l5 Flashcards
(34 cards)
what is warfarin-(3)
Anti-coagulant
Vitamin k antagonist
stops platelet formation
Warfarin prevents the carboxylation of factors?
ii, vii, ix, x
what pathway does it prolong
extrinsic pathway
what type of proteins can warfarin inhibit
anti-coagulant proteins
It’s montored via the internationalise d normalised ratio but what ranges should it be between
2.5-3.5-DVT treatment
2-3.5 =recurrent DVT
wht cytochrome helps warfarin interact with other drugs
P450
what can potentiate warfarin
enzyme inhibitors
drugs that inhibit enzymes
allopurinol
ciprofloxacin
erythromycin
drugs that depress action of coumarins
Rifampion
drugs that increase the effects of coumarins
Reduce coumarin binding to serum albumin
Inhibit hepatic microsomal degradation of coumarin
Alteration of receptor site of drug thyroxin
what can decrease vitamin k produce or absorption?
Salicylates
Liver disease
Malabsorption
Side effects of warfarin (5)
Minor bleeding
skin necrosis
Alopecia
Teratogenic-so use LMW heparin in pregnancy
Significant haemorrhage risk-intracranial bleeds
Reversing effects of warfarin (3)
Give vitamin K 2-10mg IV
Give activated prothrombin containing factors, ii, vii ix and x and frozen plasma
What is Heparin
A Mucopolysaccharride that potentiates anti-thrombin.
What factors does it irreversibly activate
iia and xa
how different is low molecular weight heparin given?
It’s given as an injection but regular heparin is given by iv infusion
benefits of heparin compared to warfarin
it’s safe in pregnancy
what is the molecular pathway of heparin
It activates antithrombin, which inactivates conversion of:
xi-xia
ix-ixa
x-xa
what does factor xa contribute to the production of
Prothrombin to thrombin
What does thrombin contribute to the conversion of
fibrinogen to fibrin
Benefit of using unfractionated heparin
safe in renal failure
how can the effects of unfractionated heparin be reversed
giving potassium sulphate
give a name of a heparin
enoxaparin
what does unfractionated heparin treat
thromboprophylaxis
