Question | Answer |
warfarin (Coumadin) | Oral Anticoagulants |
Vitamin K – “antidote for warfarin” | Oral Anticoagulants |
heparin | Parenteral Anticoagulants |
enoxaparin (Lovenox) | Parenteral Anticoagulants |
bivalirudin (Angiomax) | Parenteral Anticoagulants |
lepirduin (Refludan) | Parenteral Anticoagulants |
aspirin | Antiplatelet Drugs |
dipyridamole/aspirin (Aggrenox) | Antiplatelet Drugs |
clopidogrel (Plavix) | Antiplatelet Drugs |
(Aggrastat & Intergrilin) – for unstable angina and acute MI | Antiplatelet Drugs |
abciximab (ReoPro) – for angioplasty and stent placement | Antiplatelet Drugs |
Alteplase & Streptokinase – for PE, stroke, and acute MI | Fibrinolytics |
treat hemorrhage caused by coumarin anticoagulants | phytonadione |
what to monitor when using coumarin coagulants? | PT (prothrombin time) |
warfarin side effects | birth defects and bleeding |
PT goal of patient treated with warfarin | 1.3 to 1.5 x PT of the control |
INR goal of warfarin | normally 2 to 3, in pt with mechanical prosthtic heart valses and systemic embolization: INR = 3 to 4.5 |
drugs increase anticoagulant effect of warfarin | salicylates, cephalosporins |
drugs decrease anticoagulant effect of warfarin | refampin, barbiturates |
drug inhibit absorption of warfarin | cholestyramine |
drugs inhibit metabolism of warfarin and increase bleeding | amiodarone, cimetidine, erythromycin, fluconazole, gemfibrozil, isoniazid, metronidazole, sulfinpyrazone |
why do warfarin have many drug interactions? | b/c it is almost completely metabolized by CYP enzymes: CYP2C9, CYP1A2, CYP 2C19, Cyp 3A4 |
Warfain indications | deep vein thrombosis, atrial fibrillation, artificial heart valve,
used in combination with heparin for MI
Keep thrombus from extending, cannot dissolve |
what does dosage of warfarin depend on? | the patient's PT (prothrombi time) |
what to do when bleeding occur during administration of coumarin anticoagulant? | withheld the drug until Pt determined, reduction in drug dosage, administer phytonadione (vit K). if INR >20, use fresh frozen plasma or factor IX |
what causes HIT (heparin-induced thrombocytopenia) | heparin administration |
What causes HIT 1? | heparin-platelet interaction, leading to platelet aggregation, can continue using drugs |
What causes HIT 2? | immunoglobulin-mediated platelet inactivation, causing mortality and thrombotic complications, discontinued |
alteplase (Activase)
streptokinase
(fibrinolytic drugs)
indication | degrade thrombus in MI, stroke, PE (pulmonary embolism) |
alteplase (Activase)
streptokinase
adverse effects | hemorrhage |
abciximab indication | for angioplasty and stent placement |
abciximab adverse effect | bleeding |
tirofiban (Aggrastat) & eptifibatide (Integrilin)indications | acute coronary syndrome, adverse effect: bleeding |
dosage of heparin depends on | aPTT (activated partial thromboplastin time |
adequate level of heparin | aPTT = 1.5 to 2x normmal |
enoxaparin (Lovenox)indications | DVT, PE, thromboembolic disorders, CV surgeries, atrial fib, unstable angina |
heparin antidote | protamine sulfate |
spironolactone (Aldactone)classes | aldosterone antagonists
potassium sparing diuretic |
eplerenone (Inspra) | aldosterone antagonists
potassium sparing diuretic |
ethacrynic acid | loop diuretics |