SCDEP - Anticoag/ Antiplatelet Flashcards

1
Q

What is anti platelet?

A

Medication that interferes w/ platelet aggregation bu inhibiting steps in platelet aggregation

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2
Q

Examples of anti-platelets?

A

Aspirin

Clopidogrel

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3
Q

How does aspirin work?

A

COX1 inhibitor

Binds irreversibly - inactivate COX within platelet, last life time of platelet

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4
Q

How does clopidogrel work?

A

ADP mediated platelet inhibition

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5
Q

What are anticoagulants?

A

Inhibit factors required in coagulation cascade

Prevent fibrinogen being converted fibrin

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6
Q

Examples anticoagulants?

A

Warfarin
DOAC
Heparin

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7
Q

How to monitor warfarin?

A

INR

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8
Q

How to monitor heparin?

A

APTT

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9
Q

How can antiplatatlets be given?

A

IV
Subcutaneous
Oral

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10
Q

Give example DOAC?

A

Direct oral anti-coagulants

Apixaban, rivaroxban, dabigatran

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11
Q

Mechanism of apixaban/ rivaroxaban?

A

Inhibit factor Xa in clotting cascade

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12
Q

Mechanism of dabigatran?

A

Direct thrombin inhibitor

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13
Q

Adv DOACs?

A

Standard dose, no monitoring needed

Fewer interactions

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14
Q

Half life DOACs?

A

6-15 hours

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15
Q

How manage pt on apixaban or dabigatran?

A

Will take 2 doses a day
XLA - miss morning dose
Take usual evening dose

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16
Q

How manage pt on rivaroxban/ edoxaban?

A

Will take 1 dose a day

If morning dose, miss and take 4 hours post haemostasis

If evening dose - no miss dose, take as usual

17
Q

What is warfarin?

A

Vitamin K antagonist

Metabolised cytochrome P450 in liver

18
Q

How is warfarin measured?

A

INR

19
Q

What need INR to XLA?

A

Less 4

20
Q

How manage pt on warfarin?

A

Check INR
Pack and suture
POIG: no alcohol, no rinsing, what to do if bleed

21
Q

Issue w/ warfarin?

A

Lots of interactions
Care w/ prescribe ab: amoxicillin, metronidazole, azithromycin

Care w/ aspirin/NSAIDs

22
Q

What is tranexamic acid?

A

Anti-fibrinolytic

Inhibit breakdown fibrin clot

23
Q

What medical disorder put pt increased risk of bleeding?

A

Renal failure
Liver disease
Bleeding disorders

24
Q

What medications put pt increased risk of bleeding?

A

Anticoag/ antiplatelet
SSRIs
Cytotoxics
Immunosuppressants

25
Q

How manage pt on anti-platelets?

A

Tx w/o interruption of medication