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Samenvatting Schema anticoagulantia

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Schema alle besproken anticoagulantia.

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  • January 23, 2019
  • 5
  • 2017/2018
  • Summary

2  reviews

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By: daisykadesa • 4 year ago

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By: alanfeyaerts • 5 year ago

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ANTICOAGULANTIA
VITAMINE K ANTAGONISTEN DIRECTE ORALE INJECTEERBARE ANTICOAGULANTIA
(VKA) ANTICOAGULANTIA (DOAC) (LMWHs)
Absorptie Hoog na perorale toediening Niet peroraal (iv of sc)
Eiwitbinding Hoog
Eliminatie Metabolisate in de lever
PK Werking houdt nog 3-4 dagen aan Ogenblikkelijke werking, maar eindigt ook snel
Lage T1/2
Indicaties - (samen met hoge dosis heparine) - primaire prevente veneuze thrombo- - veneuze thrombose (prevente DVT in
prevente uitbreiding diepe thrombose en embolie geïmmobiliseerde patint en murale thrombose na
ontstaan longembolen - thrombo-embolische prevente bij VKF MI)
- prevente thrombose patinten met - behandeling DVT en secundaire
mitraalstenose, langdurige VKF, prevente
kunstkleppen, recurrente DVT - prevente thrombose, langdurige VKF,
kunstkleppen, recurrente DVT
ENKEL INDIEN GEEN KLEPLETSELS
Interacties Heel veel, met GM met invloed op: - CYP3A4 en/of Pgp
- opname of metabolisme van het - voorzichtgheid met ant-aggreganta en
coumarine of vitK NSAIDs omwille van het verhoogd
- synthese, functe en klaring van elke bloedingsrisico
factor of cel met een rol in de hemostase
of fbrinolyse
- de integriteit van het epitheel
Bijwerkingen - bloedingsrisico (vooral GI) - bloedingsrisico - spontane bloedingen (indien dit gebeurt:
- teratogeniciteit - EVALUATIE INR en nier- en leverfuncte is toediening stoppen of protaminesulfaat toevoegen
- moeilijk om juiste plasmaconcentrate te noodzakelijk die inactef complex vormt met heparine)
verkrijgen door de trage werking en de - transiinte of ernstge thrombocytopenie
lange werkingsduur. (te laag: - mogelijks osteoporose bij langdurig gebruik
stollingsgevaar; te hoog: bloedingsrisico)
PT (INR) van patint moet regelmatg
bekeken worden
CI - zwangerschap (want gaat door placenta) - patinten ouder dan 75 jaar: lagere dosis
WM Competteve antagonisten van vitK. - directe selecteve orale factor Xa - (Unfractonated) Heparine bindt aan

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