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What is the mechanism of action of direct thrombin inhibitors?
What is the indication for Dabigatran?
What is the antidote for Dabigatran?
What is the common side effect of Dabigatran?
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What is Argatroban indicated for?
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What is the route of administration for Argatroban?
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What is the serious side effect of Argatroban?
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What is Bivalirudin used for?
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What is the advantage of Bivalirudin?
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What is a contraindication for Dabigatran?
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What is the warning for Dabigatran?
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What is a common side effect of Heparin therapy?
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What is the mechanism of action of Low Molecular Weight Heparins?
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What is the antidote for Heparin overdose?
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What is a contraindication for Heparin therapy?
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What is a role of Antithrombin in Heparin therapy?
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What is a key consideration in managing the risk of bleeding during Heparin therapy?
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What is the mechanism of action of Unfractioned Heparin?
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What is the recommended dosage adjustment for Apixaban in patients who are 80 years or older and weigh 60 kg or less?
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What is the antidote for Apixaban?
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What is the most common side effect of Eptifibatide?
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What is the indication for Rivaroxaban in CAD/PAD?
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What should be avoided when taking Apixaban?
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What is the mechanism of action of Glycoprotein IIb/IIIa Inhibitors?
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What is the indication for Eptifibatide?
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What is the serious side effect of Rivaroxaban?
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What is the alternative IV agent to Eptifibatide?
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What is a common side effect of Dabigatran?
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What is a contraindication for Argatroban?
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What is Bivalirudin used for?
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What is the antidote for Dabigatran overdose?
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What is the route of administration for Dabigatran?
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What is a side effect of Argatroban?
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What is a contraindication for Bivalirudin?
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What is the mechanism of action of direct thrombin inhibitors?
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What is a warning for Dabigatran?
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What is a characteristic of Dabigatran capsules?
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What is the mechanism of action of P2Y12 inhibitors?
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Which platelet aggregation inhibitor is not recommended in patients 75 years and older unless high risk?
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What is the common side effect of Ticagrelor?
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What is the effect of Aspirin doses greater than 100 on Ticagrelor?
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When should Clopidogrel be stopped before elective surgery?
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What is the interaction between grapefruit juice and CYP2C19 inhibitors?
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What is the indication for Prasugrel?
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What is the serious side effect of Prasugrel?
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When should Ticagrelor be stopped before elective surgery?
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What is the mechanism of action of Fibrinolytics?
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What is the consequence of premature discontinuation of Apixaban in patients with Nonvalvular A-Fib?
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Which of the following is a contraindication for Eptifibatide?
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What is the mechanism of action of Rivaroxaban?
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What is the indication for Rivaroxaban in Nonvalvular A-Fib?
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What is the antidote for Apixaban overdose?
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What is the consequence of taking grapefruit juice with Apixaban?
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What is the mechanism of action of Unfractioned Heparin?
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What is the indication for Eptifibatide?
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What is the common side effect of Eptifibatide?
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What is the alternative IV agent to Eptifibatide?
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What is the indication for Apixaban in Nonvalvular A-Fib patients?
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What is the antidote for Rivaroxaban overdose?
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What is the mechanism of action of Glycoprotein IIb/IIIa Inhibitors?
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What is the consequence of premature discontinuation of Apixaban in patients with Nonvalvular A-Fib?
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What is the recommended dosage adjustment for Apixaban in patients who are 80 years or older and weigh 60 kg or less?
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What is the indication for Eptifibatide?
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What is the serious side effect of Rivaroxaban?
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What is the alternative IV agent to Eptifibatide?
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What should be avoided when taking Apixaban?
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What is the mechanism of action of Unfractioned Heparin?
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Which platelet aggregation inhibitor is not recommended in patients 75 years and older unless high risk?
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What is the effect of Aspirin doses greater than 100 on Ticagrelor?
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When should Clopidogrel be stopped before elective surgery?
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What is the interaction between grapefruit juice and CYP2C19 inhibitors?
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What is the indication for Prasugrel?
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What is the serious side effect of Prasugrel?
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When should Ticagrelor be stopped before elective surgery?
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What is the mechanism of action of Fibrinolytics?
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What is the consequence of premature discontinuation of Apixaban in patients with Nonvalvular A-Fib?
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Which of the following is a contraindication for Eptifibatide?
