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38 Cards in this Set
- Front
- Back
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MOA - unfractionated heparin
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'activates' antithrombin
inhibits factor IIa and Xa |
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MOA - LMWH
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'activates' antithrombin
inhibits mainly factor Xa |
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MOA - warfarin
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inhibits production of vitamin K dependent clotting factors in liver
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MOA - lepirudin
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inhibits thrombin
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antidote for bleeding from excessive heparin
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protamine sulfate
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antidote for bleeding from excessive warfarin
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vitamin K or fresh frozen plasma
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What is used to monitor the anticoagulant effect of unfractionated heparin
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aPTT
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What is used to monitor the anticoagulant effect of LMWH
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generally not needed.
Factor Xa activity |
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What is used to monitor the anticoagulant effect of warfarin
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PT or INR
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What is the onset of action of heparin
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immediate anticoaglulant effect
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What is the onset of action of warfarin
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Takes a few days
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What are the symptoms of HIT type 2
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low platelet count and possible clot or thrombosis
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HIT type 2 usually occurs within hours, days or weeks after starting heparin
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days (5-7 or so)
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Which of the following would you use to treat thrombosis from HIT type 2?
unfractionated heparin, enoxaparin, lepirudin, warfarin, aspirin, clopidogrel |
lepirudin
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Which of the following are only used parenterally?
UFH, LMWH, lepirudin, warfarin, aspirin, clopidogrel, abciximab, streptokinase, alteplase |
UFH, LMWH, lepirudin, abciximab, streptokinase, alteplase
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Side effects - warfarin
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bleeding, skin necrosis, purple toe syndrome, teratogenic
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Side effects - lepirudin
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bleeding, allergic reactions
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Side effects with short term use of heparin
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bleeding, HIT
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Side effect with long term use of heparin
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osteoporosis
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What will eating vitamin K containing foods do to the INR of a patient on warfarin
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Decrease INR
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Which of the following is teratogenic?
heparin or warfarin |
warfarin
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MOA - aspirin (as antiplatelet)
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irreversibly inhibits COX-1 in platelets
decreases TxA2 production |
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MOA - clopidogrel
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inhibits ADP induced platelet aggregation
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MOA - abciximab
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inhibits GPIIb/IIIa receptor to prevent platelet aggregation
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Where is PGI2 produced?
platelet or endothelial cell |
endothelial cell
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What does TxA2 do regarding bleeding/clot formation?
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promotes platelet aggregation
vasoconstricts |
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What is the final common pathway for platelet aggregation
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activation of the GPIIb/IIIa receptor (aka fibrinogen receptor)
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What is alteplase?
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recombinant t-PA
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Side effect - alteplase
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bleeding
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Side effects - streptokinase
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bleeding, allergic reactions, hypotension
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What immediate anticoagulant would you use for DVT?
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heparin
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Which of the following is the best treatment for secondary prevention of DVT?
enoxaparin, warfarin, lepirudin, aspirin, clopidogrel, alteplase |
warfarin
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Which of the following is the best treatment for secondary prevention of MI?
enoxaparin, warfarin, lepirudin, aspirin, abciximab, alteplase |
aspirin
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What would you use for a patient that presents with unstable angina (more than 1)?
heparin, warfarin, aspirin, streptokinase |
heparin, aspririn
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What would you use for a patient that is going to have an angioplasty (more than 1)?
heparin, warfarin, aspirin, clopidogrel, abciximab, streptokinase |
heparin, aspirin, clopidogrel, abciximab
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What antiplatelet would you use for a person who presents with an ischemic stroke?
heparin, warfarin, bivalirudin, aspirin, tenecteplase |
aspirin
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Does heparin break up a clot?
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No, it prevents expansion of the clot
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Should you use alteplase for a patient who has atrial fibrillation?
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No
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