anticoagulation Flashcards
(24 cards)
what are the phases of blood clotting?
1-vascular phase
2-platlet phase
3-coagulation phase
what are the indications of the anticoagulants??
-DVT
-ischemic heart disease
-rheumatic heart disease and AF
-cerebral emboli
-vascular surgery,prosthetic heart valve
-DIC
what are the contraindicators?
-high risk of bleeding
-allergy
what are the contraindicators that have high risk of bleeding?
-hemophilia
-hypertension
-intracranial hge
-active peptic ulcer
-active TB
-threatened abortion
what are the oral anticoag.??
warfarin
dabigatran
apixaban and rivaroxaban
parenteral anticoag. are??
-heparin
-LMWheparin
-fondaparinux (synthetic xa inhibitor)
-bivalirudin and argatroban (direct thrombin inhibitor)
what is the function of warfarin?
inhibit vit k dependent clotting factors 2,7,9,10
and protien s,c
warfarin cross the placenta and do??
fatal warfarin syndrome
what decrease warfarin binding to albumin?
aspirin
sulfanomide
what inhibit degredation of warfarin?
enzyme inhibitors
what decrease the synthesis of clotting factors?
antibiotic specially cephalosporin
what inhibit the platelets?
aspirin
what inhibit the clotting factors?
heparin
what induce the metabolizing enzymes?
barbituates and phenytoin
what promote synthesis of clotting factors?
vit k
what reduce the absorbtion of the warfarin?
cholestyramin
what are the adverse effect of warfarin?
-HGE
-SKIN NECROSIS
-teratogenic
what is the antidote for warfarin?
vit k
disadvantages of warfarin?
-delayed onset
-narrow therapeutic index
-routine monitoring
-drug interaction
what are the advantages of new anticoag.?
-rapid onset
-short half life
-NO routine monitoring
disadvantages of new anticoag.?
-NO antidote
-drug interaction
-effect of renal impairment on pharmacokinetics
heparin function?
stimulate antithrombin 3 so inhibit thrombin and factor 2,9,10,11,12
adverse effects of heparin?
-HGE
-allergy and anaphylaxis
-hair loss and alopecia
-osteoprosis
-thrombocytopenia
what is the antidote of heparin?
protamine sulfate
