**anticog meds** Flashcards
(149 cards)
1
Q
what type of drugs decrease plt aggregation & formation of platelet clot?
A
anti-platelet drugs
2
Q
what kind of drug is Warfarin (Coumadin)?
A
anticoagulant
3
Q
what kind of drug is Clopidogrel (Plavix)?
A
antiplatelet
4
Q
what med, when taken with heparin, increases risk of toxicity?
A
Acetylsalicylic acid (ASA)
5
Q
what kind of drug is Acetylsalicylic acid (ASA)?
A
antiplatelet
6
Q
what med inhibits prostaglandin production?
A
Acetylsalicylic acid (ASA)
7
Q
what med is a precursor to prostaglandins?
A
Clopidogrel (Plavix)
8
Q
what type of drugs interfere w clotting cascade & thrombin formation?
A
anticoagulant drugs
9
Q
when should Warfarin (Coumadin) be taken?
A
in the evening
10
Q
what kind of drug is Ticagrelor (Brilinta)?
A
antiplatelet
11
Q
what med inhibits ADP receptors through P2Y12 inhibitors?
A
Clopidogrel (Plavix)
12
Q
what meds are P2Y12 inhibitors that inhibit platelet function? (4)
A
1) Ticagrelor (Brilinta)
2) Prasurgrel (Effient)
3) Ticlopidine (Ticlid)
4) Cangrelor (Kengreal)
13
Q
what drugs prevent factor Xa from changing prothrombin to thrombin and bind directly to factor Xa?
A
Direct factor Xa inhibitors (DOAC)
14
Q
what med is used to prevent platelet aggregation?
A
Acetylsalicylic acid (ASA)
15
Q
what med is used to inhibit platelet aggregation?
A
Clopidogrel (Plavix)
16
Q
what type of drugs function to prevent new clots from forming?
A
Anticoagulants
17
Q
what med, when taken with methotrexate, increases risk of toxicity?
A
Acetylsalicylic acid (ASA)
18
Q
what drugs cause increased bruising or bleeding such as gums, shaving, & small cuts?
A
Antiplatelets
19
Q
what med can cause hypersensitivity?
A
Unfractionated Heparin
20
Q
what drugs can cause severe bleeding with trauma & falls?
A
Antiplatelets
21
Q
what med will often be combined with ASA?
A
Clopidogrel (Plavix)
22
Q
what drugs have many herbal interactions?
A
Antiplatelets
23
Q
with what drug is there NO ABGs (blood gas) done?
A
thrombolytics
24
Q
what med starts to work in 24-48 hours but not see full effect for 4-6 days?
A
Clopidogrel (Plavix)
25
what drugs can cause headaches?
Antiplatelets
26
what kind of drug is Prasurgrel (Effient)?
antiplatelet
27
what drugs can cause GI side effects like N/V?
Antiplatelets --> Acetylsalicylic acid (ASA)
28
what drugs can cause skin rashes?
Antiplatelets --> Clopidogrel (Plavix)
29
what med, when taken with oral DM meds, increases risk of toxicity?
Acetylsalicylic acid (ASA)
30
what kind of drug is Ticlopidine (Ticlid)?
antiplatelet
31
what med needs to be stopped for 4-10 before surgery? why?
Clopidogrel (Plavix)
it needs to be stopped until platelets begin to function again
32
what meds reduce the risk of stroke and embolism in patients with NON-VALVULAR induced a-fibrillation, and DVT/ PE?
Direct factor Xa inhibitors (DOAC)
33
what med is indicated for prevention of coronary artery disease (CAD)?
Acetylsalicylic acid (ASA)
34
what type of drugs function to prevent the growth of new clots (ex MI)?
Anticoagulants
35
what type of drug is Heparin?
Anticoagulant
36
what med CANNOT be given to children under 18 because it can cause Reye syndrome?
