AP cardio drugs

Question 1

Warfarin - Indication?

Answer 1

Treatment + prevention of venous thromboembolism (DVT + PE)
Prevent arterial embolism from mechanical heart valves + AF

Question 2

Warfarin - MOA?

Answer 2

Inhibits Vitamin K epoxide reductase - reduces the production of vitamin k dependent clotting factors - produces an anticoagulant effect

Question 3

Warfarin - main side effects?

Answer 3

Haemorrhage/ peptic ulceration/ epistaxis

Question 4

Warfarin - contraindications?

Answer 4

Active bleeding
Caution - hepatic failure
1st trimester pregnancy

Question 5

DOAC’s - Indications
(Rivaroxaban/ apixaban/ edoxaban)

Answer 5

1) Prevention + treatment of venous thromboembolism (VTE - DVT + PE)/ alternative to warfarin/ heparin
2) 1st line treatment - prevention of VTE after hip + knee surgery
3) Prevent arterial embolism + stroke for pt’s with non-valvular AF

Question 6

DOAC’s - MOA

Answer 6

Works on the final stage of the anticoagulant cascade/ inhibits fibrin
Directly inhibits the activated factor Xa/ prevents conversion of prothrombin - thrombin/ fibrinogen - fibrin

Question 7

DOAC’s - Side effects

Answer 7

Haemorrhage (genitourinary)/ epistaxis/ anaemia

Question 8

DOAC’s - Contraindications

Answer 8

Pregnancy/ breast feeding X
Active bleeding/ high risk - bleeding disorders/ previous peptic ulceration/ trauma etc

Caution - renal/ hepatic impairment

Question 9

DOAC’s - Interactions

Answer 9

Anticoagulants - warfarin + heparin
Anti-platelets

Increased - CYP inhibitors
Decreased - CYP inducers