warfarin

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revision tool for anticoagulants phar2102
jenny schneider
Flashcards by jenny schneider, updated more than 1 year ago
jenny schneider
Created by jenny schneider almost 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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