Lilley Chapter 27: Coagulation Modifier Drugs Flashcards
(13 cards)
A female patient has been prescribed warfarin in addition to a heparin infusion. What is the reason for her receiving two anticoagulants?
a. The oral and injection forms work synergistically.
b. The combination of heparin and an oral anticoagulant results in fewer adverse effects than heparin used alone.
c. Oral anticoagulants are used to reach an adequate level of anticoagulation when heparin alone is unable to do so.
d. When oral anticoagulants are prescribed, heparin is often used to initiate therapy until laboratory tests indicate an adequate therapeutic response.
d. When oral anticoagulants are prescribed, heparin is often used to initiate therapy until laboratory tests indicate an adequate therapeutic response.
So what’s happening here?
• The patient’s on heparin (IV anticoagulant, fast-acting)
• AND starting an oral anticoagulant like warfarin (slowpoke)
You’re wondering, “Why two at once? Is this an overachiever move?”
Nope—it’s because warfarin takes days to work. Like that friend who says they’re “on their way” but hasn’t left the house yet
Which is a true statement about dipyridamole?
a. It has anti-inflammatory and antipyretic properties.
b. It has analgesic properties and antithrombotic effects.
c. It is useful for reducing the risk of fatal and nonfatal thrombotic stroke.
d. It is used as an adjunct to warfarin the prevention of postoperative thromboembolic complications.
d. It is used as an adjunct to warfarin the prevention of postoperative thromboembolic complications.
Dipyridamole is an antiplatelet agent, not an anti-inflammatory, not an analgesic, and definitely not a stroke superhero by itself. It works by inhibiting the uptake of adenosine into platelets, endothelial cells, and erythrocytes. Translation: it makes platelets lazy and less likely to clump together and throw a clot party.
But on its own? Meh. That’s why it’s used with warfarin (because warfarin handles the clotting cascade like a boss), especially in patients with prosthetic heart valves, where the risk of throwing clots is basically the sequel to Final Destination.
“Throwing a clot” = A blood clot forms and travels somewhere it absolutely shouldn’t.
Think of it like this:
• A clot forms (say, in the leg — deep vein thrombosis, DVT).
• Then that clot decides it’s bored and wants to see the world.
• It breaks off (this is the “throw” part) and travels through the bloodstream like a tourist with no visa.
• Eventually it lodges somewhere awful — like the lungs (causing a pulmonary embolism), brain (causing a stroke), or heart (cue heart attack).
What is the most frequent adverse effect of thrombolytic therapy?
a. Dysrhythmia
b. Nausea and vomiting
c. Anaphylactic reactions
d. Internal and superficial bleeding
d. Internal and superficial bleeding
What is the recommended antidote for warfarin toxicity?
a. Vitamin E
b. Vitamin K
c. Protamine sulphate
d. Potassium phosphate
b. Vitamin K
The nurse is administering heparin subcutaneously. Which instruction for doing this is correct?
a. Aspirate before injecting
b. Massage site after injection
c. Apply heat to the injection site.
d. Use a new, sterile 1.5cm to 28 gauge needle for the injection.
d. Use a new, sterile 1.5cm to 28 gauge needle for the injection.
Which statement is true for the patient receiving long-term therapy with aspirin?
a. Aspirin should be taken on an empty stomach to ensure maximal absorption.
b. Bleeding tendencies are not of much concern to those taking aspirin therapy.
c. Laboratory studies should be done to monitor liver, renal, and clotting functions.
d. Development of a rash is expected and does not warrant discontinuing the medication.
c. Laboratory studies should be done to monitor liver, renal, and clotting functions.
Because if you’re on long-term aspirin therapy, you’re basically in a mildly toxic relationship with your own organs.
• Clotting? Aspirin irreversibly inhibits platelets. Great for preventing clots, terrible if you enjoy not bruising like a banana or spontaneously bleeding during dental cleanings.
• Renal function? NSAIDs (including aspirin) can wreck your kidneys over time, especially if you’re already a little fragile in the nephron department.
• Liver? Not usually aspirin’s top target, but still worth checking if you’re taking it chronically. Liver’s the unsung hero that gets dragged into everybody’s mess.
A male patient will be receiving streptokinase as part of the treatment of acute myocardial infarction. He asks why he is being prescribed this drug. the nurse’s best response is to tell him that the drug is being prescribed to:
a. Relieve chest pain
b. Prevent further clot formation
c. Dissolve the clot in his coronary artery
d. Control bleeding in the coronary microcirculation
c. Dissolve the clot in his coronary artery
Streptokinase is a thrombolytic, a.k.a. clot-busting drug, and it doesn’t mess around. It goes into the bloodstream like a biochemical wrecking ball, converting plasminogen to plasmin, which then dissolves fibrin clots like a boss.
What it’s not for:
• a. Relieve chest pain – Indirectly, sure, but that’s not its job title. That’s nitroglycerin’s part-time gig.
• b. Prevent further clot formation – That’s the role of antiplatelets (like aspirin) and anticoagulants (like heparin). Streptokinase is there to break stuff, not babysit.
• d. Control bleeding in the coronary microcirculation – The opposite of what it does. Streptokinase is basically the bleeding fairy godmother. If anything, it increases bleeding risk.
So yeah, if someone’s coronary artery is plugged up and their heart cells are throwing a tantrum, streptokinase swoops in to dissolve the clot and restore blood flow before the myocardium throws in the towel
Which laboratory study is used to monitor the therapeutic effects of heparin?
a. Prothrombin time
b. Activated partial thromboplastin time (aPTT)
c. Vitamin K
d. Hematocrit
b. Activated partial thromboplastin time (aPTT)
A patient has started on anticoagulant drugs. What is the primary goal of this therapy>
a. To prevent thrombus formation
b. To dissolve an existing thrombus
c. To stabilize an existing thrombus
d. To prevent the thrombus from becoming an embolus
a. To prevent thrombus formation
A patient is taking anticoagulant therapy. Which natural health product should the patient avoid taking?
a. Valerian
b. Ginkgo
c. St. John’s wort
d. Saw palmetto
b. Ginkgo
Ginkgo biloba can increase the risk of bleeding when taken with anticoagulants like warfarin. This is due to ginkgo’s potential to inhibit platelet aggregation, which can enhance the effects of blood-thinning medications. Therefore, it’s generally advised to avoid combining ginkgo with anticoagulants unless under medical supervision.
A patient who is taking warfarin therapy has a headache and wants to take a pain reliever. Which action is recommended?
a. Taking aspirin tablets
b. Taking ibuprofen or NSAID
c. Taking acetaminophen
d. Calling the physician’s office an order for an opioid
c. Taking acetaminophen
• Aspirin: Stops platelets from clumping = higher bleeding risk. • NSAIDs (like ibuprofen): Also mess with platelets, just not as strongly = still risky. • Opioids: Don’t thin blood, but not first choice for headaches = overkill. • Acetaminophen: Doesn’t affect platelets = safest pain choice with warfarin.
Which laboratory study is used to monitor the therapeutic effects of warfarin?
a. International normalized ratio (INR)
b. aPTT
c. Vitamin K
d. Hematocrit
a. International normalized ratio (INR)
Which drug is the recommended antidote for heparin toxicity?
a. Vitamin E
b. Vitamin K
c. Protamine sulphate
d. Potassium phosphate
c. Protamine sulphate
