Zusammenfassung der Ressource
A N T I C O A G U L A N T S
- MOA
- HIGH MOLECULAR WEIGHT HEPARINS
- SIGNIFICANT inhibition of Xa & IIa • • • MINOR inhibition of VIIa, IXa, & XIIa • • • Active clotting factors INACTIVATED • • • INDIRECT thrombin inhibitor • • • enhances effects of antithrombin III
- HEPARIN
- LOW MOLECULAR WEIGHT HEPARINS
- ENHANCES the effects of antithrombin III • • • SIGNIFICANT inhibition of Xa • • • Some inhibition of IIa • • • Active clotting factors INACTIVATED
- ENOXAPARIN • • Lovenox
- DALTEPARIN • • Fragmin
- VITAMIN K ANTAGONIST
- Interacts with Vit K cycle • • • Factor II, VII, IX, & X • • • INHIBITS Vit K epoxide reductase ( VKORC1 ) which converts Vit K to its activa form ( KH2 ) →
→ No longer a cofactor of carboxylase → → less K → Less K dependent clotting factors produced → ALSO inhibits protein C and S
- WARFARIN • • Coumadin
- FACTOR Xa INHIBITORS
- ACUTE
- FONDAPARINUX • • Atrixa
- Augments function of ATII • • Significant inhibition of Xa only • • Active clotting factors inactivated (Only Xa)
- CHRONIC
- DOES NOT AFFECT ANTITHROMBIN • • • Directly inhibits Factor Xa by BLOCKING the active site
- APIXABAN • Eliquis • • • • RIVAROXABAN • Xarelto • • • • EDOXABAN • Sayvasa • • • • BETRIXABAN • Bevyxxa
- DIRECT THROMBIN INHIBITORS
- DABIGATRAN • Pradaxa • • • • ARGATROBAN • • • • BIVALIRUDIN • Angiomax • • • • DESIRUDIN • Iprivask
- DIRECTLY inhibits Factor IIa ( Thrombin ) by binding the active site
- FIBRINOLYTICS
- Breaks up clots by converting plasminogen to plasmin
- ALTEPASE • Activase / Cathflo
- INDICATIONS
- MONITORING
- REQUIRED MONITORING
- HEPARIN
- APTT (ACTIVATED PARTIAL THROMBOPLASTIN TIME) • • • GOAL = 1.5 - 2.5 CONTROL RANGE
- NO REGULAR - REQUIRED MONITORING
- INTERACTIONS
- CONTRAINDICATIONS
- CONTRAINDICATED IN CRCL < 30 ML/MIN
- DABIGATRAN (- PRADAXA -)
- FONDAPARINUX (- ATRIXA -)
- AGENT - AGENT CONVERSION
- FORMULATIONS
- ORAL
- WARFARIN
- APIXABAN
- RIVAROXABAN
- EDOXABAN
- BETRIXABAN
- DABIGATRAN
- S Q
- ENOXAPARIN
- DALTEPARIN
- HEPARIN - NOT COMMON
- IV
- HEPARIN
- FONDAPARINUX
- ARGATROBAN
- BIVALIRUDIN
- DESIRUDIN
- ATLEPASE
- RETEPLASE
- TENECTEPLASE
- DRUG SPECIFIC POINTS
- ADRs
- COUNSELING
- REVERSAL AGENTS
- MEDICATION CLASS
- HIGH MOLECULAR WEIGHT HEPARIN (HMWH)
- UNFRACTIONATED HEPARIN (UFH)
- LOW MOLECULAR WEIGHT HEPARINS
- ENOXAPARIN - (LOVENOX)
- DALTEPARIN - (FRAGMIN)
- COURMARIN ( - VIT K - ) DERIVATIVE
- WARFARIN ( - COUMADIN - )
- FACTOR Xa INHIBITORS
- FONDAPARINUX ( - ARIXTRA - )
- APIXABAN ( - ELIQUIS - )
- RIVAROXABAN ( - XARELTO - )
- EDOXABAN ( - SAVAYSA - )
- BETRIXABAN ( - BEVYXXA - )
- DIRECT THROMBIN INHIBITORS
- DABIGATRAN ( - PRADAXA - )
- ARGATROBAN
- BIVALIRUDIN (- ANGIOMAX -)
- DESIRUDIN (- IPRIVASK -)
- FIBRINOLYTICS
- ATLEPASE (- ACTIVASE / CATHFLO -)
- RETEPLASE (- RATEVASE -)
- TENECTEPLASE (- TNKase -)