Warfarin
- Interferes with Vitamin K-dependent Clotting Factors
- Extrinsic Pathway
- Bridge with Heparin
- Chronic Anticoagulation
- Bleeding
- Necrosis
- Cytochrome P450
- Pregnancy
- FFP + Vitamin K
Warfarin Antidotes
- Vitamin K
- Fresh Frozen Plasma
Heparin Mechanisms
- Short Half-life
- Antithrombin Activation Cofactor
- Decrease Thrombin, Factor Xa
- Bleeding
- Heparin Induced Thrombocytopenia (HIT)
- Protamine Sulfate
Heparin Indications
- Acute Coronary Syndrome (ACS)
- Prophylaxis
- Pulmonary Embolism
- Atrial Fibrillation
- Used during Pregnancy
Heparin Induced Thrombocytopenia (HIT)
- 5-10 Days After Heparin Exposure
- Heparin-Platelet Factor 4 Complex
- Autoantibodies Form Against Complex
- Heparin-Platelet Factor 4-Antibody Complex Binds Platelets
- Platelet Aggregation
- Procoagulant Release
- Thrombocytopenia
- Serotonin Release Assay (SRA)
- Stop Heparin, Start Direct Thrombin Inhibitor
Aspirin
- Fever
- Pain and Headache
- Cardiovascular Disease (CAD)
- Irreversible inhibition of COX-1 and COX-2
- Suppress Thromboxanes and Prostaglandins
- NSAID
- Reye's Syndrome
- Tinnitus
- Peptic Ulceration
- Mixed Acidosis/Alkalosis
- Nephropathy
Enoxaparin (Lovenox)
- Inhibits Clotting Factors
- Factor Xa
- Clot Formation Prevention
- Heparin Induced Thrombocytopenia (HIT)
- Bleeding
- Medication Education
- Subcutaneous Injection
- 2 Inches from Umbilicus or Incisions
- Protamine Sulfate
Clopidogrel (Plavix)
- ADP Receptor Antagonist
- Prevent Platelet Aggregation
- Acute Coronary Syndrome (ACS)
- Prevention of Thrombotic Events
- Bleeding
- Thrombotic Thrombocytopenic Purpura (TTP)
- Pancytopenia
- Abdominal Pain
- Withhold Before Surgery
Abciximab and Tirofiban (GP IIb/IIIa Inhibitors)
- IIb/IIIa Receptor Inhibitors
- Inhibits Platelet Aggregation
- Thrombotic Event Prevention
- Acute Coronary Syndrome (ACS)
- Percutaneous Coronary Intervention (PCI)
- Bleeding
- Expensive
- Combination Drug Therapy
Ticlopidine (Ticlid)
- ADP Receptor Antagonist
- Irreversibly Inhibits Platelet Aggregation
- Thrombotic Event Prevention
- Neutropenia
- Thrombotic Thrombocytopenic Purpura (TTP)
- GI Distress
- Rash
- Withhold Before Surgery
- Monitor Blood Count
Alteplase
- Tissue Plasminogen Activator
- Thrombosis
- Bleeding
- Intracranial Hemorrhage
- Internal Hemorrhaging
- Minimize Bleeding
- Monitor for Shock
- Aminocaproic Acid
Cilostazol and Dipyridamole
- Phosphodiesterase 3 Inhibitor (PDE-3)
- Inhibits Platelet Aggregation
- Vasodilation
- Intermittent Claudication
- Stroke Prevention
- Coronary Stent Stenosis Prevention
- Cardiac Stress Testing (Dipyridamole)
- Flushing
- Hypotension
Factor Xa Inhibitors
- Inhibit Factor Xa
- -xaban
- Apixaban
- Rivaroxaban
- Pulmonary Embolism
- Nonvalvular Atrial Fibrillation
- Deep Vein Thrombosis
- Andexanet Alfa
Direct Thrombin Inhibitors
- Heparin Induced Thrombocytopenia (HIT)
- Nonvalvular Atrial Fibrillation
- Venous Thromboembolism
- Dabigatran
- Bivalirudin
- Argatroban
- Inhibition of Thrombin
- Idarucizumab
- Activated Prothrombin Complex Concentrate
- Bleeding