Anticoagulant Drugs Differences Quiz

Thrombolytic Therapy

• The primary purpose of thrombolytic therapy is to dissolve blood clots.
• Anticoagulant drugs are given following thrombolytic therapy to prevent re-clotting.

Alteplase

• Alteplase is primarily metabolized in the liver.
• The primary action of alteplase in thrombolytic therapy is to break down fibrin, a component of blood clots.
• Alteplase is considered first-line therapy for acute ischemic stroke.
• Alteplase is primarily eliminated from the body through the liver.
• The main adverse effect of alteplase is bleeding.
• Alteplase is not recommended in patients over 80 years of age due to the increased risk of bleeding.
• Intracranial hemorrhage is a contraindication for alteplase use.

Heparin

• The antidote for heparin overdose is protamine sulfate.
• Mast cells and basophils contain endogenous heparin.
• The primary action of heparin in the body is to inhibit thrombin, preventing the formation of blood clots.
• Heparin takes 2-3 hours to act when given subcutaneously.
• Low doses of heparin are recommended for prophylaxis of deep vein thrombosis (DVT).
• Enoxaparin, an anticoagulant drug, binds to antithrombin and is administered for prophylaxis of DVT in people undergoing hip or knee surgery.

Warfarin

• Warfarin acts in the liver to prevent the synthesis of vitamin K-dependent clotting factors.
• Fondaparinux, an anticoagulant drug, poses a bleeding risk in patients with renal dysfunction.
• The primary adverse effect associated with Warfarin therapy is bleeding.
• Warfarin has a BLACK BOX WARNING for the risk of causing major or fatal bleeding.
• Warfarin is most useful in long-term prevention or management of venous thromboembolic disorders.
• The goal of heparin therapy in disseminated intravascular coagulation (DIC) is to prevent further thrombosis.
• Platelet counts should be monitored during heparin therapy due to the risk of thrombocytopenia.
• Heparin-induced thrombocytopenia (HIT) is a potentially life-threatening complication of heparin administration.
• Uncontrolled bleeding is a contraindication for the use of heparin.
• Heparin dosage is regulated during therapy based on activated partial thromboplastin time (aPTT).

Low Molecular Weight Heparins (LMWHs)

• The primary advantage of LMWHs over traditional heparin is that they have a more predictable dose response.
• Heparin does not cross the placental barrier or get secreted in breast milk.

Antiplatelet Drugs

• Clopidogrel is converted into its active form by the enzyme CYP2C19.
• Platelet inhibition essentially lasts for 7-10 days after taking clopidogrel.
• The approved loading dose range for clopidogrel is 300-600 mg.
• Elderly patients are more likely to experience bleeding and complications with antiplatelet drugs like clopidogrel.
• TTP (thrombotic thrombocytopenic purpura) is a contraindication for using clopidogrel.
• Prasugrel might be recommended for CYP2C19 poor or intermediate metabolizers who cannot benefit adequately from clopidogrel.
• Dual antiplatelet therapy with clopidogrel and aspirin is recommended for 1-12 months for patients receiving implants with a bare-metal stent or a drug-eluting stent.

Prasugrel

• Prasugrel differs from clopidogrel in terms of metabolism activation, requiring only one-step conversion to its active form.
• The TRITON-TIMI 38 trial demonstrated different clinical responses to prasugrel and clopidogrel in individuals who are poor metabolizers of CYP2C19.

Ticagrelor

• Ticagrelor differs from clopidogrel and prasugrel in terms of receptor blockade, binding reversibly to the P2Y12 receptor.
• The common adverse effects associated with ticagrelor use are dyspnea, bleeding, and bradycardia.
• In cases of life-threatening or serious bleeding with the use of ADP receptor antagonists like ticagrelor, platelet transfusion may be required.

Warfarin

• The primary action of Warfarin in the body is to inhibit the synthesis of vitamin K-dependent clotting factors.
• Warfarin differs from vitamin K in terms of action, as vitamin K promotes the synthesis of clotting factors.
• The antidote for Warfarin overdose is vitamin K.
• The liver is primarily responsible for the metabolism of Warfarin.
• Renal impairment affects Warfarin excretion, leading to increased drug levels.
• The main use of Warfarin is in the prevention and treatment of thromboembolic disorders.
• A lower dose of Warfarin may be required in older patients due to decreased metabolism and increased sensitivity.
• The liver eliminates Warfarin from the body.
• Critically ill patients require concurrent treatment with heparin or LMWHs due to the increased risk of bleeding.
• The primary adverse effect associated with Warfarin therapy is bleeding.
• The US FDA has issued a BLACK BOX WARNING for Warfarin due to the risk of bleeding.
• Warfarin is classified as category X for use during pregnancy, meaning it is contraindicated.

Test your knowledge on anticoagulant drugs by understanding the differences between Dalteparin, Enoxaparin, and Fondaparinux. Learn about their administration methods, effects, and mechanisms of action.