Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Drugs affecting blood coagulation chapter 48 > Flashcards

Drugs affecting blood coagulation chapter 48 Flashcards

1
Q

What are drugs that are affecting blood coagulation?

A
  • Antiplatelet Drugs
  • Anticoagulation Drugs
  • Thrombolytic Drugs
  • Hemostatic Drugs
  • Drugs to Control Bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe anti platelet drug?

A
  • Antiplatelet drugs inhibit platelet aggregation and adhesion
  • Decrease responsiveness of stimuli that cause plt to aggregate on vessel wall
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are indications of anti platelet drugs?

A
  • CAD – prone to occluded vessels
  • Maintenance of arterial/venous grafts
  • Prevent cerebrovascular occlusion
  • During/post MI for thrombolytic effect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

whats aspirin?

A

Antiplatelet drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are therapeutic actions of asprin?

A

Antiplatelet drug
Inhibits synthesis of thromboxane A2
* Decreases plt aggregation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are adverse affects of aspirin

A

Anti platelet drug

  • Bleeding
  • CNS –> HA dizziness, weakness
  • Monitor for salicylate poisoning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are contras of aspirin?

A

Anti platelet drug

  • Bleeding disorder
  • Uncontrolled HTN
  • Recent/impending surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are drug to drug interaction with aspirin?

A

Increase risk of bleeding when
combined with other
anticoag/antiplatelet drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe anticoagulation?

A
  • All anticoagulants work in clotting cascade
    but do so at different points
  • Prevent formation of new clots and
    extension of clots already present
  • Do not dissolve clots
  • Heparin and warfarin are commonly used
  • Used to prevent or manage
    thrombophlebitis, deep vein thrombosis
    (DVT), and pulmonary emboli (PE)
  • Main adverse effect is bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is heparin?

A

Anticoagulants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the therapeutic action of heparin?

A

Anticoagulants
* Interfere with normal coagulation by disrupting normal clotting cascade
* Blocks formation of thrombin from prothrombin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are indications of heparin ?

A

Anticoagulants

  • Acute clinical situations
  • DVT prevention
  • Prevention of clotting in blood samples/dialysis tubing
  • NOT used in routine IV locks
  • Drug of choice in pregnancy – if necessary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are pharmacokinetics of heparin ?

A

Anticoagulants
SC
* Onset within 20-60 minutes
IV Administration
* IVP rapid action
IV continuous
* Weight based ordering
* Monitor PTT every 6 hours until stabilized and on
maintenance dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are contras for heparin?

A

Anticoagulants

Active bleeding – hemorrhagic disorders, trauma, spinal taps, GI ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are cautions of heparin?

A

Anticoagulants
* Thrombocytopenia
* HIT – drop in platelets approx. 30-50% from baseline
(Heparin induced thrombocypenia)
could cause platelets to clot in presence in heparin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What to monitor for the therapeutic response heparin?

A

-PTT (60-80 most common range)
Partial thromboplastin; How long it takes your blood to clot
* aPTT (1.5 – 2.5 x control value)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is heparin antidote?

A

protamine sulfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How is warafin given?

A

Most commonly used oral anticoagulant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are therapeutic actions of warfarin (Coumadin)?

A

Anticoagulant
Prevents synthesis of vitamin K by bacteria in the GI tract
* This inhibits production of clotting factors II, VII, IX and X– known as the Vit K dependent factors

INR (nl < 1.1) determined by dx (2-3 most common range. Person on warfarin should be at 2-3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are indications with warfarin?

A

Anticoagulant
** Prevention or management of DVT, PE and embolization associated with atrial fibrillation and
prosthetic heart valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are pharmacokinetics of Warfarin?

A

Anticoagulant
Anticoagulant effects occur 2-5 days after oral use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are contras/cautions with warafin?

A

Anticogulant
* Pregnancy, renal/hepatic dz, all others as per heparin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are drug to drug interactions with warafin?

A

Anticoagulant
MANY!! (ex: increased coag effect with PCN; decreased coag effect with digoxin)

Food high in Vit K

24
Q

What is antidote for warfarin?

A

Anticoagulant
Antidote – phytonadione (vitamin K)
* PO, SQ, IVPB (beware)

25
Q

What is dabigatran etexilate mesylate (Pradaxa)?

A

Anticoagulant

26
Q

What is therapeutic action of dabigatran etexilate mesylate (Pradaxa)?

A

Anticoagulant
Acts by inhibiting thrombin

27
Q

What are indications of dabigatran etexilate mesylate (Pradaxa)?

A

Anticoagulant
Indicated for atrial fibrillation (not caused by
valve problems) to prevent stroke

28
Q

What are contras/ cautions of dabigatran etexilate mesylate (Pradaxa)?

A

same as warfarin and heparin

Contras:
* Active bleeding – hemorrhagic disorders, trauma, spinal taps, GI ulcers
* Cautions:
* Thrombocytopenia
* HIT – drop in platelets approx. 30-50% from baseline

29
Q

difference between dabigatran etexilate mesylate (Pradaxa) and older drugs?

