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5. Anticoagulants > Pathophysiology > Flashcards

Flashcards in Pathophysiology Deck (11)
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1
Q

Antiplatelets

A

Prevent platelet aggregation => less chance of clot formation

2
Q

Anticoagulation

A

Prevent fibrin formation

3
Q

Thrombolytics

A

break down fibrin/thrombus/clot but have a high risk of bleeding

4
Q

Heparin works on which pathway

A
  • Intrinsic pathway

- Inactivates IIa and Xa

5
Q

Warfarin inhibits which pathway

A
  • Extrinsic pathway

- Inactivates factor 2, 7, 9, and 10

6
Q

APTT or PTT

  • Normal:
  • Therapeutic Level
A
  • Measure how effective Heparin is working as a blood thinner/anticoagulant
  • Normal PTT = 20-40s
  • Therapeutic PTT: 1.5-2.5 x N = 45-70s
7
Q

INR/PT

  • Normal level w/o anticoagulation
  • Level w/ coagulation
A
  • Measure of anticoagulation. It’s affected by coumadin
  • Normal person NOT on warfarin: 1
  • On Warfarin: 2-3.5
8
Q

INR goal:

  • A. fib/A. flutter:
  • Elective CV of a.fib
  • DVT or PE:
  • Mechanical prosthetic heart valve:
A
  • A. fib/A. flutter: 2-3
  • Elective CV of a.fib: 2-3
  • DVT or PE: 2-3
  • Mechanical prosthetic heart valve: 2.5-3.5
9
Q

How to treat DVT?

How to treat PE?

A
  • DVT: Heparin/LMWH follow by PO anticoagulant x 3 mo. ACCP rec warfarin over dabigatran (Indication for non-valvular a.fib) or rivaroxaban (off label for DVT). Thrombolytics are NOT rec in DVT => risk of bleeding outweight benefits
  • PE: same as DVT but thrombolytic may be in massive PE w/ HYPOTN
10
Q

Risk factors for DVT?

A
  • Immobilization/Prolong bed rest
  • Estrogen: OCP/HRT/Pregnany
  • Cancer
  • HIP/Knee surgery
  • Advanced age
  • High risk medical illness: CHF, MI, AF
  • Valvular disorder
  • Blood disorder: protein C, S, or anti-thrombin III deficiency & antiphospholipid antibody syndrome.
11
Q

ACCP guidelines 2012 for tx of DVT/PE

  • Distal Leg DVT (below knee)
  • Proximal leg DVT (thigh) or Arm DVT
A

Distal Leg:

  • No, mild, or mod sx: no treatment => monitor
  • Severe sx: tx x 3mo

Proximal leg DVT

  • Tx regardless of sx
  • 3 mo for provoked by a transient risk factor
  • “extended” tx if unprovoked.