Acetylsalicylic acid (ASA)
37
what type of drugs break down the thrombus by stimulating plasmin?
thrombolytic agents
they promote the conversion of plasminogen to plasmin leading to fibrinolysis
38
what meds are indicated for prevention of cerebrovascular accident (CVA)?
1) Acetylsalicylic acid (ASA)
2) Warfarin (Coumadin)
39
what type of drug is Warfarin (Coumadin)?
Anticoagulant
40
what drugs should NOT be taken with clopidogrel?
Direct factor Xa inhibitors (DOAC)
41
what kind of drug is Cangrelor (Kengreal)?
antiplatelet
42
what med is indicated for prevention of peripheral artery disease (PAD)?
Acetylsalicylic acid (ASA)
43
what drugs are contraindicated in Uncontrolled BP (185/110 or >)?
thrombolytics
44
what med is generally well-tolerated?
Clopidogrel (Plavix)
45
what meds are highly bound to plasma proteins? (2)
1) Acetylsalicylic acid (ASA)
2) Warfarin (Coumadin)
46
what drugs are commonly used for both DVT prophylaxis and MIs?
Low Molecular Weight Heparin (LMWH)
47
what drug is used in atrial fibrilation?
Warfarin (Coumadin)
48
how long can a single dose of Acetylsalicylic acid (ASA) (325 mg) inhibit platelet aggregation?
for the lifespan of the platelet (about 7 days)
49
what med should be stopped AT LEAST one week before surgery?
Acetylsalicylic acid (ASA)
50
what type of drug is **Apixaban (Eliquis)?**
Anticoagulant --> Direct factor Xa inhibitors (DOAC)
51
what med maintains AV grafts?
Acetylsalicylic acid (ASA)
52
what med inhibits production of vitamin K which plays a role in blood clotting?
Warfarin (Coumadin)
53
what med can cause diarrhea?
Clopidogrel (Plavix)
54
what kind of drug is Tenecteplase (TPA)?
thrombolytic **biggest one**
55
what med, when taken with insulin, increases risk of toxicity?
Acetylsalicylic acid (ASA)
56
what are the only way thrombolytics can be given and why?
what route is NEVER allowed?
through a peripheral IV, not a central line (so you can compress the site)
NO injections (SQ, IM)
57
what drugs are contraindicated in closed head injuries?
antiplatelets
58
what type of drug is Dabigatran (Pradaxa)?
Anticoagulant --> (DOAC)
**it is a direct thrombin inhibitor**
59
what meds are used post MI? (2)
Acetylsalicylic acid (ASA)
Clopidogrel (Plavix)
60
what drug is used in valvular heart disease?
Warfarin (Coumadin)
61
steroids can decrease the effects of what med & cause ulcers?
Acetylsalicylic acid (ASA)
62
what med is indicated for the prevention of deep vein thrombosis?
Warfarin (Coumadin)
63
what drugs are contraindicated in pts with a platelet count of <100,000?
thrombolytics
64
What meds are used post stent placement? (2)
Acetylsalicylic acid (ASA)
Clopidogrel (Plavix)
65
Acetylsalicylic acid (ASA) can be used for other _____ ______
vascular disease
66
what type of drug is Enoxaparin (Lovenox)?
Anticoagulant
67
what drugs are contraindicated in hx of Hemorrhagic Stroke?
thrombolytics
68
what is the antidote for heparin?
protamine sulfate
69
what drugs have a narrow therapeutic range & requires lab monitoring? (2)
1) Unfractionated Heparin
2) Warfarin (Coumadin)
70
what drugs are contraindicated in pregnancy (risk/benefit) and lactation?
antiplatelets
71
what two drugs BOTH withhold a clotting factor?
heparin & warfarin
72
what med is safe during pregnancy but considered 2nd line therapy?
unfractionated heparin
73
what med should be used cautiously in pts with hepatic or renal impairment?
