Anticoagulant Drugs Differences Quiz

GentleVanadium avatar
GentleVanadium
·

Start Quiz

Study Flashcards

55 Questions

What is the primary purpose of thrombolytic therapy?

To stimulate conversion of plasminogen to plasmin

Why are anticoagulant drugs given following thrombolytic therapy?

To decrease reformation of a thrombus

Where does metabolism of alteplase predominantly occur?

Liver

What is the primary action of alteplase in thrombolytic therapy?

Lyse unwanted fibrin blood clots

For what condition is alteplase considered first-line therapy?

Acute Ischemic Stroke

How is alteplase primarily eliminated from the body?

In urine

What is the main adverse effect of alteplase?

Internal bleeding

Why is alteplase not recommended in patients over 80 years of age?

Increased risk of bleeding

Which condition is a contraindication for alteplase use?

Recent major surgery

What is the antidote for heparin overdose?

Protamine sulfate

What body tissues contain endogenous heparin?

Liver and lungs

What is the primary action of heparin in the body?

Prevents blood clotting

How long does it take for heparin to act when given subcutaneously?

20-30 minutes

What is the recommended use of low doses of heparin?

Preventing deep vein thrombosis

Why is it important to minimize intramuscular injections in patients receiving systemic thrombolytic therapy?

Minimize bleeding risk

What should a nurse check 2-3 hours after starting thrombolytic therapy?

Fibrinogen levels

Which anticoagulant drug binds to antithrombin and is administered for prophylaxis of DVT in people undergoing hip or knee surgery?

Fondaparinux

Why should Enoxaparin not be given intramuscularly?

It may be administered intravenously in specific situations

Which anticoagulant drug acts in the liver to prevent the synthesis of vitamin K-dependent clotting factors?

Warfarin

Why does Fondaparinux pose a bleeding risk in patients with renal dysfunction?

It is primarily eliminated by the kidneys

What is the primary adverse effect associated with Warfarin therapy?

Hemorrhage

Which anticoagulant drug has a BLACK BOX WARNING for the risk of causing major or fatal bleeding?

Warfarin

Why is Warfarin most useful in long-term prevention or management of venous thromboembolic disorders?

It prevents the synthesis of vitamin K-dependent clotting factors

What is the goal of heparin therapy in disseminated intravascular coagulation (DIC)?

To prevent further thrombus formation and embolization

When should platelet counts be monitored during heparin therapy?

Before therapy begins and every 2 to 3 days

What is a potentially life-threatening complication of heparin administration?

Decrease in platelet count

What is a contraindication for the use of heparin?

Peptic ulcer disease

How is heparin dosage regulated during therapy?

Using aPTT (activated partial thromboplastin time)

What is the primary advantage of LMWHs over traditional heparin?

Smaller molecular structures

Which condition does heparin not cross the placental barrier or get secreted in breast milk?

DISSEMINATED INTRAVASCULAR COAGULATION

What is the primary enzyme responsible for converting clopidogrel into its active form?

CYP2C19

How long does platelet inhibition essentially last after taking clopidogrel?

7-10 days

What is the approved loading dose range for clopidogrel?

400-600 mg

Which population is more likely to experience bleeding and complications with antiplatelet drugs like clopidogrel?

Older adults

Which adverse effect is NOT commonly associated with clopidogrel use?

Constipation

What is a contraindication for using clopidogrel?

Active bleeding conditions

Which antiplatelet drug might be recommended for CYP2C19 poor or intermediate metabolizers who cannot benefit adequately from clopidogrel?

Prasugrel

What is the recommended duration of dual antiplatelet therapy for patients receiving implants with a bare-metal stent or a drug-eluting stent?

12 months

How does prasugrel differ from clopidogrel in terms of metabolism activation?

Prasugrel activation is a rapid single-step process

Which trial demonstrated different clinical responses to prasugrel and clopidogrel in individuals who are poor metabolizers of CYP2C19?

TRITON-TIMI 38 trial

What distinguishes ticagrelor from clopidogrel and prasugrel in terms of receptor blockade?

Ticagrelor has reversible receptor blockade

What is a common adverse effect associated with ticagrelor use?

Increased uric acid levels

What action may be required in cases of life-threatening or serious bleeding with the use of ADP receptor antagonists like ticagrelor?

Use platelet transfusion

What is the primary action of Warfarin in the body?

Inhibits the synthesis of clotting factors II, VII, IX, and X

How does Warfarin differ from vitamin K in terms of action?

Warfarin competes with vitamin K to inhibit clotting factor synthesis

What is the antidote for Warfarin overdose?

Vitamin K

Which organ is primarily responsible for the metabolism of Warfarin?

Liver

How does renal impairment affect Warfarin excretion?

Decreases excretion of inactive metabolites

What is the main use of Warfarin?

Prevention of stroke in atrial fibrillation

Why might a lower dose of warfarin be required in older patients?

Decreased synthesis of vitamin K in hepatic disease

Which organ eliminates warfarin from the body?

Liver

Why do critically ill patients require concurrent treatment with heparin or LMWHs?

To achieve immediate anticoagulation

What is the primary adverse effect associated with warfarin therapy?

Hemorrhage

Why has the US FDA issued a BLACK BOX WARNING for warfarin?

Risk of causing major or fatal bleeding

In which category is Warfarin classified for use during pregnancy?

Category X

Study Notes

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.

Make Your Own Quizzes and Flashcards

Convert your notes into interactive study material.

Get started for free
Use Quizgecko on...
Browser
Browser