Notes in anticoagulants

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Status	Last Update	Fields
Published	09/08/2024	Antiplatelets are:{{c1::Thienopyridinenon-Thienopyridineaspirin (ASA)}}
Published	09/08/2024	Direct Oral Anticoagulants (DOACs) are: {{c1::Direct Thrombin Inhibitorfactor Xa Inhibitor}}
Published	09/08/2024	{{c2::heparin and Enoxaparin and Fondaparinux}} are {{c1::Parenteral Anticoagulants}}
Published	09/08/2024	{{c3::Direct Thrombin Inhibitors}} (IV) are: {{c2::Argatroban}}and{{c1::Bivalirudin}}
Published	09/08/2024	Vitamin K Antagonist is an {{c1::Oral Anticoagulants}}
Published	09/08/2024	Vitamin K Antagonists are :{{c1::Warfarin (PO)Coumadin}}
Published	09/08/2024	Antiplatelets available {{c1::Intravenous}} are:Eptifibatide CangrelorTirofiban
Published	09/08/2024	{{c2::Intrinsic}} pathway (PTT): initiated by exposed endothelium, negative charge sets off cascade (TENET)
Published	09/08/2024	{{c1::Extrinsic}} pathway (PT): initiated by tissue factor, via vascular injury or trauma
Published	09/08/2024	All anticoagulants have a main adverse reaction of {{c1::bleeding}}
Published	09/08/2024	Antithrombotic considerations: afib requires {{c1::stroke}} prevention if 1+ non-sex CHADSVASC point
Published	09/08/2024	Heparins are {{c1::porcine}} derivatives
Published	09/08/2024	Heparins needs {{c1::antithrombin II}}I to work (while direct thrombin inhibitors do not)
Published	09/08/2024	Heparins to antithrombin III potentiate its inhibitory effects on factor {{c1::Xa}} and {{c1::IIa}} to prevent conversion of …
Published	09/08/2024	{{c1::Antithrombin III}} is a native anticoagulant that slowly binds to {{c2::thrombin}} & others
Published	09/08/2024	{{c1::Enoxaparin }}(SQ) Lovenox is a Low Molecular Weight Heparin (LMWH)
Published	09/08/2024	{{c1::Fondaparinux }}(SQ) is a Synthetic LMWH
Published	09/08/2024	indications for {{c1::heparin}}:VTE (DVT or PE), ACS, AF: full-dose anticoagulation administered IV +/- bolus if emergent eventVTE prophylaxis: SQPare…
Published	09/08/2024	indications for {{c1::fondaparinux}}:VTE, AF: full dose anticoagulation administered SQVTE prophylaxis: SQ*HIT tx in stable pt (on the floor, no acute…
Published	09/08/2024	indications for {{c1::enoxaparin}}:VTE (DVT or PE), ACS, AF: full dose anticoagulation, administered SQVTE prophylaxis: SQ (smaller dose than full)Bri…
Published	09/08/2024	Monitoring really only needed for {{c1::IV}} heparin which would be a {{c2::PTT}} and {{c3::anti-Xa assay }}
Published	09/08/2024	Half life 60-90 minutes →so {{c1::heparin}} is ideal agent for {{c2::unstable/high }} risk patient or patient with {{c3::unpl…
Published	09/08/2024	{{c1::Fondaparinux}} is preferred SQ agent for treatment of HIT in stable patient
Published	09/08/2024	Enoxaparin and Fondaparinux are Contraindicated if {{c1::CrCl < 30}} (renally cleared)
Published	09/08/2024	side effects of {{c1::heparin}}:  induced thrombocytopenia (HIT)Bleeding: think about pt stability, organ function, and time since last dose…
Published	09/08/2024	HIT treatment: Immediately stop heparin products and use {{c1::direct thrombin inhibitors}} to address their anticoagulation needs (argatroban or…
Published	09/08/2024	Bivalirudin and Argatroban directly inhibits {{c1::thrombin}} activity (independent of {{c2::antithrombin III}})Does not need antithrombin III to…
Published	09/08/2024	{{c2::Argatroban}} and {{c1::Bivalirudin}} are Drug of choice for unstable, acute {{c3::HIT}} (shorter half life than fo…
Published	09/08/2024	monitor {{c1::aPTT}} in direct thrombin inhibitors
Published	09/08/2024	Argatroban is {{c1::hepatically}} cleared while bivalirudin is {{c1::renally}} cleared
Published	09/08/2024	NO direct {{c1::reversal}} agent for either direct thrombin inhibitors
Published	09/08/2024	Argatroban is a better option for {{c1::renal}} dysfunciton