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Which of the following direct thrombin inhibitors is used for thromboprophylaxis?
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What is the indication for Dabigatran in patients with non-valvular atrial fibrillation?
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What is the consequence of premature discontinuation of Dabigatran in patients with non-valvular atrial fibrillation?
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Which of the following is a boxed warning for Dabigatran?
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What is the antidote for Dabigatran overdose?
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Which of the following direct thrombin inhibitors is safe to use in patients with heparin-induced thrombocytopenia (HIT)?
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What is the route of administration for Argatroban?
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What is the common side effect of Argatroban?
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Which of the following is a contraindication for Argatroban?
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What is the effect of Dabigatran on international normalized ratio (INR)?
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What is the dose adjustment for Apixaban in patients who are 80 years or older and weigh 60 kg or less?
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What is the indication for Rivaroxaban in Cardiovascular Disease?
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What is the antidote for Apixaban overdose?
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What is the mechanism of action of Glycoprotein IIb/IIIa Inhibitors?
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What is the common side effect of Eptifibatide?
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What is the consequence of premature discontinuation of Apixaban in patients with Nonvalvular A-Fib?
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What is the alternative IV agent to Eptifibatide?
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What should be avoided when taking Apixaban?
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What is the mechanism of action of Unfractioned Heparin?
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What is the indication for Rivaroxaban in Nonvalvular A-Fib?
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What is the mechanism of action of P2Y12 inhibitors on platelets?
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Which platelet aggregation inhibitor is not recommended in patients 75 years and older unless high risk?
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What is the effect of Aspirin doses greater than 100 on Ticagrelor?
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When should Clopidogrel be stopped before elective surgery?
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What is the interaction between grapefruit juice and CYP2C19 inhibitors?
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What is the indication for Prasugrel?
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What is the serious side effect of Prasugrel?
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When should Ticagrelor be stopped before elective surgery?
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What is the mechanism of action of Fibrinolytics?
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What is the common side effect of Ticagrelor?
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Which direct thrombin inhibitor is indicated for stroke risk reduction in nonvalvular atrial fibrillation?
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What is the consequence of premature discontinuation of Dabigatran in patients with nonvalvular atrial fibrillation?
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Which antidote is used to reverse the effects of Dabigatran?
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Which platelet aggregation inhibitor is not recommended in patients 75 years and older unless at high risk?
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What is the advantage of Bivalirudin in patients with heparin-induced thrombocytopenia (HIT)?
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What is the characteristic of Dabigatran capsules that should be noted?
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What is the effect of Aspirin doses greater than 100 on Ticagrelor?
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When should Clopidogrel be stopped before elective surgery?
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What is the common side effect of Ticagrelor?
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What is the mechanism of action of Fibrinolytics?
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What is the effect on Ticagrelor's effectiveness when Aspirin doses are greater than 100?
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Which P2Y12 inhibitor is not recommended in patients 75 years and older unless high risk?
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When should Ticagrelor be stopped before elective surgery?
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What is the mechanism of action of Fibrinolytics?
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What is a characteristic of P2Y12 inhibitors?
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What is the interaction between grapefruit juice and CYP2C19 inhibitors?
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When should Clopidogrel be stopped before elective surgery?
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What is the indication for Prasugrel?
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What is the serious side effect of Prasugrel?
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What is the mechanism of action of P2Y12 inhibitors?
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Which of the following direct thrombin inhibitors is used for PCI-thrombosis and has a benefit in patients with a risk of HIT?
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What is a common side effect of Dabigatran that is related to the gastrointestinal system?
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Which of the following anticoagulants has a specific reversal agent?
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What is the route of administration for Argatroban?
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Which of the following direct thrombin inhibitors is used for stroke prevention in patients with nonvalvular atrial fibrillation?
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What is a contraindication for Dabigatran?
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Which of the following direct thrombin inhibitors has a higher risk of bleeding?
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What is the advantage of using Bivalirudin in patients with a risk of HIT?
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Which of the following direct thrombin inhibitors can be used for thromboprophylaxis?
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What is the warning for Dabigatran?
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What is the recommended dosage adjustment for Apixaban in patients who are 80 years or older and weigh 60 kg or less?
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What is the mechanism of action of Glycoprotein IIb/IIIa Inhibitors?
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What is the consequence of premature discontinuation of Apixaban in patients with Nonvalvular A-Fib?
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What is the antidote for Rivaroxaban overdose?
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What is the indication for Rivaroxaban in CAD/PAD?
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What is the common side effect of Eptifibatide?
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What is the mechanism of action of Unfractioned Heparin?
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What is the alternative IV agent to Eptifibatide?
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What is the serious side effect of Rivaroxaban?
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What should be avoided when taking Apixaban?
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Study Notes
Heparin
- Prevents conversion of fibrinogen to fibrin
- Uses: VTE prophylaxis, treatment of VTE, and ACS
- Contraindications: History of uncontrolled active bleeding, severe thrombocytopenia
- Side effects: Bleeding risk, thrombocytopenia, increased LFT's
- Antidote: Protamine
Low Molecular Weight Heparin
- Binds to AT, inhibiting Factor Xa more than Factor IIa
- Side effects: Vfib, retroperitoneal/intracranial bleeding
Factor Xa Inhibitors
- Reversible and selective inhibitor of Factor Xa, decreasing thrombin generation and thrombus formation
- Examples: Apixaban (Eliquis) and Rivaroxaban (Xarelto)
- Indications: DVT/PE treatment and prevention, nonvalvular atrial fibrillation (reduce stroke risk)
- Side effects: Bleeding risk, GI bleeding, hemorrhage, increased LFT's
- Antidotes: Andexanet alfa (Andexxa) and Prothrombin complex concentrate (Kcentra)
Glycoprotein IIb/IIIa Inhibitor
- Inhibits platelet aggregation by binding to GPIIb/IIIa and preventing fibrinogen
- Example: Eptifibatide (Integrilin)
- Indications: Percutaneous coronary intervention, adjunct to PCI
- Contraindications: CVA within 30 days, active abnormal bleeding, surgery/trauma within 6 weeks
- Side effects: Bleeding risk, thrombocytopenia, anaphylaxis, CVA, intercranial hemorrhage
Direct Thrombin Inhibitors
- Directly inhibits thrombin (Factor IIa), binding to the active thrombin site of free and clot-associated thrombin
- Examples: Dabigatran (Pradaxa) and Argatroban
- Indications: DVT/PE treatment and prevention, nonvalvular atrial fibrillation (reduce stroke risk), thromboprophylaxis, HIT, PCI-thrombosis
- Side effects: Bleeding risk, dyspepsia, gastritis-like symptoms, anemia, hypotension, chest pain
- Antidotes: Idarucizumab (Praxbind) for dabigatran, no specific antidote for argatroban
Factor Xa Inhibitors
- Reversible and selective active site inhibitor of Factor Xa, resulting in decreased thrombin generation and thrombus formation.
- Apixaban (Eliquis) is used for DVT/PE treatment and prevention, and nonvalvular A-Fib stroke risk reduction.
- Dose reduction to 2.5mg BID for patients 80 years or older, weighing 60 kg or less, and having a SCr of 1.5 or more.
- Andexanet alfa (Andexxa) and Prothrombin complex concentrate (Kcentra) are antidotes.
- Avoid grapefruit juice and CYP3A4 inhibitors.
Glycoprotein IIb/IIIa Inhibitor
- Inhibits platelet aggregation by specifically binding to GPIIb/IIIa and preventing fibrinogen.
- Eptifibatide (Integrilin) is used for percutaneous coronary intervention, adjunct to PCI, and acute coronary syndrome.
- Contraindications include CVA within 30 days, active abnormal bleeding, and severe hypertension.
Unfractionated Heparin
- Binds to antithrombin (AT), which then inactivates thrombin (Factor IIa) and Factor Xa.
- Used for OA, RA, and other conditions.
P2Y12 Inhibitors
- Irreversibly inhibit P2Y12 (On ADP Receptors) on platelets, resulting in inhibition of platelet activation and aggregation.
- Clopidogrel (Plavix) is used for ACS, stroke, and established PAD.
- Contraindications include active bleeding, history of stroke or TIA.
- Prasugrel (Effient) is used for ACS patients managed with PCI, and has fatal bleeding as a boxed warning.
- Ticagrelor (Brilinta) is used for ACS and has fatal bleeding, aspirin doses greater than 100, and severe hepatic impairment as contraindications.
