleeding | No monitoring
46
How do antiplatelets work?
Decrease platelet aggregation and inhibit thrombus formation in the arterial circulation
47
What is the dose for aspirin for the secondary prevention of CVD?
75mg OD
48
What is clopidogrel used for?
Used following ACS or PCI
49
What is dipyridamole used for and what are the counselling points?
Secondary prevention of strokes Take 30-60 mins before food
50
What are the glycoprotein IIa/IIb inhibitors?
Abciximab Eptifibatide Tirofiban

Pre-reg Exam 2021 (79 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions