Medications related to blood clotting

Question 1

What types of drugs are used to reduce clotting

Answer 1

• anticoagulants
• antiplatelets
• fibrinolytic

Question 2

Anticoagulants-uses

Answer 2

• used to prevent clots in the venous system
• DVT pophylaxis and treatment
• post-surgical (increased risk of DVT)
• prolonged bed rest and immobility
• severe trauma

Question 3

What are some common anticoagulants

Answer 3

• heparin
• warfarin
• factor Xa inhibitors
• direct thrombin inhibitors

Question 4

Heparin- what does it do

Answer 4

• increases antithrombin (prevents clots)
• interfere with clotting factors

Question 5

Heparin- administration

Answer 5

• usually in hospitals
• once they stop it the affects can be reversed
• must be given IV or subcutaneous injection that is often given in the abdomen

Question 6

Heparin- uses

Answer 6

• treat existing DVT or prevent DVT
• primarily acute short term use
• subcutaneous can sometimes be used longer

Question 7

Heparin - risks

Answer 7

• hemorhage
• heparin-induced thrombocytopenia

Question 8

Factor Xa inhibitors

Answer 8

• can treat and prevent clots
• risk of hemorrhage is lower and does not cause thrombocytopenia

Question 9

Factor Xa inhibitors- administration

Answer 9

• orally
• as effective or possibly more effective than heparin

Question 10

Factor Xa inhibitors-side effects

Answer 10

• GI distress
• rash

Question 11

Warfarin- how does it work?

Answer 11

• interferes with vit. K synthesis in liver
• interfere with clotting factors

Question 12

warfarin-administration

Answer 12

• oral
• longer term use
• takes days reach a therapeutic dose
• takes longer to reverse the affects

Question 13

what should be monitored with patients on warfarin

Answer 13

• INR (nternational normalised ratio) should eb 2-3

Question 14

Side effects or warfarin

Answer 14

• may bruise easily
• risk of hemorrhage if INR is too high
• ## blood is not thinner

Question 15

Direct thrombin inhibitors-administration

Answer 15

• some oral and some parenteral via IV or subcutaneous

Question 16

Direct thrombin inhibitors - use

Answer 16

• used primarily for atrial fibrillation
• reduce risk of thromboembolism from blood pulling in the atria

Question 17

Direct thrombin inhibitors-side effects

Answer 17

• GI distress
• rash

Question 18

Important signs and symptoms of someone on anticoagulants

Answer 18

• increased or excessive bruising or bleeding
• back pain (bleeding within an organ)
• joint pain
• blood in stool and urine
• nosebleeds
• bleeding gums

Question 19

Dietary considerations: natural anticoagulants

Answer 19

• garlic
• ginger
• celery seed
• aniseed
• foods rich in vitamins E: olive oil, spinach, tomatoes, almonds, mangoes, peanut butter, broccoli

Question 20

What are some anti-platelet medications and where do they work?

Answer 20

• aspirin (low dose)
• ADP inhibitors
• work at arterial

Question 21

Aspirin: how does it work as an anti-platelet medicaiton

Answer 21

• inhibits COX enzyme and prevents formation of
• prostaglandins
• thromboxanes
• these are involved in platelet aggregation

Question 22

Aspirin as an anti-platelet medication

Answer 22

• low dose is required = less GI upset
• effective at reducing arterial clots
• reduce risk of heart attack, stroke
• can be used during a heart attack to break up some of the clot/prevent more from forming
• sometimes used to treat or prevent DVT
• long-term use associated with increased risk of hemorrhagic stroke
• long term can cause HTN

Question 23

ADP receptor inhibitors

Answer 23

• prevent platelet aggregation
• stronger inhibitor than aspirin
• used with known cardiac conditions or during/after invasive cardiac procedures

Question 24

Other antiplatelet drugs

Answer 24

• some used during surgical proceures
• some used for intermittent claudication
• impaired blood flow while walking
• decreases pain, improves circulation

Question 25

Intermittent claudication

Answer 25

- plaque in arteries especially in the LE and then there is not enough Oxygen to the area/muscles

Question 26

Fibrinolytics

Answer 26

- fibrin forms clots so these break down fibrin - break down formed clots - can stop a heart attack - can reduce severity of ischemic stroke - best affects with early administration (works best in first 15 minutes) - biggest risk: brain intracerebral hemorrhage - can prevent clots but then risk of bleeding is increased

Question 27

Hyperlipidemia drugs: most commone and what they do

Answer 27

- statins are the most common = HMG-CoA reductase inhibitors - inhibits production of LDL cholesterol

Question 28

Side effects of statins/adverse effects

Answer 28

side effects: - GI distress - statin myopathy Adverse event: - rhabdomyolysis