2942507
Description
Flashcards by jenny schneider, updated more than 1 year ago
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Created by jenny schneider
over 9 years ago
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| Question | Answer |
| Explain mechanism of action of warfarin | warfarin exerts its effect by inhibiting Vitamin K dependent coagulation factors which are Factors II, VII, IX and X. It also inhibits the anticoagulant proteins C and S |
| Why is there a delay in onset of activity of warfarin? | it does not affect the clotting factors already there, we have to wait for those to clear before we see full effect of warfarin |
| why can we see a paradoxical hypercoagulable state during the first few days of therapy? | it inhibits the natural anticoagulants Protein C and S which have shorter half-lives and this depletion can resut in the hypercoagulable state; therefore patients should receive fast acting anticoagulants while transitioning to warfarin therapy |
| True or False Warfarin is administered orally and is a racemic mix of two isomers- the R isomer and the S isomer | True |
| Which of the isomers of warfarin is most potent in terms of anticoagulant effect? | the S isomer is 2 to 5 times more potent than the R isomer |
| True or False: Both isomers of warfarin are extensively bound to albumin and warfarin is extensivley metabolised in liver by several enzymes | True |
| True or False: genetic polymorphism in CYP450 enzymes can result in large inter-individual variation in dose requirements | True |
| True or False Warfarin follows linear kinetics | False |
| True or False Warfarin dose can be influenced by diet, drug-drug interactions and health status | True |
| How do we monitor warfarin | measure INR |
| What advice would you give patient regarding diet and warfarin? | need to keep their intake of Vitamin K containing foods relatively constant (avoid intake of Vit K rich foods) |
| What drug is used to reverse the effects of warfarin? | Vitamin K- also called phytomenadione |
| Of the following oral anticoagulants, which requires regular routine monitoring of anticoagulant effect? warfarin rivaroxaban dabigatran | warfarin |
| Which of the following drugs is administered as a prodrug? warfarin rivaroxaban dabigatran | dabigatran |
| Which of the following drugs does not have predictable pharmacokinetics? warfarin dabigatran rivaroxaban | warfarin |
| which of the oral anticoagulants has very low bioavalability (about 6%): warfarin rivaroxaban dabigatran etexilate | dabigatran etexilate |
| which of the following oral anticoagulants has long onset of action? warfarin dabigatran rivaroxaban | warfarin |
| which of the following oral anticoagulants has an antidote? warfarin rivaroxaban dabigatran | warfarin (the antidote is vitamin K) |
| which of the following oral anticoagulants is most likely to be affected by patient diet? rivaroxaban dabigatran warfarin | warfarin |
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