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