16 Questions
What are the three stages involved in haemostasis?
Vascular spasm, platelet aggregation and plug formation, coagulation
What is the difference between a thrombus and an embolus?
A thrombus remains in the vessel, while an embolus travels to another location within the CV system
How does low dose aspirin inhibit platelet aggregation?
It irreversibly inhibits COX 1, reducing the production of TXA2 and thus platelet aggregation
What is the primary purpose of anticoagulation drugs?
To prevent venous thromboembolic events and treat conditions such as deep venous thrombosis
Which anticoagulant requires ongoing routine monitoring of INR?
Warfarin
What is the target INR range for warfarin?
2-3
Which anticoagulant is contraindicated for prosthetic heart valves?
Dabigatran
Which anticoagulant directly and reversibly inhibits activated factor X?
Apixaban
What is the sustained cardiac dysrhythmia characterized by very fast, disorganized electrical activity in the atria?
Atrial fibrillation
Which anticoagulant is recommended for valvular AF?
Warfarin
What are the symptoms of AF?
Tiredness, breathlessness, dizziness, and palpitations
What is the main effect of digoxin on the heart?
Positive inotropic effect
What is the purpose of using anticoagulants in non-valvular AF?
To prevent stroke and thromboembolism
What treatment options are available for AF?
Rhythm control with cardioversion and rate control with antiarrhythmic therapy
Which anticoagulant has fewer drug interactions than warfarin?
Dabigatran
Which anticoagulant competitively and reversibly inhibits thrombin?
Dabigatran
Study Notes
Anticoagulants and Atrial Fibrillation Treatment Summary
- Warfarin is a coumarin anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors and requires ongoing routine monitoring of INR.
- Warfarin has many drug interactions and the target INR range is 2-3. It should be taken consistently with a balanced vitamin K intake.
- Dabigatran is a direct oral anticoagulant (DOAC) that competitively and reversibly inhibits thrombin and does not require routine monitoring.
- Dabigatran has fewer drug interactions than warfarin and is contraindicated for prosthetic heart valves.
- Apixaban and rivaroxaban are also DOACs that directly and reversibly inhibit activated factor X and do not require routine monitoring.
- Atrial fibrillation (AF) is a sustained cardiac dysrhythmia characterized by very fast, disorganized electrical activity in the atria.
- AF can be asymptomatic but may cause symptoms such as tiredness, breathlessness, dizziness, and palpitations.
- AF increases the risk of thrombi formation in the atria, leading to ischemic stroke or TIA (transient ischemic attack).
- Treatment options for AF include rhythm control with cardioversion and rate control with antiarrhythmic therapy such as atenolol, digoxin, and verapamil.
- Digoxin produces a positive inotropic effect on the heart, reduces hospitalizations for heart failure, and is useful in controlling the ventricular rate in rate-controlled treatment of AF.
- Anticoagulants should be used to prevent stroke and thromboembolism in patients with non-valvular AF, while warfarin is recommended for valvular AF.
- Overall, the text provides detailed information about the mechanisms of action, monitoring, and treatment options for anticoagulants in the context of atrial fibrillation.
Test your knowledge of anticoagulants and treatment options for atrial fibrillation with this informative quiz. From warfarin to direct oral anticoagulants (DOACs) like dabigatran, apixaban, and rivaroxaban, to rhythm and rate control strategies, this quiz covers essential information for healthcare professionals and students in the field of cardiology.
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