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Flashcards in Coagulation drugs Deck (112)
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1

Unfractionated heparin: routes of administration?

Mainly IV, also subQ.

2

Unfractionated heparin: MoA?

Complexes w/AT III and mainly inhibits factors Xa and IIa. (also XIa, XIIa).

Increases AT-III's binding affinity by 1000x.

3

Unfractionated heparin: indications?

Surgical anticoagulation

4

Unfractionated heparin: adverse effects?

Bleeding, HIT, osteoporosis, alopecia

5

How is unfractionated heparin monitored?

Monitored by APTT (2-2.5x baseline therapeutic)

6

LMW heparins: routes of administration?

SubQ

7

LMW heparins: MoA?

Complexes w/AT and mainly inhibits factors Xa and IIa.

8

LMW heparins: indications?

Prophylaxis and tx of DVT and ACS. (Alt. tx for HIT)

9

LMW heparins: adverse effects?

Bleeding

10

How is LMW heparin monitored?

Monitored by anti-Xa.

11

Fondaparinux (pentasaccharide): route of administration?

SubQ

12

Fondaparinux (pentasaccharide): MoA?

What class of drugs does it fall under?

Complexes w/AT to inhibit factor Xa (not IIa)

"Heparin anticoagulants"

13

Indications for fondaparinux?

Mgmt of DVT

14

Toxic/adverse effects of Fondaparinux?

Bleeding

15

Argatroban: route of administration?

IV

16

Argatroban: MoA?

What drug category does it fall under?

Direct IIa inhibitor

"Heparin anticoagulants"

17

Argatroban: indications?

Anticoagulant mgmt of HIT pts

18

Argatroban: adverse effects?

Bleeding

19

*Besides argatroban, name 2 other drugs with the same MoA, indications, and toxic effects?

Bivalrudin & hirudin

 

("Heparin anticoagulants." 

MoA: direct IIa inhibitor.

Indications: mgmt of HIT pts.

Adverse effects: bleeding)

20

Argatroban, bivalrudin, and hirudin are all direct IIa inhibitors. How are each of them excreted?

Is there T1/2 longer or shorter?

  • Argatroban: Liver
  • Bivalrudin: Renal
  • Hirudin: Renal

All short T1/2

21

How is antithrombin concentrate administered?

IV

22

Antithrombin concentrate: MoA?

Direct IIa inhibitor

23

Antithrombin concentrate: indications?

DIC, sepsis, thrombophilia, hypercoagulable state

24

Antithrombin concentrate: toxicity?

None!

25

What is protamine sulfate? What is it used for?

  • Heparin antagonist
  • Reverses the effects of heparin

26

Protamine sulfate: adverse effects/toxicity?

Bradycardia, hypotension

27

One USP unit of heparin is neutralized by ___ ug of protamine sulfate.

10

28

Try to name all all 8 types of "heparin anticoagulants," including the inhibitor.

  1. Unfactionated heparin

  2. LMW heparin (branded + generic)

  3. Fondaparinux (pentasaccharide)

  4. Argatroban

  5. Bivalirudin

  6. Hirudin

  7. Antithrombin concentrate

  8. Protamine sulfate

29

What is the brand name of warfarin?

How is it administered?

Coumadin

PO ("oral anticoagulant")

30

Warfarin: MoA?

Competitive antagonist of vitamin K. Suppresses the synthesis of functional forms of factors II, VII, IX and X by blocking enzyme epoxide reductase in liver