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Pharmacology > anticoagulants, antiplatelets, and thrombolytic medications > Flashcards

anticoagulants, antiplatelets, and thrombolytic medications Flashcards

(71 cards)

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1
Q

antiplatelets

A

alter the formation of the platelet plug

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1
Q

anticoagulants

A

interfere with clotting cascade and thrombin formation

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2
Q

thrombolytics

A

break down the thrombus by stimulating the plasmin system

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3
Q

anti-platelet examples

A

aspirin
clopidogrel
abciximad

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4
Q

anticoagulant examples

A

heparin
enoxaprin
warfarin
dabigatran

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5
Q

thrombolytic example

A

tPA

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6
Q

aspirin action

A

-suppress platelet aggregation
-primarily in arteries

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7
Q

aspirin indications

A

-primary & secondary prevention of MI
-prevention of stroke in pts with hx of TIAs
-anti-inflammatory & anti-febrile

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8
Q

aspirin precaution

A

IRREVERSIBLE ACTION
-single dose of aspirin persists fro the life of a platelet (7-10 days)

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9
Q

if someone taking aspirin was having an elective surgery, when would you tell them to stop taking the aspirin?

A

7 days prior to surgery

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10
Q

adverse effects of aspirin

A

-GI upset & bleeding
-hemorrhagic stroke
-salicylate toxicity

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11
Q

what does salicylate toxicity look like?

A

-agitation
-confusion
-tachycardia
-fever
-ringing in ears

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12
Q

should you recommend someone take aspirin with food?

A

yes

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13
Q

aspirin contraindications

A

-peptic ulcer
-thrombocytopenia

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14
Q

aspirin teaching

A

-bleeding
-GI upset
-overuse

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15
Q

clopidogrel indications

A

-reduces risk of thrombotic events in patients with CAD
-prior to or after cardiac procedures (Cath/stent)

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16
Q

what type of medication is clopidogrel?

A

anti platelet

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17
Q

clopidogrel adverse effects

A

-bleeding
-TTP (big flat bruising)

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18
Q

clopidogrel teaching

A

-monitor for GI side effects
-look for blood in stool and urine
-look for bruising
-take with or without food

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19
Q

what cannot be taken with clopidogrel?

A

PPI

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20
Q

What are the most effective anti platelet drugs??

A

-super aspirins
-Abciximab
-tirofiban

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21
Q

abciximab / tirofiban indications

A

-prevent ischemic events due to acute coronary syndromes and those undergoing percutaneous coronary intervention (PCI)

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22
Q

abciximab / tirofiban adverse effects

A

-monitor for Brady cardia & hypotension
-bleeding

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23
Q

what do anticoagulants do?

A

-prevent blood clots from forming or extending
-interfere with the clotting cascade & thrombin formation

