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17 Cards in this Set
- Front
- Back
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What are the three classes of anticoagulant drugs?
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1. indirect thrombin inhibitors
Direct thrombin inhibitors: 2. Parenteral 3. Oral |
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What do indirect thrombin inhibitors interact with?
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ATIII & Xa
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What are the three indirect thrombin inhibitors?
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1. HMWH
2. LMWH 3. fondaparinux (all called "heparin".. I think) |
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What does ATIII degrade when bound to heparin?
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X and thrombin
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Three Parental Direct Thrombin Inhibitors?
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1. Hirudin
2. Bivalirudin 3. Argatroban |
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What is hirudin?
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A bivalent, specific, irreversible thrombin inhibitor (from leech saliva)
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What is Bivalirudin?
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A bivalent inhibitor of thrombin
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What is Argatroban?
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A small molecule thrombin inhibitor
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What do the parenteral, direct thrombin inhibitors target?
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Thrombin
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With which type of patients do you use parenteral, direct cautiously?
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Renal failure; can accumulate, cause bleeding, pts may develop antibodies that may cause an increased aPTTT
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Which is the oral direct thrombin inhibitor?
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Warfarin
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What's cool about warfarin?
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It's 100% bioavailable!
And... it has a long half-life |
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What does warfarin do?
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Inhibits the (Vit-K dependant) synthesis of clotting factors: prothrombin, VII, IX, X, and protein C
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How does warfarin block the factors that it blocks?
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Inhibits gamma-carboxylation of glutamate residues in coagulation factors
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What can cause a decrease in the coagulation effect of warfarin?
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barbituates and rifampin.. duh.
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What can augment the effects of warfarin?
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Asprin and cephlosporins
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What are the new anti-coag oral direct thrombin inhibitors?
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Apixaban, pradaxa, rivaroxiban (prax = thrombin, others = Xa)
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