Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
25 Cards in this Set
- Front
- Back
|
What is the mechanism of heparin?
|
Catalyzes the activation of antithrombin III, decreased thrombin and Xa.
|
|
|
What is the clinical use of heparin?
|
Immediate anticoagulation for PE, stroke, angina, MI, DVT.
|
|
|
How do you monitor heparin?
|
PTT
|
|
|
Can heparin be used during preganacy?
|
Yes, does not cross placenta
|
|
|
What is the toxicity of heparin?
|
Bleeding, heparin-induced thrombocytopenia, osteoporosis, drug-drug interactions
|
|
|
What do you use to reverse heparin and how does it act?
|
Protamine sulfate: positively charged molecule that acts by binding negatively charged heparin
|
|
|
What is the difference between old and new heparins?
|
Newer heparins act more on Xa, have better availability and longer half-life. They are also more difficult to reverse.
|
|
|
What is the mechanism of heparin-induced thrombocytopenia?
|
Heparin binds to platelets causing autoantibody production that destroys platelets and overactivates the remaining ones, resulting in a thrombocytopenic, hypercoaguable state.
|
|
|
What is the use and mechanism of lepirudin and bivalirudin?
|
Used as an alternative to heparin for patients with heparin-induced thrombocytopenia; Directly inhibit thrombin
|
|
|
What is the mechanism of warfarin?
|
Interferes with normal synthesis and gamma-carboxylation of vitamin K-dependent clotting factors II, VII, IX, X and protein C and S --> affects extrinsic pathway and increases PT
|
|
|
What is the clinical use of warfarin?
|
Chronic anticoagulation
|
|
|
How do you monitor warfarin?
|
PT/INR
|
|
|
Can warfarin be used during pregnancy?
|
No, crosses placenta
|
|
|
What is the toxicity of warfarin?
|
Bleeding, teratogenic, skin/tissue necrosis, drug-drug interactions
|
|
|
How do you treat acute warfarin overdose?
|
IV vitamin K and fresh frozen plasma
|
|
|
Heparin or warfarin: large anionic polymer, acidic
|
Heparin
|
|
|
Heparin or warfarin: administer parenterally (IV, SC)
|
Heparin
|
|
|
Heparin or warfarin: site of action is blood
|
Heparin
|
|
|
Heparin or warfarin: acts in seconds and duration is hours
|
Heparin
|
|
|
Heparin or warfarin: inhibits coagulation in vitro
|
Heparin
|
|
|
Heparin or warfarin: small lipid-soluble molecule
|
Warfarin
|
|
|
Heparin or warfarin: site of action is liver
|
Warfarin
|
|
|
Heparin or warfarin: administer orally
|
Warfarin
|
|
|
Heparin or warfarin: duration of action is days
|
Warfarin
|
|
|
Heparin or warfarin: onset of action is slow, limited by the half-lives of normal clotting factors
|
Warfarin
|
