Coagulation Meds Exam 3

Question 1

MOA for heparin

Answer 1

prevents clotting by activating antithrombin –> indirectly inactivates thrombin & factor Xa

Question 2

MOA for enoxaparin (Lovenox)

Answer 2

prevents clotting by activating antithrombin –> inactivates factor Xa

Question 3

Side effects of heparin

Answer 3

bleeding
hematoma
anemia
thrombocytopenia

Question 4

what is HIT

Answer 4

heparin induced thrombocytopenia

-low platelet count and increased development of thrombi –> caused by antibody development

Question 5

what are nursing considerations for HIT

Answer 5

monitor platelet counts

stop heparin immediately if platelet count <100,000/mm^3

Question 6

what is the antidote for heparin

Answer 6

protamine sulfate

Question 7

side effects of enoxaparin (Lovenox)

Answer 7

bleeding, thrombocytopenia, HIT

Question 8

antidote for enoxaparin

Answer 8

protamine

Question 9

nursing considerations for enoxaparin

Answer 9

DO NOT GIVE WITH HEPARIN
pregnant women can receive 
slower onset of heparin but LONGER half-life
pre-filled syringes 
rotate injection sites

Question 10

black box warning for enoxaparin

Answer 10

potential spinal hematoma if patient has epidural catheter

Question 11

MOA for warfarin

Answer 11

vitamin K inhibitor - prevents synthesis of four coagulation factors (VII, IX, X, prothrombin)

Question 12

indications for warfarin

Answer 12

prevention VTE/DVT/PE
thrombotic events for patients with afib or heart valves
reduce recurrence of TIA or MI

Question 13

SE of warfarin

Answer 13

BLEEDING
lethargy
muscle pain
purple toes

Question 14

antidote for warfarin

Answer 14

Vitamin K

Question 15

nursing considerations for warfarin

Answer 15

cannot give to pregnant women or breastfeeding women
monitor and TEACH for signs of bleeding
onset is 24 hours
-duration is 2-5 days

Question 16

MOA for apixaban & rivaroxaban

Answer 16

direct inhibitor of factor Xa

Question 17

indications for apixaban & rivaroxaban

Answer 17

prevent strokes in patients with afib
post-op thrombo-prophylaxis
treat DVT & PE

Question 18

adverse effects of apixaban & rivaroxaban

Answer 18

bleeding, hematoma, dizziness, rash, GI distress, peripheral edema

Question 19

black box warning for apixaban & rivaroxaban

Answer 19

spinal hematomas

risk of thrombosis if drugs abruptly stopped

Question 20

nursing considerations for apixaban & rivaroxaban

Answer 20

drug interactions - no grapefruit
no routine monitoring required 
do not give with other anticoagulants 
watch liver 
antidote: andexxa (giving factor Xa)

Question 21

MOA of aspirin

Answer 21

antiplatelet
NSAID
blocks prostaglandin synthesis through the COX enzyme pathways - through this mechanism also BLOCKS PLATELET AGGREGATION
prevents platelets from clumping together

Question 22

indications for aspirin

Answer 22

prevent/threat MI, prevent ischemic stroke

Question 23

SE for aspirin

Answer 23

GI (n/v), drowsiness/confusion, bleeding

Question 24

nursing considers for aspirin

Answer 24

dont crush enteric coated
OTC medication
reye’s syndrome: children with a virus NO ASPIRIN

Question 25

antidote for aspirin

Answer 25

DDAVP

Question 26

clopidogrel & ticagrelor MOA

Answer 26

antiplatelet ADP inhibitor

Question 27

indications for clopidogrel and ticagrelor

Answer 27

reduce risk of stroke prophylaxis of TIAs post MI

Question 28

SE of clopidogrel and ticagrelor

Answer 28

chest pain, edema, flu-like symptoms, abdominal pain, diarrhea, nausea, epistaxis (nose bleed), rash, pruritus

Question 29

BLACK BOX warning for clopidogrel

Answer 29

patients with certain genetic abnormalities who may have higher rate of CV events due to reduced conversion to its active metabolite

Question 30

BLACK BOX for ticagrelor

Answer 30

increased bleeding risk with aspirin doses over 100 mg

Question 31

what is the antidote for clopidogrel and ticagrelor

Answer 31

DDAVP