DVT C5

Question 1

what is a DVT

Answer 1

clot in a vein

Question 2

treatment options for a DVT

Answer 2

enoxaparin, DOAC, warfarin

Question 3

MOA warfarin

Answer 3

Vitamin K antagonist

Vitamin K is essential for the production of prothrombin and factors VII, IX, X: all essential in the clotting cascade (see apixaban MOA)
Warfarin blocks the enzyme vitamin K reductase preventing it from being used in the production of the clotting factors

Question 4

monitoring with warfarin

Answer 4

INR - dose is based on this

Question 5

DOAC (apixaban, rivaroxaban) MOA

Answer 5

DOAC - direct oral anti coagulant
Apixaban and rivaroxaban are oral reversible inhibitors of activated factor X.
Clotting factors and thromboplastin activate factor X. Activated factor X converts prothrombin to thrombin. Thrombin converts fibrinogen to fibrin, which, when stable, leads to clotting.

Question 6

counselling with blood thinners

Answer 6

unexplained bruising, exessive bleeding, headaches

Question 7

MOA enoxaparin

Answer 7

Heparin binds to antithrombin III to activate it. This inhibits serine proteases so there is no production of clotting factors and thrombin. This therefore prevents a clot

Question 8

what does QRISK tell us

Answer 8

probability of having a stroke in next ten years.

depending on score you may need to add a statin