Heparin - LMWH Flashcards Preview

Year 3 - Cardiovascular Drugs > Heparin - LMWH > Flashcards

Flashcards in Heparin - LMWH Deck (11)
Loading flashcards...
1
Q

Give some examples of heparins

A

LMWH- Tinzaparin, Enoxaparin and Daltaparin

Fondaparinux

2
Q

How do heparins work?

A

Heparins bind to antithrombin III and activate it
Antithrombin III is responsible for the inactivation of Factor 10a and thrombin
UFH work to inactivate BOTH factor 10a and thrombin however LMWH work to preferentially inactivate factor 10a

3
Q

Which has more of a predictable effect LMWH or UFH?

A

LMWH as they preferentially inhibit factor 10a

4
Q

What are heparins used for?

A
  1. FIRST LINE prophylaxis and treatment for VTE (along with warfarin to cover pro-coagulation phase while warfarin is not working)
  2. FIRST LINE treatment for ACS (revascularisation and anticoagulation, given along with atiplatelets e.g. clopidogrel and aspirin)
5
Q

What are some contraindications of using heparin?

A

Bleeding disorders (thrombocytopenia and haemophilia)

6
Q

When should you use heparins with caution?

A
Pregnancy
Uncontrolled hypertension
Surgery/ trauma
Kidney insufficiency 
Peptic Ulcer/ Oesphageal varices
Hepatic Insufficiency
7
Q

What are some common interactions with warfarin?

A

Other anticoagulant/thrombotic drugs - use with caution unless required e.g. with warfarin for VTE
Antiplatlet drugs - use with caution unless required e.g. with aspirin/clopidogrel for ACS

8
Q

What are the common side effects of heparins?

A

Bleeding
Bruising
Heparin induced thrombocytopenia
Hypersensitivity reactions due to large molecules

9
Q

How are heparins excreted?

A

Renal Excretion

10
Q

How are heparins administered?

A

Subcutaneous

11
Q

How are heparins monitored?

A

APTR: aim for 1.5-2.5

Less required when using LMWH or fondaparinux