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Pharmacology > Anticoagulant Anti platelet Thrombolytics > Flashcards

Anticoagulant Anti platelet Thrombolytics Flashcards

1
Q

thrombus

A

blood clot

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2
Q

arterial thrombus

A

adhesions of platelets to the arterial wall; composed of white clots (platelets) and red clots (Rbcs)

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3
Q

venous thrombi

A

develop at sites where blood flow is slow; venous stasis initiates this; long tails that break and can cause pulmonary embolism

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4
Q

venous clots are from

A

platelet aggregation within fibrin that attaches to RBCs

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5
Q

the body will work to remove the clot through

A

plasmin; enzyme that degrades fibrin meshwork of clot

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6
Q

treatment for thrombus

A

anticoagulants
antiplatelets
thrombolytics aka fibrinolytic

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7
Q

anticoagulants

A

suppress coagulation, suppress fibrin production, factors II VII IX X
best against VENOUS

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8
Q

antiplatelets

A

inhibit platelet aggregation, best against ARTERIAL

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9
Q

thrombolytics aka fibrinolytic

A

promoting lysis of fibrin promotes clot deterioration

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10
Q

anticoagulants inhibit

A

the synthesis and activity of clotting factors; does not dissolve clots that are already formed

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11
Q

anticoagulant types

A 
Heparin
Enoxaparin 
Warfarin
Dabigatran
Rivaroxaban
Apixaban
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12
Q

Heparin

A

activate antithrombin and Xa; preferred for PE, DVT, open-heart surgery, renal dialysis, DIC; also for MI; IV or SUB 1.5 half life works within minutes

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13
Q

heparin adverse effects

A

hemorrhage (protamine sulfate fixes); avoid antiplatelet drugs (aspirin clopidogrel); hep induced thrombocytopenia (monitor platelets 2-3x a week)

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14
Q

heparin education

A 
dosed in units
sub q prophylax
Iv acute
PTT (40 seconds normal)
Tx (60-80 seconds)
anti xa; platelet counts
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15
Q

Protamine Sulfate is the

A

antidote to Heparin

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16
Q

Anticoagulants: Low Molecular Weight Heparins

A

inactive Xa no affect on thrombin; lower bleeding risk; 1st line DVT; half-life 6x longer 1-2x a day;

enoxaparin
dalteparin

17
Q

Anticoagulants: warfarin (Oral)

A

decrease prothrombin and factors VII IX X (vit K); vit k antag, high protein-bound, delayed; DVT PE prosthetic heart valves a FIb

18
Q

warfarin half life

A

6 hr to 2.5 days; peak can take several days; if stopped effects continue for 2-5 days

19
Q

Anticoagulants: warfarin (Oral) labs

A

PT for time of blot to clot; INR no INR without PT; normal INR about 1; TX INR 2-3

20
Q

warfarin side effects

A

Hemorrhage
Antidote: VITAMIN K
Can cause fetal hemorrhage in pregnancy

21
Q

Anticoagulants: warfarin (Oral)-Education

A

take vitamin K; dark greens, mayo, oil; soft bristle toothbrush and electric razor; report signs of bleeding; wear alert band, no new meds

22
Q

warfarin drug interactions

A

blood thinners, antibiotics, OTC pain relievers, and seizure medications

Patient’s taking carbamazepine will need to increase their dose

23
Q

Anticoagulant (Oral): Direct Thrombin Inhibitors

A

direct inhibition of thrombin; rapid onset EMPTY TUM; no need to watch blood levels; low bleed risk; no food interactions

Dabigatran etexilate (oral)

24
Q 
Dabigatran etexilate (oral)
uses
A 
A-fib
DVT/PE prevention
VTE prophylaxis following Knee or hip replacement
NO MOISTURES
13hr half life
25
Q

admin of Dabigatran etexilate (oral)

A

reversal praxbind; do not crush chew or open; doses twice daily

GI symptoms

26
Q

Anticoagulant (Oral): Xa Inhibitors

A

directly with Xa; rapid onset fixed-dose low risk fewer interactions no routine labs;

DVT PE strokes
Rivaroxaban
Apixaban

27
Q

Rivaroxaban

A

80-90 bioavailable
high protein bound
5-9 half life

Andexxa reversal for rivaro and apixaban

28
Q

Apixaban

A

inhibits XA, uses prevent strokes, systemic embolism; low risk drug interactions

50 bioavailable
2-4 hr peak
12 hour half life
high protein bound

29
Q

Antiplatelet Drugs

A

prevent thrombosis in the arteries by suppressing platelet aggregation; aspirin, P2Y12, GP llb/llla

30
Q

aspirin

A

irreversible inhibition of cyclooxygenase; 1 dose 7-10days; reduce MI stroke(death) reocclusion vascular mortality; and prevent MI

31
Q

aspirin side effects and dose

A

Hemorrhagic stroke
GI bleed

81mg/day or 325mg/day

32
Q

clopidogrel

A

similar antiplatelet aggregation effects as aspirin; adenosine diphosphate antagonist; 50 bioavail; 2 hrs after dose; irreversible; prevent atherothrombitic event

33
Q

Thrombolytics

A

clot busters;
Acute MI
Massive PE
Ischemic stroke; plasmin digests fibrin; 2-4 hr after symptom; brain and heart susceptible to ischemia

alteplase tPA (Activase) IV

34
Q

alteplase tPA (Activase) IV

A

Tissue-type plasminogen activator
5 minute half-life
the large dose could be hemorrhage; reversal agent : aminocaproic acid

Pharmacology (17 decks)

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