Published	09/08/2024	{{c1::Direct Thrombin Inhibitors}} (IV) are Used in the setting of {{c2::HIT}} (especially acute patients)
Published	09/08/2024	{{c1::Oral Anticoagulants}} are Most commonly indicated for {{c2::stroke}} prophylaxis in Afib (loss of atrial kick → blood pools in th…
Published	09/08/2024	Vitamin K Antagonist Warfarin (PO), Coumadin:Inhibits {{c1::VKOR}} complex which depletes functional vitamin K reserves
Published	09/08/2024	{{c1::vitamin k antagonist}}s are indicated for VTE (DVT or PE), AFib, mechanical valves: full dose anticoagulation
Published	09/08/2024	mechanical heart valves MUST receive {{c1::warfarin}} (+ {{c2::aspirin 81mg}})
Published	09/08/2024	monitor {{c1::INR}} for vitamin k antagonists
Published	09/08/2024	{{c1::vitamin k anatagonists}} have the longest clotting factor half life is 42-72 h
Published	09/08/2024	warfarin will take {{c1::3-5 days}} to see full effect
Published	09/08/2024	warfarin will take 3-5 days to see full effect (only shuts down factory, does not impact existing clotting factors) → need bridge! Bridge with&nb…
Published	09/08/2024	{{c1::vitamin k antagonists}} have Drug interactions: antibiotics, antipsychotics, antiarrhythmics
Published	09/08/2024	side effects of vitamin k antagonists:{{c1::Reversal}}if acute bleeding:↑ INR = higher bleed riskIV vit K (onset 4-6 h), SQ not recommendedPO vit K (o…
Published	09/08/2024	(DOAC) {{c1::Direct Thrombin Inhibitor}} ( Dabigatran (PO), Pradaxa) {{c3::competitively}} and {{c2::reversibly}} blocks the activ…
Published	09/08/2024	{{c1::Factor Xa Inhibitor }} Competitively and reversibly blocks the active site of free and clot-bound factor X
Published	09/08/2024	{{c1::direct thrombin inhibtors}} are for PO anticoagulant for stroke prevention with nonvalvular Afib (no mechanical valve) and VTE (DVT or PE)
Published	09/08/2024	{{c1::Apixaban}} is indicated for:Nonvalvular AfibAcute VTE treatmentVTE prophylaxis (hip / knee)*only DOAC that is FDA approved for renal dysfun…
Published	09/08/2024	{{c1::Edoxaban}} indications: Nonvalvular AfibAcute VTE treatmentVTE prophylaxis (hip / knee)
Published	09/08/2024	{{c1::Rivaroxaban}} indications:Nonvalvular AfibAcute VTE treatment
Published	09/08/2024	factor Xa inhibitors end in {{c1::-xoban}}
Published	09/08/2024	{{c1::no routine}} monitoring for DOACs
Published	09/08/2024	Direct Thrombin Inhibitor need to be dose adjusted for {{c1::renal }}
Published	09/08/2024	{{c1::dabigatran (direct thrombin inhibitor) }}*Has similar bleed risk to warfarin and is more expensive. DON’T USE THIS!Reversal agent if bleedi…
Published	09/08/2024	with {{c1::factor Xa inhibtors}}, bleeding is less common and associated with less morbidity and mortality as compared to warfarin (better drugs …
Published	09/08/2024	Dosing aspirin above {{c1::81}}mg = no increase in cardio benefit but increased risk of {{c2::GI bleed}} because of COX-1 inhibition (a…
Published	09/08/2024	{{c1::ticagrelor}} proven mortality benefit in ACS compared to clopidogrel but may be cost prohibitive, more expensive than Clopidogrel
Published	09/08/2024	antiplatelets have no routine monitoring but may consider {{c1::CBC}}
Published	09/08/2024	Clopidogrel or prasugrel platelet transfusions can restore platelet function only {{c1::4-6}} hours after the last drug intake
Published	09/08/2024	{{c1::Cangrelor}} useful for bridging ACS to cardiac surgery
Published	09/08/2024	{{c1::Eptifibatide}} and {{c2::tirofiban}} are used at discretion of cardiology in ACS cath lab setting
Published	09/08/2024	Eptifibatide and tirofiban are {{c1::GP IIb/IIIa inhibitor}}
Published	09/08/2024	{{c1::Tirofiban}} and {{c1::Eptifibatide}} are Potent antiplatelet agents that dramatically increase risk of {{c3::bleeding}}
Status	Last Update	Fields