ANTICOAGULANTS AND ANTIPLATELETS -- PHARM
EXAM 2| TOP SCORES MADE SIMPLE | TRUSTED TEST
SOLUTIONS!
anticoagulants - enteral drugs Answer: warfarin, dabigatran, apixaban, rivaroxaban,
edoxaban, betrixaban
anticoagulants - parenteral drugs Answer: heparin, low molecular weight heparins,
fondaparinux, argatroban, bivalirudin, desirudin
enteral vs parenteral Answer: enteral - by mouth
parenteral - anything not by mouth (IM, SQ, IV)
heparin MOA Answer: potentiates the action of antithrombin III, which inactivates
thrombin and prevents the conversion of fibrinogen to fibrin
heparin contraindications Answer: HIT (heparin induced thrombocytopenia)
heparin SE Answer: bleeding, bruising, allergic reactions, osteoporosis
we are preventing clots so bleeding and bruising SE
heparin concerns Answer: DO NOT have to dose adjust in renal impairment
LMWHs drugs Answer: enoxaparin (lovenox), dalteparin (fragmin), tinzaparin (innohep)
LMWH drug MOA Answer: inhibitor of factor Xa
LMWH contraindications Answer: HIT
LMWH concerns Answer: dose adjust in renal impairment
SQ injections --> we don't want to inject the same spot, alternate due to bleeding and
bruising
LMWH side effects Answer: bleeding, bruising
unfractionated heparin vs LMWH Answer: unfractionated heparin is larger and
accelerates interaction of antithrombin with both thrombin and factor Xa
LMWH selectively accelerates interaction of antithrombin with factor Xa
heparin and LMWH uses Answer: treatment in DVT and PE
prophylaxis of post-op DVT
1
APPHIA - Crafted with Care and Precision for Academic Excellence.
, prophylaxis of thromboembolism post-MI
anticoagulant of choice during pregnancy
Fondaparinux (Arixtra) MOA Answer: antithrombin III-mediated selective inhibition of
factor Xa
Fondaparinux (Arixtra) contraindications Answer: severe renal impairment, HIT, body
weight <50 kg when used for prophylaxis
Fondaparinux (Arixtra) SE Answer: bleeding, bruising, anemia, dizziness
Fondaparinux (Arixtra) uses Answer: treatment of DVT and PE and prophylaxis post-
surgery
heparin induced thrombocytopenia (HIT) definition, management Answer: an immune-
mediated reaction that causes a decrease in platelets and an increased risk for
embolism
if a patient develops HIT, they must be taken off of heparin or LWMH
a direct thrombin inhibitor may be used for anticoagulation
parenteral direct thrombin inhibitors Answer: argatroban (IV)
bivalirudin (IV)
desirudin (SQ)
used for anticoagulation after HIT and during PCI (percutaneous coronary intervention)
argatroban MOA Answer: direct thrombin inhibitor
argatroban SE Answer: bleeding, bruising, hypotension, fever, dyspnea, n, d
argatroban concerns Answer: caution when using in those with hepatic impairment
IV
bivalirudin MOA Answer: direct thrombin inhibitor
bivalirudin SE Answer: bleeding, bruising, hypotension, pain, headache, nausea
bivalirudin concerns Answer: dose adjust in renal impairment
IV
desirudin MOA Answer: direct thrombin inhibitor
desirudin SE Answer: bleeding, bruising, injection site reactions
desirudin concerns Answer: dose adjust in renal impairment (Compare to bivalirudin)
2
APPHIA - Crafted with Care and Precision for Academic Excellence.
EXAM 2| TOP SCORES MADE SIMPLE | TRUSTED TEST
SOLUTIONS!
anticoagulants - enteral drugs Answer: warfarin, dabigatran, apixaban, rivaroxaban,
edoxaban, betrixaban
anticoagulants - parenteral drugs Answer: heparin, low molecular weight heparins,
fondaparinux, argatroban, bivalirudin, desirudin
enteral vs parenteral Answer: enteral - by mouth
parenteral - anything not by mouth (IM, SQ, IV)
heparin MOA Answer: potentiates the action of antithrombin III, which inactivates
thrombin and prevents the conversion of fibrinogen to fibrin
heparin contraindications Answer: HIT (heparin induced thrombocytopenia)
heparin SE Answer: bleeding, bruising, allergic reactions, osteoporosis
we are preventing clots so bleeding and bruising SE
heparin concerns Answer: DO NOT have to dose adjust in renal impairment
LMWHs drugs Answer: enoxaparin (lovenox), dalteparin (fragmin), tinzaparin (innohep)
LMWH drug MOA Answer: inhibitor of factor Xa
LMWH contraindications Answer: HIT
LMWH concerns Answer: dose adjust in renal impairment
SQ injections --> we don't want to inject the same spot, alternate due to bleeding and
bruising
LMWH side effects Answer: bleeding, bruising
unfractionated heparin vs LMWH Answer: unfractionated heparin is larger and
accelerates interaction of antithrombin with both thrombin and factor Xa
LMWH selectively accelerates interaction of antithrombin with factor Xa
heparin and LMWH uses Answer: treatment in DVT and PE
prophylaxis of post-op DVT
1
APPHIA - Crafted with Care and Precision for Academic Excellence.
, prophylaxis of thromboembolism post-MI
anticoagulant of choice during pregnancy
Fondaparinux (Arixtra) MOA Answer: antithrombin III-mediated selective inhibition of
factor Xa
Fondaparinux (Arixtra) contraindications Answer: severe renal impairment, HIT, body
weight <50 kg when used for prophylaxis
Fondaparinux (Arixtra) SE Answer: bleeding, bruising, anemia, dizziness
Fondaparinux (Arixtra) uses Answer: treatment of DVT and PE and prophylaxis post-
surgery
heparin induced thrombocytopenia (HIT) definition, management Answer: an immune-
mediated reaction that causes a decrease in platelets and an increased risk for
embolism
if a patient develops HIT, they must be taken off of heparin or LWMH
a direct thrombin inhibitor may be used for anticoagulation
parenteral direct thrombin inhibitors Answer: argatroban (IV)
bivalirudin (IV)
desirudin (SQ)
used for anticoagulation after HIT and during PCI (percutaneous coronary intervention)
argatroban MOA Answer: direct thrombin inhibitor
argatroban SE Answer: bleeding, bruising, hypotension, fever, dyspnea, n, d
argatroban concerns Answer: caution when using in those with hepatic impairment
IV
bivalirudin MOA Answer: direct thrombin inhibitor
bivalirudin SE Answer: bleeding, bruising, hypotension, pain, headache, nausea
bivalirudin concerns Answer: dose adjust in renal impairment
IV
desirudin MOA Answer: direct thrombin inhibitor
desirudin SE Answer: bleeding, bruising, injection site reactions
desirudin concerns Answer: dose adjust in renal impairment (Compare to bivalirudin)
2
APPHIA - Crafted with Care and Precision for Academic Excellence.