A

Antocoag
Benefits over older coags:
* Does not require frequent lab follow-up
* Low potential for drug-drug interactions
* No drug-food interactions

30
Q

What are concerns with dabigatran etexilate mesylate (Pradaxa)

A

Anticoag
* Bleeding episodes more serious

Antidote – idarucizumab (Praxbind)
ANTICOAGULANTS: DABIGATRAN

31
Q

What is enoxaparin (Lovenox)?

A

ANTICOAGULANTS: LOW-MOLECULAR-
WEIGHT HEPARINS (LMWH)

31
Q

What a therapeutic actions of enoxaparin (Lovenox)?

A

Low molecular weight heparins
Synthetic – inhibits thrombus/clots by binding to factors Xa and II

32
Q

What are benefits of enoxaparin (Lovenox)?

A

Low molecular weight heparins

More predictable response
* No intense monitoring of blood required
* Prevention or management of thromboembolic disorders
* Less thrombocytopenia than heparin

33
Q

What are indications enoxaparin (Lovenox)?

A

Low molecular weight heparins

Often used for bridge therapy with warfarin

34
Q

What are antidotes for enoxaparin (Lovenox)?

A

Low molecular weight heparins

Antidote: protamine sulfate (?)

35
Q

What is contra for enoxaparin (Lovenox)?

A

Low molecular weight heparins

  • Contra: epidural catheters
36
Q

What is lepirudin (Refludan)?

A

Anticoag- Heparin/LMWH alternatives

37
Q

What is therapeutic action of lepirudin (Refludan)?

A

Anticoag- Heparin/LMWH alternatives

Inhibits thrombin – similar to heparin mechanism

38
Q

What are indications for lepirudin (Refludan)??

A

Anticoag- Heparin/LMWH alternatives

  • Allergy to heparin
  • Pts at risk for HIT or with a documented history
39
Q

What are pharmacokinetics of lepirudin (Refludan)?

A

Anticoag- Heparin/LMWH alternatives

  • PTT followed for therapeutic effect
  • IV route only (continuous infusion)
40
Q

What are nursing considerations with lepirudin (Refludan)?

A
  • Soft toothbrush
  • Electric razor
  • No IM shots
  • Hold veni puncture sites
  • Monitor for bleeding, bruising
  • When/what to report
  • Dietary restrictions (warfarin)
  • Let PCP know of other meds/ herb/
    vitamins
  • No contact sports
  • Note allergy – consider for ALL
    heparin products
  • Medical alert bracelet
  • Avoid OTC drugs –addition of
    other drugs
41
Q

Describe THROMBOLYTIC AGENTS

A

Dissolve thrombi
* Stimulate conversion of plasminogen to plasmin – breaks fibrin clot
* Goal is to reestablish blood flow and prevent or limit tissue damage

42
Q

What are indications of thrombolytic agents?

A
  • Indications:
  • Management of acute, severe thromboembolic disease such as MI, PE
  • Dissolve clots in arterial or venous catheters
43
Q

What is alteplase (Activase)

A

thrombolytic agents
tissue plasminogen
activator (t-PA)

-Fibrin specific – work
specifically at the site of the
clot
* Lower risk of systemic
thrombolysis than earlier drugs

44
Q

What are contras of alteplase (Activase)

A

thrombolytic agents
tissue plasminogen
activator (t-PA)

  • Recent surgery
  • Active bleeding
  • CVA within last two months
  • Uncontrolled HTN
  • Pregnancy
45
Q

What are cautions with alteplase (Activase)

A

thrombolytic agents
tissue plasminogen
activator (t-PA)

  • Monitor for bleeding
  • Cardiac reperfusion syndrome
  • Hypersensitivity – flushing, bronchospasm
46
Q

What is **aminocaproic acid (Amicar)? And what is the therapeutic action

A

Hemostatic agent

  • Therapeutic actions:
  • Stop excessive bleeding –>prevents the lysis/breakdown of clots
47
Q

What are indications aminocaproic acid (Amicar)?

A

Hemostatic angents/help control bleeding
* Indications:
* Used in surgery (IV), wound care (gel form/sponge), subarachnoid hemorrhage

48
Q

What are contras aminocaproic acid (Amicar)?

A

Hemostatic agents/help control bleeding

  • Allergy, pregnancy
  • Cautions:
  • Renal/hepatic disease, monitor for excessive clotting
49
Q

What are cautions aminocaproic acid (Amicar)?

A

Hemostatic agents/help control bleeding
* Renal/hepatic disease, monitor for excessive clotting
HEMOSTATIC AGENTS

50
Q

What is therapeutic action and indications of Antihemophilic factor- (Factor VIII)

A

Help control bleeding:
* Replacement factors for the specific clotting factors patient is missing/low
* Factors VIII, VIIa, IX

51
Q

What are Pharmacokinetics of Antihemophilic factor- (Factor VIII)

A

control bleeding

  • Given IV
52
Q

What are adverse effects of Antihemophilic factor- (Factor VIII)

A

control bleeding

  • HA, flushing, fevers, chills
53
Q

What are contras of Antihemophilic factor- (Factor VIII)

A

control bleeding
* Allergy to mouse/bovine proteins
* Pregnancy/ lactation

54
Q
A

Pharmacology (39 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions