Chapter 9: Drug Therapy for Coagulation

Question 1

drugs that prevent formation of new clots and extension of clots already present; do not dissolve formed clots

Answer 1

Anticoagulants

Question 2

drugs that prevent one or more steps in the prothrombotic activity of platelets

Answer 2

Antiplatelets

Question 3

object that migrates through the circulation until it lodges in a blood vessel, causing occlusion; may be a thrombus, fat, air, amniotic fluid, a bit of tissue, or bacterial debris

Answer 3

Embolus:

Question 4

chronic blood disorder characterized by the overproduction of platelets by megakaryocytes in the absence of another cause

Answer 4

Essential thrombocythemia:

Question 5

enzyme that breaks down the fibrin meshwork that stabilizes blood clots; also referred to as plasmin

Answer 5

Fibrinolysin:

Question 6

prevention or stoppage of blood loss from an injured blood vessel and is the process that maintains the integrity of the vascular compartment

Answer 6

Hemostasis

Question 7

immune-mediated adverse effect that leads to thrombogenesis resulting in a decrease in platelet count associated with heparin administration in patients with detectable HIT antibodies

Answer 7

Heparin induced thrombocytopenia (HIT)

Question 8

enzyme that breaks down the fibrin meshwork that stabilizes blood clots; also referred to as fibrinolysin

Answer 8

Plasmin:

Question 9

inactive protein found in many body tissues and fluids

Answer 9

Plasminogen

Question 10

formation of a blood clot

Answer 10

Thrombogenesis:

Question 11

breakdown or dissolution of blood clots

Answer 11

Thrombolysis

Question 12

drugs that dissolve blood clots

Answer 12

Thrombolytics

Question 13

formation of a blood clot

Answer 13

Thrombosis

Question 14

Blood clot

Answer 14

Thrombus

Question 15

Why is it necessary to give heparin intravenously?

Answer 15

It is necessary to give heparin intravenously or subcutaneously, because the gastrointestinal (GI) tract does not absorb the drug.

Question 16

Indications for use of heparin:

Answer 16

Prevention and management of thromboembolic disorders (e.g., DVT, pulmonary embolism, atrial fibrillation with embolization)

Question 17

Dosage of heparin:

Answer 17

Adults: IV injection, 5000 units initially, followed by 5000–10,000 units every 4 to 6 h, to a maximum dose of 25,000 units/d; IV infusion, 5000 units (loading dose), then 15–25 units/kg/h
DIC, IV injection, 50–100 units/kg every 4 h; IV infusion, 20,000–40,000 units/d at initial rate of 0.25 units/kg/min, then adjusted according to aPTT; Sub-Q 10,000–12,000 units every 8 h, or 14,000–20,000 units every 12 h
Low-dose prophylaxis, Sub-Q 5000 units 2 h before surgery, then every 12 h until discharged from hospital or fully ambulatory
Children: DIC, IV injection, 25–50 units/kg every 4 h; IV infusion, 50 units/kg initially, followed by 100 units/kg every 4 h or 20,000 units/m2 over 24 h