Fibrinolytics
- Breaks down clots by binding to fibrin in a thrombus and converting plasminogen to plasmin.
- 2nd Generation, due to clot-specific binding.
Direct Thrombin Inhibitors
- Directly inhibits thrombin (Factor IIa) by binding to the active thrombin site of free and clot-associated thrombin.
- Dabigatran (Pradaxa) is used for DVT/PE treatment and prevention, nonvalvular A-Fib stroke risk reduction, and thromboprophylaxis.
- Contraindications include premature discontinuation, spinal/epidural hematoma, and active bleeding.
- Idarucizumab (Praxbind) is an antidote.
- Argatroban is used for HIT, PCI - thrombosis and has active major bleeding as a contraindication.
- Bivalirudin (Angiomax) is used for PCI - thrombosis and has active major bleeding as a contraindication.
Factor Xa Inhibitors
- Reversible and selective active site inhibitor of Factor Xa, resulting in decreased thrombin generation and thrombus formation.
- Apixaban (Eliquis) is used for DVT/PE treatment and prevention, and nonvalvular A-Fib stroke risk reduction.
- Dose reduction to 2.5mg BID for patients 80 years or older, weighing 60 kg or less, and having a SCr of 1.5 or more.
- Andexanet alfa (Andexxa) and Prothrombin complex concentrate (Kcentra) are antidotes.
- Avoid grapefruit juice and CYP3A4 inhibitors.
Glycoprotein IIb/IIIa Inhibitor
- Inhibits platelet aggregation by specifically binding to GPIIb/IIIa and preventing fibrinogen.
- Eptifibatide (Integrilin) is used for percutaneous coronary intervention, adjunct to PCI, and acute coronary syndrome.
- Contraindications include CVA within 30 days, active abnormal bleeding, and severe hypertension.
Unfractionated Heparin
- Binds to antithrombin (AT), which then inactivates thrombin (Factor IIa) and Factor Xa.
- Used for OA, RA, and other conditions.
P2Y12 Inhibitors
- Irreversibly inhibit P2Y12 (On ADP Receptors) on platelets, resulting in inhibition of platelet activation and aggregation.
- Clopidogrel (Plavix) is used for ACS, stroke, and established PAD.
- Contraindications include active bleeding, history of stroke or TIA.
- Prasugrel (Effient) is used for ACS patients managed with PCI, and has fatal bleeding as a boxed warning.
- Ticagrelor (Brilinta) is used for ACS and has fatal bleeding, aspirin doses greater than 100, and severe hepatic impairment as contraindications.
Fibrinolytics
- Breaks down clots by binding to fibrin in a thrombus and converting plasminogen to plasmin.
- 2nd Generation, due to clot-specific binding.
Direct Thrombin Inhibitors
- Directly inhibits thrombin (Factor IIa) by binding to the active thrombin site of free and clot-associated thrombin.
- Dabigatran (Pradaxa) is used for DVT/PE treatment and prevention, nonvalvular A-Fib stroke risk reduction, and thromboprophylaxis.
- Contraindications include premature discontinuation, spinal/epidural hematoma, and active bleeding.
- Idarucizumab (Praxbind) is an antidote.
- Argatroban is used for HIT, PCI - thrombosis and has active major bleeding as a contraindication.
- Bivalirudin (Angiomax) is used for PCI - thrombosis and has active major bleeding as a contraindication.
Factor Xa Inhibitors
- Reversible and selective active site inhibitor of Factor Xa, resulting in decreased thrombin generation and thrombus formation.
- Apixaban (Eliquis) is used for DVT/PE treatment and prevention, and nonvalvular A-Fib stroke risk reduction.
- Dose reduction to 2.5mg BID for patients 80 years or older, weighing 60 kg or less, and having a SCr of 1.5 or more.
- Andexanet alfa (Andexxa) and Prothrombin complex concentrate (Kcentra) are antidotes.
- Avoid grapefruit juice and CYP3A4 inhibitors.
Glycoprotein IIb/IIIa Inhibitor
- Inhibits platelet aggregation by specifically binding to GPIIb/IIIa and preventing fibrinogen.
- Eptifibatide (Integrilin) is used for percutaneous coronary intervention, adjunct to PCI, and acute coronary syndrome.
- Contraindications include CVA within 30 days, active abnormal bleeding, and severe hypertension.