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24
do anticoagulants break down existing clots?
no
25
heparin method od action
activates antithrombin thus indirectly inactivating thrombin & factor Xa which inhibits fibrin formation
26
heparin indication
-treat PE, DVT, stroke, when prompt anticoagulant activity is needed -low dose for prophylaxis for surgery -treatment of DIC
27
heparin contraindications
-thrombocytopenia -Pts with high risk of bleeding (peptic ulcer disease, severe hypertension) -post-op surgeries on the brain, eye, or spinal cord, lumbar puncture
28
people with what type of chronic illnesses should not take heparin?
-peptic ulcer disease -severe hypertension
29
people with what type of surgery should not take heparin?
-eye -brain -spinal cord -lumbar puncture
30
where would you administer a heparin injection?
SQ 2 inches below umbilicus
31
can heparin be a drip?
yes
32
monitoring for heparin
-frequent monitoring and titration of drip rate based upon aPTT
33
what are therapeutic aPTT values for someone on heparin?
-1.5-2 times the control
34
heparin most common adverse effects
-hemorrhage -heparin-induced thrombocytopenia -hypersensitivity reaction
35
heparin antidote
protamine sulfate
36
heparin teaching
-avoid aspirin -report bleeding, bruising, dark tray stool
37
enoxaparin mechanism of action
-activates antithrombin thus indirectly inactivating factor Xa which inhibits fibrin formation
38
enoxaparin indications
-prevent DVT post-op -treat DVT & PE -prevents complications of MI
39
enoxaparin contraindications
-thrombocytopenia -pts with a high risk of bleeding (peptic ulcer disease, severe hypertension -post-op surgeries on brain, spinal cord, eye or lumbar puncture
40
where do you give enoxaparin injections?
SQ at anterior or posterolateral sites
41
monitoring for enoxaparin
-predictable pharm-kinetics: does not require PTT monitoring -weight based -monitor CBC
42
adverse effects of enoxaparin
bleeding
43
antidote for enoxaparin
protamine sulfate
44
warfarin mechanism of action
antagonizes vitamin K which prevents formation of coagulation factors
45
indications for warfarin
-prevent DVT & PE -prevent thrombosis in fib or prosthetic heart valve -reduce risk for recurrent TIA/CVA or MI
46
warfarin contraindications
-pts with high risk of bleeding, post-op brain/eye/spinal cord surgery -liver disorders & alcohol use disorders
47
warfarin most common side effect
bleeding
48
warfarin assessment
MONITOR FOR BLEEDING -watch INR -PT should be 1.5-2 times patient's baseline value -INR level is 1.1 or lower, desired therapeutic range of 2-3
49
warfarin antidote
Vitamin K
50
general teaching points for heparin, enoxaparin, & warfarin
-avoid aspirin -electric razors & soft toothbrushes -report bruising, dark tarry stools, fatigue, dizziness, palpations -stay away from foods high in vitamin K
51
foods high in vitamin K
spinach, green leafy veggies, broccoli, kale
52
indication for thrombin inhibitors
-DVT -PE -CVA with afib
53
dabigatran antidote
Praxbind
54
direct thrombin inhibitors administration
-oral -short acting
55
direct thrombin inhibitors contraindications
-pts with high risk of bleeding or active bleeding -liver disorders & alcohol use disorders (higher risk for bleeding)
56
direct thrombin inhibitors precautions
-aspirin -NSAIDS -other anticoagulants -hepatic of renal impairment -pregnancy category C
57
rivaroxavan/apiaxban antagonist
andexanet alfa
58
why would an antidote to a direct thrombin inhibitor be given?
-in the event of an emergency surgery -urgent procedure -life-threatening or uncontrolled bleeding
59
risks of dabigatran
-surgery or dental work bleeding concerns -spinal or epidural blood clots leading to paralysis
60
biggest concern about dabigatran
no reliable lab test to identify overdose
61
teaching for dabigatran
-monitor for bleeding signs -soft tooth brush, electric razor -avoid over the counter meds like feverfew, garlic, ginger, gingko biloba, saw palmetto
62
alteplASE action
-breaks down formed clots -can interfere with new clot formation
63
alteplASE indications
-evolving MR or CVA -massive PE -extensive DVT -arterial thrombosis -open clotted paths
64
alteplASE administration
-IV, time is priority
65
alteplASE contraindications
-intracranial hemorrhage -active internal bleeding -ischemic stroke within past 3 months -cautious with uncontrolled hypertension
66
alteplASE adverse effects
-bleeding -hypotension -fever
67
management of bleeding with thrombolytics (alteplASE)
-use whole blood, FFP if bleeding is excessive
68
what to use if blood products don't work to fix bleeding with thrombolytics?
aminocoproic
69
management of bleeding
-minimize physical manipulations of patient -avoid sub Q or Im injections -minimize invasive proceures -manual BP no automated cuff -minimize concurrent use of anticoagulants and anti-platelet drugs -monitor aPTT, INR -monitor CDC: H&H -no foley Cath
70
complementary therapies that suppress platelet aggregation
-feverfew -ginger root -glucosamine -garlic -ginko biloba

Pharmacology (60 decks)

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