Term
|
Definition
| endothelial injury/ dysfunction, hypercoagulation, hemodynamic changes |
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|
Term
| two general mechanism of clotting |
|
Definition
| platelet aggregation, and thrombin activation (coagulation cascade) |
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Term
|
Definition
| endothelial damage and inflammation activates platelets; forms "white clot" |
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Term
|
Definition
| extrinsic and intrinsic converge to "common pathway" by activating factor X to factor Xa |
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Term
|
Definition
|
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Term
|
Definition
| contact activation pathway |
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|
Term
|
Definition
| aspirin, thienopyridines, GpIIb/IIIa receptor blockers |
|
|
Term
|
Definition
| heparin, Vit K antagonists, direct thrombin inhibitors, factor Xa antag |
|
|
Term
| anti-platelet agent action |
|
Definition
| act on or within platelets to inhibit activation and aggregation |
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Term
|
Definition
| bind to P2Y (12) ADP receptor on platelet surface |
|
|
Term
| indications for anticoagulation |
|
Definition
| coronary artery Dx, acute coronary syndrome, valvular heart disease, AFib, venous thromboembolism treatment and prevention, hypercoagulable states |
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|
Term
|
Definition
| test measures activity of fibrinogen and factors II, V, VII and X or the extrinsic pathway |
|
|
Term
| international normalizied ratio (INR) |
|
Definition
| standardizes the wide variability in commercial PT testing reagents which heps prevent variation in test results |
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Term
|
Definition
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|
Term
|
Definition
| decreases warfarin effect, vice versa |
|
|
Term
| hepatic impairment and warfarin |
|
Definition
| decreased synthetic function of the liver, increased baseline INR, no analogues to effect warfarin--NOT auto-anticoagulated |
|
|
Term
| nephrotic syndrome and warfarin |
|
Definition
| hypoproteinemia leads to increased vol of distribution; increased warf clearance and decreased half-life |
|
|
Term
| hypermetabolic states and warfarin |
|
Definition
| increased catabolism of vit K dependent clotting factor; increased antocoag effect of warf |
|
|
Term
| heart failure exacerbations and warfarin |
|
Definition
| hepatic congestion may acutely decrease synthesis of clotting factors; increased anticoag effect of warf |
|
|
Term
|
Definition
| lead to rapid decrease in factor VII, rapind increase in INR, rapid decrease of protein C |
|
|
Term
| adequate anticoagulation with warf not achieved after 5 days |
|
Definition
| require significant reduction in factor II |
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|
Term
|
Definition
| are made according to total weekly dose |
|
|
Term
| direct thrombin inhibitors |
|
Definition
|
|
Term
|
Definition
| Xarelto (rivaroxaban), Eliquis (apixaban) |
|
|
Term
|
Definition
| frequent monitoring, dose adjustable based on effect, drug and dietary interactions, reliably reversible, years of clinical experience |
|
|
Term
| newer agent pros and cons |
|
Definition
| no monitoring, fewer drug interactions and no dietary restrictions, no reliable reversal agents, less experience and much more expensive |
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