Term
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Definition
| Endothelial injury/dysfunction; hypercoagulability; hemodynamic changes |
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Term
| traditionally thought to form primarily in areas of high-speed arterial flow on atherosclerotic lesions |
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
| aspirin, thienopyridines, GpIIb/IIIa receptor blockers |
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Term
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Definition
| heparin and derivatives, vitamin K antagonists, direct thrombin inhibitors, factor Xa antagonists |
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Term
| irreversibly inhibits COX-1 within platelets, blocking production of thromboxane A2 and platelet aggregation |
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Definition
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Term
| bind to P2Y (12) ADP receptor on platelet surface, inhibiting platelet activation |
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Definition
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Term
| Indications for Anticoagulation |
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Definition
| coronary artery disease, acute coronary syndrome, valvular heart disease, atrial fibrillation, venous thromboembolism treatment, venous thromboembolism prevention, hypercoagulable states |
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Term
| inhibit the enzyme vitamin K epoxide reductase (VKOR) |
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Definition
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Term
| reduces oxidized vitamin K for reuse |
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Definition
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Term
| vitamin K antagonists leads to |
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Definition
| increase in prothrombin time |
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Term
| identified after recognition of hemorrhagic disorder in cattle who ate spoiled sweet clover |
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Definition
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Term
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Definition
| S-warfarin (compared to R-warfarin) |
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Term
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Definition
| extensively (99%) protein-bound. primarily bound to albumin |
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Term
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Definition
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Term
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Definition
| metabolized by CYP3A4 and CYP1A2 |
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Term
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Definition
| decreased ability to metabolize S-warfarin- increased risk of bleeding |
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Term
| CYP2C9 mutations: heterozygosity |
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Definition
| deceases dose requirements by 20-30% |
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Term
| CYP2C9 mutations: homozygosity |
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Definition
| decrease dose requirements by 50-70% |
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Term
| Warfarin Drug Interactions: FAB 4 |
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Definition
| Fluconazole, Amiodarone, Bactrim, Metronidazole |
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Term
| Classes of interacting medications (warfarin interactions) |
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Definition
| antibiotics, antidepressants, antiarrhythmics |
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Term
| hepatic impairment while on warfarin |
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Definition
| increased baseline INR; not analogous to effect of warfarin (NOT "auto-anticoagulated") |
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Term
| nephrotic syndrome while on warfarin |
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Definition
| hypoproteinemia leads to increased volume of distribution-- increased warfarin clearance and decreased half life |
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Term
| hypermetabolic states while on warfarin |
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Definition
| increased catabolism of vitamin K dependent clotting factors; increased anticoagulant effect of warfarin |
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Term
| heart failure exacerbations while on warfarin |
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Definition
| hepatic congestion may acutely decrease synthesis of clotting factors- increased anticoagulant effect of warfarin |
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Term
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Definition
| bleeding; skin necrosis; purple toe syndrome; birth defects |
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Term
| direct thrombin inhibitors |
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Definition
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Term
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Definition
| Xarelto (Rivaroxaban), Eliquis ( apixaban) |
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Term
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Definition
| binds directly to and inhibits free and clot-bound thrombin (Factor IIa)--- prevents conversion of fibrinogen to fibrin, also inhibit thrombin-mediated platelet activation |
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Term
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Definition
| first non-VKA oral anticoagulant approved by FDA; approved for thromboprophylaxis in non-valvular atrial fibrillation |
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Term
|
Definition
| rapidly converted to active form by serine esterases |
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Term
| catalyzes conversion of factor II to factor IIa |
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Definition
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Term
|
Definition
| dose-dependent, decreases with larger doses; food increases availability of 20 mg doses |
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Term
| Rivaroxaban Black Box Warnings |
|
Definition
| abrupt discontinuation increases risk of thrombotic events; risk of spinal/epidural hematoma in patients receiving neuraxial anesthesia or spinal puncture |
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Term
| Rivaroxaban Hepatic impairment |
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Definition
| Child-Pugh classes B and C associated with increased risk of coagulopathy |
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Term
| Concomitant use of strong CYP3A4 and P-glycoprotein inducers or inhibitors |
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Definition
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Term
|
Definition
| primarily hepatic via CYP3A4/5 and 2J2 |
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Term
|
Definition
| primarily hepatic via CYP3A4 |
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Term
| Apixaban Black Box Warning |
|
Definition
| Abrupt discontinuation increases risk of thrombotic events |
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Term
| Apixaban Hepatic Impairment |
|
Definition
| no dosing recommendations provided for moderate impairment, package insert recommends against use in severe impairment |
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