Unfractionated Heparin
- Binds to antithrombin (AT), which then inactivates thrombin (Factor IIa) and Factor Xa.
- Used for OA, RA, and other conditions.
P2Y12 Inhibitors
- Irreversibly inhibit P2Y12 (On ADP Receptors) on platelets, resulting in inhibition of platelet activation and aggregation.
- Clopidogrel (Plavix) is used for ACS, stroke, and established PAD.
- Contraindications include active bleeding, history of stroke or TIA.
- Prasugrel (Effient) is used for ACS patients managed with PCI, and has fatal bleeding as a boxed warning.
- Ticagrelor (Brilinta) is used for ACS and has fatal bleeding, aspirin doses greater than 100, and severe hepatic impairment as contraindications.
Fibrinolytics
- Breaks down clots by binding to fibrin in a thrombus and converting plasminogen to plasmin.
- 2nd Generation, due to clot-specific binding.
Direct Thrombin Inhibitors
- Directly inhibits thrombin (Factor IIa) by binding to the active thrombin site of free and clot-associated thrombin.
- Dabigatran (Pradaxa) is used for DVT/PE treatment and prevention, nonvalvular A-Fib stroke risk reduction, and thromboprophylaxis.
- Contraindications include premature discontinuation, spinal/epidural hematoma, and active bleeding.
- Idarucizumab (Praxbind) is an antidote.
- Argatroban is used for HIT, PCI - thrombosis and has active major bleeding as a contraindication.
- Bivalirudin (Angiomax) is used for PCI - thrombosis and has active major bleeding as a contraindication.
Factor Xa Inhibitors
- Reversible and selective active site inhibitor of Factor Xa, resulting in decreased thrombin generation and thrombus formation.
- Apixaban (Eliquis) is used for DVT/PE treatment and prevention, and nonvalvular A-Fib stroke risk reduction.
- Dose reduction to 2.5mg BID for patients 80 years or older, weighing 60 kg or less, and having a SCr of 1.5 or more.
- Andexanet alfa (Andexxa) and Prothrombin complex concentrate (Kcentra) are antidotes.
- Avoid grapefruit juice and CYP3A4 inhibitors.
Glycoprotein IIb/IIIa Inhibitor
- Inhibits platelet aggregation by specifically binding to GPIIb/IIIa and preventing fibrinogen.
- Eptifibatide (Integrilin) is used for percutaneous coronary intervention, adjunct to PCI, and acute coronary syndrome.
- Contraindications include CVA within 30 days, active abnormal bleeding, and severe hypertension.
Unfractionated Heparin
- Binds to antithrombin (AT), which then inactivates thrombin (Factor IIa) and Factor Xa.
- Used for OA, RA, and other conditions.
P2Y12 Inhibitors
- Irreversibly inhibit P2Y12 (On ADP Receptors) on platelets, resulting in inhibition of platelet activation and aggregation.
- Clopidogrel (Plavix) is used for ACS, stroke, and established PAD.
- Contraindications include active bleeding, history of stroke or TIA.
- Prasugrel (Effient) is used for ACS patients managed with PCI, and has fatal bleeding as a boxed warning.
- Ticagrelor (Brilinta) is used for ACS and has fatal bleeding, aspirin doses greater than 100, and severe hepatic impairment as contraindications.
Fibrinolytics
- Breaks down clots by binding to fibrin in a thrombus and converting plasminogen to plasmin.
- 2nd Generation, due to clot-specific binding.
Direct Thrombin Inhibitors
- Directly inhibits thrombin (Factor IIa) by binding to the active thrombin site of free and clot-associated thrombin.
- Dabigatran (Pradaxa) is used for DVT/PE treatment and prevention, nonvalvular A-Fib stroke risk reduction, and thromboprophylaxis.
- Contraindications include premature discontinuation, spinal/epidural hematoma, and active bleeding.
- Idarucizumab (Praxbind) is an antidote.
- Argatroban is used for HIT, PCI - thrombosis and has active major bleeding as a contraindication.
- Bivalirudin (Angiomax) is used for PCI - thrombosis and has active major bleeding as a contraindication.
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Description
This quiz covers the treatment of Acute Coronary Syndrome (ACS) and Venous Thromboembolism (VTE), including prophylaxis and management of related complications such as thrombocytopenia and HIT.
