Anesthesia Pharmacology: Anticoagulants

Enoxaparin:
1. high-molecular-weight heparin fraction
2. acts by preventing platelet degranulation
3. primary prevention of deep venous thrombosis after hip replacement surgery
Major adverse effect of heparin:
1. osteoporosis
2. alopecia
3. bleeding
4. spontaneous fractures
5. reduced glomerular filtration
Management of excessive heparin anticoagulant action:
1. discontinue drug
2. administer protamine sulfate
3. both
4. neither
Heparin contraindications:
1. severe hypertension
2. threatened abortion
3. visceral carcinoma
4. advanced renal disease
5. all of the above
Specified in anti-factor Xa units:
1. heparin
2. enoxaparin
3. dalteparin and danaproid
Heparin biological activity depends most directly on:
1. fibrinogen
2. platelets
3. antithrombin III
4. aminocaproic acid
5. tissue plasminogen activator
Consequences of heparin administration
1. thromboembolism
2. bleeding
3. transient thrombocytopenia
4. B & C
5. A, B & C
Coumarin agents:
1. oral anticoagulants
2. most reliable drug:Warfarin
3. rodenticide
4. racemate
5. all of the above
Mechanism of action: coumarin anticoagulants --
1. increases degradation rates of 4 vitamin K dependence clotting factors
2. blocks gamma-carboxylation of glutamate in prothrombin, protein C, and factors VII, IX, X
3. accelerates vitamin K epoxide conversion to active hydroquinone form
4. all of the above
Warfarin effects on the fetus:
1. none-Warfarin does not cross the placental barrier
2. causes abnormal bone formation
3. despite limited Warfarin effects on the fetus, it may be used at low dosages