Acetylsalicylic acid (ASA)
74
what are the signs of Acetylsalicylic acid (ASA) toxicity? (3)
Tinnitus (ringing of ears)
Hyperventilation
Metabolic acidosis
75
can heparin and warfarin be given at the same time?
yes
76
what drugs are contraindicated in hx of aneurysm?
thrombolytics
77
what drug is indicated for the prevention of pulmonary embolism (PE)?
Warfarin (Coumadin)
78
what med, when taken with other oral anticoagulants, increases risk of toxicity?
Acetylsalicylic acid (ASA)
79
What kind of drug is Alteplase?
thrombolytic
80
what med interacts with ACE inhibitors?
Acetylsalicylic acid (ASA)
81
what drugs are contraindicated in active bleeding?
antiplatelets
82
what must be monitored when a pt is on thrombolytics?
vital signs and neurologic status → any N/V, H/A, change in LOC
83
what med interacts with beta blockers?
Acetylsalicylic acid (ASA)
84
antiplatelets are contraindicated in CVA until when?
its proved there is no bleed
85
what med interacts with NSAIDs because it competes with COX-1?
Acetylsalicylic acid (ASA)
86
what drugs are contraindicated in hx of AV malformations?
thrombolytics
87
what type of drug is **Rivaroxaban (Xarelto)?**
Anticoagulant --> Direct factor Xa inhibitors (DOAC)
88
For what med should pts be taught to use a soft toothbrush?
Acetylsalicylic acid (ASA)
89
for what med should pts be taught to use an electric razor?
Acetylsalicylic acid (ASA)
90
what drug is used post joint replacement?
Warfarin (Coumadin)
91
what med can cause heparin-induced thrombocytopenia?
Unfractionated Heparin
92
what is med of choice for acute patients due to its fast onset of action?
Heparin
93
what med should pts NOT stop taking on their own?
Acetylsalicylic acid (ASA)
94
what meds have a quicker onset than other antiplatelet drugs? (4)
1) Ticagrelor (Brilinta)
2) Prasurgrel (Effient)
3) Ticlopidine (Ticlid)
4) Cangrelor (Kengreal)
95
what drugs are contraindicated if the pt has had heparin in the last 48 hrs?
thrombolytics
96
for what meds should we watch for drug interactions?
Direct factor Xa inhibitors (DOAC)
97
for pts taking Acetylsalicylic acid (ASA), what signs of bleeding should they call their doctor for? (4)
1) Nosebleed that doesn’t stop after 5 min
2) Black tarry stool
3) Heavy menstrual cycle
4) Excessive bruising (that gets bigger)
98
what is considered FIRST LINE in pregnancy?
Low Molecular Weight Heparin (LMWH)
99
what med should always be taken with food?
Acetylsalicylic acid (ASA)
100
what is the suffix for Direct factor Xa inhibitors (DOAC)s?
"ban" or "an"
101
for what med should pts be taught to watch alcohol intake?
Acetylsalicylic acid (ASA)
102
for what type of meds should we inform the pt that meds must stay in original bottle and DO NOT place in pill box?
Direct factor Xa inhibitors (DOAC)
103
for what med should pts be taught to watch caffeine intake?
Acetylsalicylic acid (ASA)
104
When must the dose of Direct factor Xa inhibitors (DOAC) be reduced?
renal failure
105
what med should not be mixed with other medications bc it has multiple interactions?
unfractionated heparin
106
for what type of meds should we tell pts NOT to crush the pills?
Direct factor Xa inhibitors (DOAC)
107
what drugs are contraindicated in known bleeding disorder?
antiplatelets
108
what med is an anti-thrombin inhibitor that interferes with conversion of thrombin to prothrombin ?
Heparin
109
what are the 2 types of heparin?
Unfractionated
Low molecular weight heparin (LMWH)
110
for what med should pts be taught to NOT chew enteric-coated tablets?
Acetylsalicylic acid (ASA)
111
what drugs are contraindicated with use of current oral anticoagulants?
thrombolytics
112
what drugs may be more effective in decreasing platelet aggregation than Clopidogrel? (4)
1) Ticagrelor (Brilinta)
2) Prasurgrel (Effient)
3) Ticlopidine (Ticlid)
4) Cangrelor (Kengreal)
113
antiplatelet drugs should be stopped AT MINIMUM how many days before surgery?
