anticoags: HEPARIN

Mind Map: anticoags: HEPARIN

1. MOA: accelerates ability of antithrombin to active coag->

1.1. prevents thrombus prop by facilitating fibrinolysis BUT does not lyse existing thrombi

2. unfractionated

2.1. short half life (rapid anticoag)

2.2. tx of DVT/PE; prophylaxis for VTE; acute coronary syndrome

2.3. safe in pregnancy

2.4. variable dosing ->

2.4.1. adjust dosage according to aPTT

2.5. AE: bleeding (more c in elderly women); reversal agent is IV protamine sulfate; GI; thrombocytopenia (HIT)

3. low molecular weight

3.1. dalteparin; enoxaparin; tinzaparin

3.2. prophylaxis AND tx for DVT and PE

3.3. enoxaparin tx ACS

3.4. predictable dose

3.4.1. no lab monitoring

3.5. longer 1/2 life

3.6. outpt tx: LMWH overlapped w/warfarin for 5 days

3.7. AE: bleeding; less thrombocytopenia than unfractionated

4. heparin derivative: heparinoid

4.1. Fondaparinux

4.2. MOA: heparin derivative; binds to antithrombin which inhibits factor Xa; indirectly inhibit conversion of prothrombin to thrombin

4.3. approved for HIT, DVT prevention, ACS; subq administration

5. Protamine sulfate; a reversal for heparin od

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