Hematology meds

Question 1

anticoagulants

Answer 1

-heparin and LMWH: Enoxaparin

Purpose: prevents cloting by activating antithrombin=inactivates thrombin and factor Xa

Question 2

heparin

Answer 2

use: DVT, PE, strokes, open heart surgery, prophylaxis against post-op venous thrombus, treat DIC, complications with MI and angina

antidote: Protamine

caution in those with bleeding disorders or antiplatelet meds

Question 3

vitamin k inhibitors

Answer 3

prototype: warfarin

Purpose: blocks synthesis of vitamin k and prevent coagulation factors: factor VII, IX, X, prothrombin

Uses: DVT, PE, A fib or prosthetic heart valves where thrombi events are high, reduce risk of TIA and MIS

Antidote: vitamin K

-check for indications due to high interaction with meds

Question 4

direct thrombi inhibitors

Answer 4

-prototype: dabigatran

purpose: inhibits thrombin

antidotes: Idarucizumab or dialysis

-can cause GI discomfort
-take whole capsule with or without food

Bleeding precautions: electric razors, no aspirin, small gauge needles, needlestick injuries, protect from injury,

Question 5

direct inhibitor of factor Xa

Answer 5

-prototype: rivaroxaban

purpose: inhibits factor Xa to prevent thrombin formation

Question 6

antiplatelets

Answer 6

Antiplatelet/cyclooxygenase inhibitor: aspirin

Antiplatelet/glycoprotein inhibitor: Abciximab

Antiplatelet/ADP inhibitors: Clopidogrel

Antiplatelet/arterial vasodilator: Dipyridamole

purpose: inhibit platelet aggregation and prevent arterial clots, meds alter bleeding time

Question 7

thrombolytics

Answer 7

-prototype: alteplase (tPA)
-reteplase

purpose: dissolves already formed clots

uses: MI, ischemic stroke, PE, restore patency to central IV

-IV aminocaproic acid is available for administration in the event of excessive fibrinolysis
-Following thrombolytic therapy, administer heparin or aspirin as prescribed to decrease another clot formed
-admin beta blockers following therapy to reduce heart oxygen consumption, incident and severity of reperfusion arrythmias
-admin H2 antagonists (cimetidine) or proton pump inhibitors (omeprazole) to prevent GI bleeding

Question 8

growth factors

Answer 8

-epoetin alfa
-filgrastim

purpose: replace neutrophils and platelets, bone marrow function, or increase RBC production

Question 9

epoetin alfa

Answer 9

purpose: tells bone marrow to make more RBCs

uses: anemia

complications: HTN, HA, thrombosis, body aches

Question 10

filgrastim

Answer 10

purpose: stimulate bone marrow to increase production of neutrophils

use: reduce risk of infection, To build up numbers of hematopoietic stem cells prior to harvesting for autologous transplant