2-5 days (some cases up to a week)
114
what do Anticoagulants NOT do? (2)
thin blood
dissolve a clot
115
what are the routes of admin for heparin?
IV or SQ
116
what type of heparin can ONLY be given SQ?
Low Molecular Weight Heparin (LMWH)
117
are the types of Heparin used interchangably?
NO
118
what are used in mostly in acute stroke and can be used in acute MI (life-threatening disorders)
Thrombolytics
119
Unfractionated heparin inhibits thrombus and clot formation by doing what?
blocking factors Xa
120
what drugs is there caution in abruptly stopping?
Direct factor Xa inhibitors (DOAC)
121
what is the therapeutic range for Unfractionated Heparin?
PTT = 46-70
122
when should doctor be called regarding labs for Unfractionated Heparin?
if PTT > 70
123
what two meds are Low Molecular Weight Heparin (LMWH)?
Enoxaparin (Lovenox)
Dalteparin (Fragmin)
124
what drugs are contraindicated with DOAC use?
thrombolytics
125
how should Low Molecular Weight Heparin (LMWH) be administered?
1) 2 inch from umbilicus
2) no rubbing
3) no aspiration
126
what happens to the platelet count in Heparin-Induced Thrombocytopenia?
drops by half within 24 hrs of administration of heparin
127
Does Low Molecular Weight Heparin (LMWH) require lab monitoring?
NO!!!
128
if the pt is complaining of a headache and there is a possible CVA, what must be done before admin thrombolytics?
head CT
129
what is a potentially life threatening complication of heparin?
Heparin-Induced Thrombocytopenia
130
what antidotes are available for Heparin-Induced Thrombocytopenia?
1) **Argatroban** → direct thrombin inhibitor
2) Lepirudin (Refluden → another antidote not as used)
131
what precautions should pts on thrombolytics be on?
bleeding
132
how long does Warfarin (Coumadin) take to effect?
4-7 days
133
with Warfarin (Coumadin), what labs do we monitor?
PT/INR
134
with unfractionated heparin, what labs do we monitor?
PTT
135
what do we want the INR to be with Warfarin (Coumadin)?
2 to 3
136
what do we want the INR to be with Warfarin (Coumadin) in pts with mechanical heart valve?
2.5 to 3.5
137
what is the antidote for Warfarin (Coumadin)?
Phytonadione (Vitamin K)
138
what is route of admin for Warfarin (Coumadin)?
oral
139
what drug works IMMEDIATELY?
heparin
140
what drugs are contraindicated in pts who have had surgery in the last 3 months?
thrombolytics
141
do Direct factor Xa inhibitors (DOAC) require drug monitoring?
NO!
142
pts on Direct factor Xa inhibitors (DOAC) should NOT stop taking their medication for what type of side effects? unless what?
Don’t stop taking for GI issues, unless there is black, tarry stools or red bloody stools
143
what is the antidote for the DOAC Dabigatran (Pradaxa)?
Praxbind (idarucizumab)
144
what is the antidote for Rivaroxaban & Apixaban only?
Andexanet (andexxa)
145
what labs must the nurse know w DOACs?
Creatinine & liver enzymes
146
what precautions should pts taking DOACs be put on?
bleeding
147
what are some natural clot busters? (4)
ADH, Epinephrine , Stress, Physical Activity
148
thrombolytics are only given within how long of sx onset?
3-4 hrs
149
Signs of excessive bleeding (8)
Passing blood in the urine
Passing blood in stool
Severe bruising
Prolonged nosebleeds (lasting longer than 5-10 minutes)
Vomiting blood or coughing up blood esp if frank red blood
Sudden severe back pain
Difficulty breathing or chest pain
In women, heavy or increased bleeding during menses, or any other bleeding from the vagina in btwn menses
