drugs for coagulation disorders

Question 1

what is hemostasis

Answer 1

this is the injury to small vessels

Question 2

¡ Platelets bind with high affinity to the damaged vessel. Activated platelets release adenosine diphosphate (ADP) and thromboxane A2 which stimulate the activation of new platelets, platelet aggregation and vasoconstriction.

Answer 2

hemostasis

Question 3

how do we fix broken small blood vessels

Answer 3

¡ Platelets bind with high affinity to the damaged vessel. Activated platelets release adenosine diphosphate (ADP) and thromboxane A2 which stimulate the activation of new platelets, platelet aggregation and vasoconstriction.

Question 4

when is the extrinsic pathway activated - what is released from the damaged cells

Answer 4

when outside of the blood vessel, triggered when tissue thromboplastin is released from damaged cells

Question 5

what is release when the outside of a blood vessel is damaged

Answer 5

tissue thromboplastin is released

Question 6

what pathway catalyzes the formation of factor Xa

Answer 6

extrinsic pathway

Question 7

when is the intrinsic pathway triggered

Answer 7

it is triggered when collagen is exposed at the site of vascular injury

Question 8

what does the common pathway do

Answer 8

synthesis of factor xa

Question 9

how is clot dissolved

Answer 9

tissue plasminogen activator converts plasminogen to plasmin, dissolving the clot

Question 10

what is the dissolving of a clot called

Answer 10

firbinolysis

Question 11

what works to destroy a clot

Answer 11

plasmin

Question 12

what converts plasminogen to plasmin

Answer 12

tissue plasminogen factor

Question 13

thromboembolic disorders (3)

Answer 13

formation of non-therapeutic clots
occulsion of srterial vessels
embolus

Question 14

what leads to MI and CVA

Answer 14

occulsion of arterial vessels

Question 15

embolus occurs when

Answer 15

a piece of stable thrombi breaks off and lodges in smaller blood vessels

Question 16

anticoagulant drugs wokr to modulate what and the formation of what

Answer 16

modulate coagulation cascade and thrombin formation

Question 17

what work to lengthen clotting times and prevent thrombi from forming in the veins

Answer 17

anticoagulant drugs

Question 18

should you give anticoagulant drugs in cases of MI or CVA

Answer 18

yes, through iv or subcutaneous

Question 19

heparin catalyzes what

Answer 19

catalyzes the inactivation of thrombin

Question 20

what enhances the ability of antithrombin III to inactivate thrombin and clotting factor Xa

Answer 20

heparin

Question 21

when thrombin is inactivated what happens

Answer 21

no fibrin = no clotting

Question 22

what is heparin used for the prevention of what

Answer 22

used for the prevention of venous throbosis, PE, DIC, MI and stroke

Question 23

what should you monitor when having a patient on heparine

Answer 23

for bleeding

Question 24

low molecular weight heparins focus more on what

Answer 24

same as heparin, more focus on factor Xa

Question 25

what is the drug class of choice for prevention of DVT

Answer 25

low molecular weight heparins

Question 26

warfarin - blocks the synthesis of what clotting factors

Answer 26

block the synthesis of clotting factors thrombin, VIIa, IXa, Xa

Question 27

what does warfarin inhibit

Answer 27

epoxide reductase

Question 28

what does decreased vitamin K inhibit

Answer 28

inhibits the production of active coagulation factors

Question 29

when transitioning from heparin to warfarin therpay, why must drugs be co administered for three days

Answer 29

because of the increased risk for bleeding and the anticoagulant affect lasts 4-5daus

Question 30

what should patients avoid when on warfarin

Answer 30

vitamin k rich foods

Question 31

why must patients avoid vitamin k foods when on heparin

Answer 31

because it reduced the effectiveness of the drug

Question 32

direct acting thrombin inhibitors

Answer 32

directly binds to and inhibits thrombin

Question 33

what is approved to reduce the risk of stroke and systemic embolism in clients with atrial fibrillation, DVT and PE

Answer 33

direct acting thrombin inhibitors

Question 34

direct acting factor Xa inhibitors inhibit what pathways, and reduce the development of

Answer 34

inhibits the intrinsic and extrinsic pathways of the coagulation cascade - reducing thrombin formation and development of thrombi

Question 35

inhibits the intrinsic and extrinsic pathways of the coagulation cascade - reducing thrombin formation and development of thrombi

Answer 35

direct acting factor Xa inhibitors

Question 36

what are used for the prevention and treatment of deep vein thrombosis

Answer 36

direct acting factor Xa inhibtiors

Question 37

what reduces the risk of pulmonary emboli in pt undergoing knee or hip surgery

Answer 37

direct acting factor Xa

Question 38

what are more predicatble and require less monitoring, warfarin or direct acting thrombin and factor xa inhibitors

Answer 38

direct acting thrombin and factor Xa inhibitors

Question 39

what is contraindictaed in pregnacy and in lactation

Answer 39

warfarin

Question 40

common adverse effects of anticoagulant drugs

Answer 40

bleeding

Question 41

antiplatelet drugs

Answer 41

inhibit platelet aggregation

Question 42

irreversible cycooxygenase inhibitors - aspirin - inhibits the activity and synthesis of what

Answer 42

block the activity of COX1 and COX2, inhibiting the synthesis of prostaglandins - no prostaglandins means no thrombin

Question 43

adenosine diphosphate receptor antagonists

Answer 43

irreversibly change the molecular conformation of ADP receptors, so the platelets no longer release the chemical signal, so they cannot form a clot

Question 44

irreversibly change the molecular conformation of ADP receptors, so the platelets no longer release the chemical signal, so they cannot form a clot

Answer 44

ADP receptor antagonists

Question 45

glycoprotien IIb/IIIa receptor antagonists- prevent what?

Answer 45

prevents platelet aggregation and thrombus formation, the glycoprotien IIb/iiia are involved in platelet aggregation

Question 46

glycoprotien IIb/IIIa antagonists are reserved for people with waht

Answer 46

stroke or MI

Question 47

thrombolytic drugs promote what

Answer 47

promote firbinolysis by converting plasminogen into plasmin

Question 48

when are thrombolytic drugs contraindicated

Answer 48

with any trauma and bleeding disorders

Question 49

what should you monitor for with thrombolytic drugs

Answer 49

cerebral hemorrhage

Question 50

how can the effects be reversed for thrombolytic drugs

Answer 50

aminocapronic acid

Question 51

what is aminocapronic acid

Answer 51

this is an enzyme inhibtior that inactivates plasmin

Question 52

antifibrinolytic drugs

Answer 52

used to facilitate blood clotting and shorten bleeding time

Question 53

what prevents the dissolution of fibrin

Answer 53

antifibrinolytic drugs

Question 54

when are antifibrinolytic drugs used

Answer 54

post surgery to reduce bleeding at surgical sites

Question 55

what should you assess for when giving antifibrinolytic drugs

Answer 55

assess for excessve clotting