Non-Heparin anticoagulants-Quiz

Question 1

What are the key features of Bivalirudin?

Answer 1

A: Type: IV Direct Thrombin Inhibitor
Mechanism: Binds thrombin (free & clot-bound)
Onset & Half-Life: Onset: 5 min; t½: 25 min
Elimination: Renal & proteolytic
Monitoring: ACT (no standards)
Reversal Agent: None (dialysis clears drug)
Indications: HIT anticoagulation (ICU)
Notes: Cleaved by thrombin; short half-life

Question 2

Q: What are the key features of Argatroban?

Answer 2

A: Type: IV Direct Thrombin Inhibitor
Mechanism: Binds thrombin (active site)
Onset & Half-Life: Rapid; short half-life
Elimination: Hepatic
Monitoring: ACT or aPTT
Reversal Agent: None
Indications: HIT anticoagulation
Notes: Alters INR/PT; caution with warfarin

Question 3

Q: What are the key features of Fondaparinux?

Answer 3

A: Type: Parenteral Indirect Factor Xa Inhibitor
Mechanism: Inhibits Xa via antithrombin
Onset & Half-Life: Onset: ~2h; t½: 17-21h
Elimination: Renal (avoid in renal failure)
Monitoring: Factor Xa (not routine)
Reversal Agent: None; Andexanet alfa may help
Indications: VTE prophylaxis, HIT, ACS
Notes: Low HIT risk; once-daily SC

Question 4

Q: What are the key features of Dabigatran?

Answer 4

A: Type: Oral Direct Thrombin Inhibitor
Mechanism: Inhibits thrombin (free & clot-bound)
Onset & Half-Life: Onset: 1.5h; t½: 12-14h
Elimination: 80% Renal (adjust in impairment)
Monitoring: No reliable test (aPTT, TT, ECT not ideal)
Reversal Agent: Idarucizumab (Praxbind)
Indications: VTE, AF (non-valvular)
Notes: Up GI bleed risk; not for mechanical valves

Question 5

Q: What are the key features of Rivaroxaban?

Answer 5

A: Type: Oral Direct Factor Xa Inhibitor
Mechanism: Direct Factor Xa inhibition
Onset & Half-Life: t½: 8-12h
Elimination: Renal (avoid in severe impairment)
Monitoring: PT may rise; anti-Xa assay (not available)
Reversal Agent: Andexanet alfa
Indications: VTE, AF (non-valvular)
Notes: Less ICH vs warfarin

Question 6

Q: What are the key features of Apixaban?

Answer 6

A: Type: Oral Direct Factor Xa Inhibitor
Page 2
Anticoagulant Flashcards
Mechanism: Direct Factor Xa inhibition
Onset & Half-Life: t½: 8-12h
Elimination: Renal & hepatic (adjustable)
Monitoring: Same as rivaroxaban
Reversal Agent: Andexanet alfa
Indications: VTE, AF (non-valvular)
Notes: Dose-adjustable in renal impairment