• Know the pharmacodynamics, pharmacotherapeutics clinical use, drug interactions and adverse drug
reactions for:
Anticoagulants
• Pharmacodynamics
• Oral anticoagulants such as warfarin (Coumadin) inhibit the hepati
...
• Know the pharmacodynamics, pharmacotherapeutics clinical use, drug interactions and adverse drug
reactions for:
Anticoagulants
• Pharmacodynamics
• Oral anticoagulants such as warfarin (Coumadin) inhibit the hepatic synthesis of several clotting factors,
including factor X.
• Heparin inhibits the activity of several activated clotting factors by accelerating the activity of
antithrombin III.
• LMWH enoxaparin (Lovenox) potentiates the activity of antithrombin III and inactivates factors Xa and
IIa (thrombin).
• Dabigatran (Pradaxa) is a direct thrombin inhibitor.
• Thrombin is required for the conversion of fibrinogen to fibrin in the clotting cascade,
thus dabigatran's inhibition of thrombin prevents thrombi from forming.
Fondaparinux (Arixtra) is a selective inhibitor of antithrombin III and a factor Xa inhibitor.
Rivaroxaban (Xarelto) an anticoagulant, is a highly selective factor Xa inhibitor that inhibits thrombin
formation and the development of thrombi.
Apixaban (Eliquis) is a selective inhibitor of factor Xa.
• Aspirin antagonizes the cyclooxygenase pathway and interferes with platelet aggregation.
• NSAIDs have this same action.
• NSAIDs are not used as antiplatelet drugs, but this explains why concurrent use with
anticoagulants is contraindicated
• Ticlopidine (Ticlid) and clopidogrel (Plavix) reduce platelet aggregation by inhibiting the ADP pathway
of platelets.
• Unlike aspirin, they have no effect on prostaglandin metabolism.
• Ticagrelor (Brilinta) reversibly interacts with the platelet P2Y12 ADP-receptor to prevent platelet
activation.
• Vorapaxar (Zontivity) is a protease-activated receptor-1 (PAR-1) antagonist, inhibiting thrombin-induced
and thrombin receptor agonist peptide-induced platelet aggregation
[Show More]