Anticoagulant Fondaparinux (Arixtra®)
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Questions and Answers

What is the major difference between Dalteparin and Fondaparinux in terms of administration?

  • Dalteparin needs renal dose adjustment while Fondaparinux does not (correct)
  • Dalteparin crosses the placenta while Fondaparinux does not
  • Dalteparin is given SC every 12 hours while Fondaparinux is given SC once daily
  • Dalteparin is given SC once daily while Fondaparinux is given IV every 12 hours

Which medication is used for the treatment and prophylaxis of deep vein thrombosis as well as in patients with heparin-induced thrombocytopenia (off label)?

  • Enoxaparin
  • Fondaparinux (correct)
  • Rivaroxaban
  • Bivalirudin

Which novel oral anticoagulant (NOAC) is a direct thrombin inhibitor?

  • Rivaroxaban
  • Edoxaban
  • Dabigatran (correct)
  • Apixaban

What is the mechanism of action of heparin (UFH)?

<p>Binds to plasma proteins to accelerate Anti-thrombin (ATIII) action (C)</p> Signup and view all the answers

What is the primary method of action of Argatroban?

<p>Is a direct thrombin inhibitor (D)</p> Signup and view all the answers

Why is intramuscular (IM) administration of heparin (UFH) not recommended?

<p>Risk of causing hematoma formation (A)</p> Signup and view all the answers

Which medication has dosing adjustments based on age, weight, and renal function for stroke prevention in nonvalvular atrial fibrillation?

<p>Apixaban (B)</p> Signup and view all the answers

Which of the following coagulation factors is NOT inhibited by heparin (UFH)?

<p>Factor V (D)</p> Signup and view all the answers

Why is IV infusion of heparin (UFH) preferred over subcutaneous injection for certain situations?

<p>IV infusion allows for a quick onset and quick off effect (C)</p> Signup and view all the answers

What is an example of SC dosing frequency for heparin (UFH) used for prophylaxis of DVT and PE?

<p>5000 units SC every 8-12 hours (B)</p> Signup and view all the answers

What is the end result of the Coagulation Cascade?

<p>Conversion of fibrinogen to fibrin by thrombin (D)</p> Signup and view all the answers

Which of the following statements about indirect thrombin inhibitors is true?

<p>Includes unfractionated heparin (UFH) as a prototype (B)</p> Signup and view all the answers

What is the general source of unfractionated heparin (UFH)?

<p>Porcine/bovine intestinal mucosa (B)</p> Signup and view all the answers

Why is unfractionated heparin (UFH) considered too large to be absorbed?

<p>Its large molecular size (B)</p> Signup and view all the answers

What is the main role of heparin (UFH) in pregnancy?

<p>Can be used safely due to its large molecule size (B)</p> Signup and view all the answers

What is the specific activity of Fondaparinux (Arixtra®) in terms of increasing the neutralizing action of ATIII on activated Factor X?

<p>300-fold (D)</p> Signup and view all the answers

Which direct thrombin inhibitor was discontinued in 2012 due to anaphylactic reactions?

<p>Lepirudin (A)</p> Signup and view all the answers

Which direct thrombin inhibitor has the longest half-life of 25 minutes?

<p>Bivalirudin (C)</p> Signup and view all the answers

Which novel oral anticoagulant (NOAC) has a reversal agent called Praxbind (idarucizumab)?

<p>Dabigatran (A)</p> Signup and view all the answers

Which direct factor Xa inhibitor is indicated for preventing stroke in nonvalvular atrial fibrillation?

<p>Apixaban (D)</p> Signup and view all the answers

Which NOAC does not require routine anticoagulation tests?

<p>Apixaban (A)</p> Signup and view all the answers

Which direct factor Xa inhibitor requires dose reduction with strong inhibitors of both CYP p450 3A4 and P-gp?

<p>Rivaroxaban (A)</p> Signup and view all the answers

Which NOAC is recommended at a dose of 2.5 mg twice daily for DVT/PE prevention post hip or knee replacement?

<p>Apixaban (C)</p> Signup and view all the answers

Which NOAC is contraindicated with prosthetic heart valves and severe liver impairment?

<p>Apixaban (B)</p> Signup and view all the answers

Which NOAC has a dosing regimen that includes 10 mg twice daily for the first week followed by 5 mg twice daily for DVT/PE treatment?

<p>Apixaban (D)</p> Signup and view all the answers

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