Heme Rem Exam Flashcards
(28 cards)
Heparin reversal
Protamine sulfate originally isolated from sperm of salmon
Dosing: 1.0-1.5mg iv for every 100 iu of active heparin
What is a side effect of heparin reversal?
Hypotension & anaphylaxis
What is the reversal administered for warfarin?
Vitamin K PO or IM
P0= mephyton
IM = aquamephyton
Duration of action: a couple of hours
Why can’t vitamin K be given iv?
It will cause anaphylaxis
What is a suggested antidote for newer anticoagulants?
Fresh frozen plasma
What is an antidote for oral direct anticoagulants such as Apixaban, rivaroxaban, and edoxaban?
Andexxa
What type of antidote is andexanent & what is its mechanism of action?
A modified recombinant factor Xa that inhibits factor Xa
What are injectable anticoagulants that act on factor Xa?
Enoxaparin (Lovenox) and fondaparinux (arixtra)
What is pradaxa reversed by?
Praxbind
What are p2y12 inhibitors?
Drugs that block platelet aggregation
AKA ADP receptor blockade
What is an example of an irreversible P2Y12 inhibitor?
Plavix & plasugrel
AKA clopidogrel & effient
Class of thienopyridines
What is an example of a p2y12 inhibitor that is reversible?
Nonthienopyridines
Brilinta and kengreal
Aka ticagrelor and cangrelor
What does FFP consist of?
Mixture of factors II, VII, IX, X
Possibly C, S, Z
Coumadin does not interfere with FFP
In what situations would heparin reversal be indicated?
Patients that need urgent surgery but are on heparin
Must be administered slowly
What is the benefit of using direct thrombin inhibitors?
They are low molecular weight heparin that are more selective to factor Xa
* more predictable than warfarin
Ex) pradaxa and acova ( dabigatran and aragatroban)
What type of anticoagulant is lovenox & what is its mechanism?
Low molecular weight heparin
Short fragments of heparin that direct anti-thrombin more selectively against factor X than against activated factor IIa
What is the red cell morphology of iron deficiency anemia?
Low MCV
Normal RDW
Microcytic
Hypochromic: more than 1/3 of RBC is pale
What lab is used to measure iron deficiency anemia & why?
Ferritin = main storage form of Fe
Low in iron deficiency anemia
*helps to differentiate b/t anemia of chronic disease
Hydroxyurea
Sickle cell disease
Polycythemia
Thrombocytosis
How does hydroxyurea treat sickle cell disease?
It promotes HbF production
What causes iron deficiency anemia?
Inadequate supply of iron Either due to - decreased intake Decreased absorption Increased losses of iron
What is the cell morphology of anemia of chronic disease?
Size: microcytic to normocytic
Pattern: normochromic
What would the lab findings be in anemia of chronic disease?
Low serum iron Low/normal transferritin Ferritin is increased****** Low retic count Low / normal TIBC * total amount of iron in body is normal but access to it is limited
What is the morphology of Macrocytic anemia?
MCV > 100 fl B12 deficiency and folate deficiency Alcoholism Down syndrome Hypothyroidism Liver disease
Also seen in myelodysplasia, leukemia; reticulocytosis
