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Anesthesia Pharmacology > Coagulation Modifiers > Flashcards

Coagulation Modifiers Flashcards

1
Q

Heparin Class

A

Anticoagulant

Factors IIa and Xa Antagonist

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2
Q

Heparin MOA

A

Heparin forms a complex with antithrombin III, increasing its activity 1,000 times

Inhibits thrombin (IIa) and factor Xa

Depresses factors IXa, XIa, and XIIa

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3
Q

Heparin Uses (3)

A

DVT prophylaxis

Treats

  • Pulmonary Embolism
  • Acute coronary syndrome
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4
Q

Heparin Dosing

A

SQ:
5,000 units for DVT prophylaxis

IV:
80 units/kg bolus
Followed by 15-18units/kg/hr infusion

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5
Q

Heparin Onset and DOA

A

SubQ
-Onset: 30 min

IV

  • Onset: rapid
  • DOA: 1-2 hours
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6
Q

Heparin Metabolism

A

Liver

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7
Q

Heparin Excretion

A

Kidneys

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8
Q

Heparin Admin Considerations (3)

A

Check PTT levels
HIT
Bleeding

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9
Q

Protamine Class

A

Heparin Reversal Agent

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10
Q

Protamine MOA

A

Combines with heparin to form inactive compound w/ no anticoagulant effects

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11
Q

Protamine Uses

A

Reversal of heparin

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12
Q

Protamine Dosing

A

Based on amount of heparin given
Give @ <5mg/min
1 mg/ 100 U of heparin

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13
Q

Protamine Onset, DOA, and Half-Life

A

Onset: 5 min

DOA: 2 hours

Half-life: Shorter than heparin, so heparin rebound (bleeding) may occur

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14
Q

Protamine Metabolism and Excretion

A

Heparin-protamine complexes eliminated via reticuloendothelial system

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15
Q

Protamine Admin Considerations (6)

A

Hypersensitivity Response Possible d/t derivation from salmon sperm

  • Releases histamine
  • Hypotension
  • Pulmonary HTN
  • Circ collapse
  • Facial flushing
  • Bronchoconstriction
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16
Q

Tranexamic acid (TXA) Class

A

Antifibrinolytic agent

17
Q

Tranexamic acid (TXA) MOA

A

Synthetic reversible competitive inhibitor to the Lysine receptor found on plasminogen. The binding of this receptor prevents plasmin (activated form of plasminogen) from binding to and ultimately stabilizingthe fibrin matrix.

18
Q

Tranexamic acid (TXA) Uses

A

Prevents or reduces bleeding and the need for transfusion

19
Q

Tranexamic acid (TXA) Dosing

A

1 gram over 10 minutes.

May repeat a 1 gram dose during the next 8 hours, but do not exceed a total of2 grams.

20
Q

Tranexamic acid (TXA) Half-Life

A

IV

Around 2 hours

21
Q

Tranexamic acid (TXA) Metabolism

A

Small portion metabolized by the liver

22
Q

Tranexamic acid (TXA) Excretion

A

Kidneys (large portion unchanged)

23
Q

Tranexamic acid (TXA) Admin Considerations (4)

A

Rapid infusion may cause hypotension

Contraindications:

  • Known allergy to TXA
  • Intracranial bleeding (SAH)
  • History of venous or arterial thromboembolism or active thromboembolic disease.

Anesthesia Pharmacology (23 decks)

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