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anticoagulant

clinical med quiz

QuestionAnswer
inhibits synthesis of vitamin K dependent clotting factors by the liver that stimulate prothrombin production coumadin
activates antithrombin which indirectly blocks thrombin -made from pig or bovine mucosa heparin
thrombin inhibitor, processed heparin, chemically consistent lovenox
INDIRECTLY inhibits factor Xa arixtra
DIRECTLY inhibit factor Xa xarelto
direct thrombin inhibitor pradaxa
prevent platelets from clumping together to form a clot by various mechanisms antiplatelets
inhibits an enzyme that causes platelet clumping aspirin (NSAIDS)
inhibits two enzymes that cause platelets to clump aggrenox
used only in the hospital as part of combination therapy for acute coronary disease monoclonal antibodies / glycoprotein inhibitors: ReoPro, Integrilin, Aggrastat
block ADP receptors on the platelet surface to prevent clumping Thienopyridines: ticlid, plavix, effient
can cause coagulation disorders Thienopyridines: ticlid, plavix, effient
plavix effect can be reduced by PPI's Thienopyridines: ticlid, plavix, effient
dont dissolve clots dont thin blood anticoagulants
work by interfering with the bodys ability to clot by reducing the activity of certain proteins (clotting factors) anticoagulants
given to prevent clotting or treat existing clots by stabilizing them & preventing embolisms anticoagulants
monitor PT & INR coumadin
takes 96+ hrs for onset of action coumadin
therapeutic ranges: 2-3 for most 2.5 -3.5 for higher risk (valves, MI) coumadin
if > 4.0 high bleeding risk & no more therapeutic benefit coumadin
given orally coumadin & xarelto
reversed by vitamin K or fresh frozen plasma coumadin
unpredictable blood levels & highly individual response heparin
requires frequent monitoring of aPTT heparin
risk of HIT when body form antibodies against, check platelets heparin
given IV or SQ heparin
reversed by protamine heparin
MORE predictable plasma levels & therapeutic response lovenox
longer half-life so can be given daily or BID lovenox
monitoring PTTs is not needed or accurate lovenox
given SQ lovenox & arixtra & heparin
partially reversed by protamine lovenox
predictable plasma levels & therapeutic response arixtra & xarelto
do not require lab monitoring arixtra & xarelto & lovenox
monitor platelets arixtra & heparin
no antidote, may need dialysis arixtra & pradaxa
has to be taken twice daily pradaxa
no lab monitoring possible pradaxa
dangerous due to no reversal agent & delayed recovery of normal clotting, wait it out pradaxa
Created by: pgrams19