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Flashcards in Anticoagulation Deck (33)
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1
Q

Define embolus

A

a clot or piece of clot that travels to another location

2
Q

Where does warfarin work in the clotting cascade

A

inhibits factors 2,7,9,10

3
Q

Where does UFH and LMWH work in the clotting cascade

A

inhibits Xa and Thrombin or 2a

4
Q

What is UFH activity with Xa and 2a

A

has equally activity

5
Q

What is LMWH activity with Xa and 2a

A

Has more Xa activity than 2a

6
Q

Where do DTIs work in the clotting cascade

A

inhibit thrombin or 2a

7
Q

List direct Xa inhibitors (3)

A

Rivaroxaban
Edoxaban
Apixaban

8
Q

List indirect Xa inhibitor

A

Fondaparinux

9
Q

List DTIs (3)

A

Argatroban
Bivalrudin
Dabigatran

10
Q

Which DTIs and PO and which IV

A
PO
-Dabigatran
IV
-Argatroban
-Bivalrudin
11
Q

Warfarin MOA

A

vitamin K antagonist. Vit K is required for activation of clotting factors 2,7,9,10 without vit K the liver produces the clotting factors but they have reduced coagulant acivity

12
Q

Antithrombin does what?

A

inactivates thrombin and other proteases like factor Xa involved in blood clotting

13
Q

MOA of UFH, LMWH, fondaparinux

A

bind to antithrombin causing a conformational change which increases AT activity 1000-fold

14
Q

DTI MOA

A

bind to thrombin directly decreasing the amount of fibrin available for lcot formation

15
Q

important point about IV DTIs

A

they do not cross-react with heparin-induced thrombocytopenia (HIT) antibodies

16
Q

UFH antidote

A

protamine

17
Q

LMWH dose for ppx of VTE

A

30 mg Q12 or 40mg Q24

18
Q

LMWH dose for ppx of VTE with CrCl <30

A

30mg Q24

19
Q

LMWH dose for treatment of VTE

A

1mg/kg Q12

20
Q

LMWH dose for treatment of VTE with CrCL <30

A

1mg/kg Q24

21
Q

LMWH antidote

A

protamine

22
Q

Define HIT

A

immune-mediated IgG drug reaction that has a high risk of venous and arterial thrombosis

23
Q

antidote for apixaban and rivaroxaban

A

andexanet alfa

24
Q

Conversion between warfarin and DOAC

A
stop warfarin and convert to: 
Rivaroxaban when INR < 3
Edoxaban when INR <2.5
Apixaban when INR < 2
Dabigatran when INR <2 
"read"
25
Q

Antidote for dabigatran

A

idarucizumab

26
Q

Goal INR for most indications

-DVT, Afib

A

2-3

27
Q

Goal INR for mechanical mitral valve or 2 mechanical heart valves

A

2.5-3.5

28
Q

Which foods does warfarin have increased bleeding with?

A
5 G's
Ginger
Ginkgo
Ginseng
Glucosamine
29
Q

St. John’s Wort and Warfarin

A

decrease effectiveness of warfarin

30
Q

High INR is bleeding or clotting?

A

bleeding

31
Q

For pt with cancer and VTE which treatment is preferred

A

LMWH

32
Q

CHA2DS2VASc

A
CHF
HTN
Age >75
DM
Stroke
Vascular Disease
Age 65-74
Sex-Female
33
Q

Prevention and treatment of VTE in pregnancy

A

LMWH