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ABSN > pathopharm 1 drugs mod 6 > Flashcards

pathopharm 1 drugs mod 6 Flashcards

1
Q

class: heparins

A

-heparin
-enoxaparin (low molecular wt heparin)

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2
Q

heparins MOA

A

prevents clotting by activating antithrombin -> indirectly inactivates thrombin & factor Xa (we inactive factor VII, X and thrombin in the extrinsic pathway & XII, XI, IX,X, and thrombin in intrinsic pathway ) inhibits fibrin formation (LMWH only inactivates factor Xa, not thrombin)

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3
Q

how is heparin given

A

IV or sub q injections

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4
Q

heparin indications

A

conditions necessitating prompt anti coagulant activity like stroke, PE, massive DVT, MI

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5
Q

LMWH indication

A

prophylaxis against post op DVT

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6
Q

how is heparin dosed

A

wt based always in KG & labs: aPPT or anti Xa

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7
Q

heparin nursing considerations

A

-rapid onset
-use cautiously in pt w/ spinal or epidural anesthesia bc increased risk for hematoma
-high risk med
-monitor signs for bleeding
must double check w/ another RN for rate changes or boluses

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8
Q

heparin SE

A

-bleeding
-hematoma
-anemia
-thrombocytopenia

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9
Q

heparin antidote

A

protamine sulfate (SE: hypotension)

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10
Q

do you need to do all the lab monitoring for LMWH

A

no

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11
Q

LMWH SE

A

-bleeding
-thrombocytopenia
-HIT

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12
Q

LMWH antidote

A

protamine

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13
Q

LMWH nursing considerations

A

-only injectable, no IV
-can be given at home, pre dosed
-use cautiously in pts w/ spinal or epidural anesthesia
do not give w/ heparin
BBW: potential spinal hematoma if pt has epidural catheter

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14
Q

warfarin MOA

A

vitamin K inhibitor -> prevents the synthesis of factors VII, IX, X & prothrombin

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15
Q

warfarin indications

A

prevention VTE/DVT/PE, thrombotic events for pt w/ Afib or heart valves, reduce recurrence of TIA or MI

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16
Q

warfarin SE

A

-bleeding
-lethargy
-muscle pain
-purple toes

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17
Q

warfarin antidote

A

vitamin K

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18
Q

warfarin nursing considerations

A

-can’t give to pregnant or breast feeding women
-hold before surgeries
-lab monitoring
-many drug & foods interactions (dark leafy greens)
-avoid alcohol
-once a day @5pm

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19
Q

apixaban & rivaroxaban MOA

A

direct inhibitor of factor Xa

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20
Q

apixaban & rivaroxaban indications

A

prevent strokes in pt w/ afib, post op thrombo-prophylaxis, treat DVT & PE

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21
Q

apixaban & rivaroxaban SE

A

-bleeding
-hematoma
-dizziness
-rash
GI distress
-peripheral edema

22
Q

apixaban & rivaroxaban nursing considerations

A

BBW: spinal hematomas if pt has epidural catheter
-risk of thrombosis if drugs abruptly stopped
-CYP inhibitor, dont have grapefruit & lots of interactions
-do not give w/ other anticoags
-watch liver function (ALT, AST, GGT)

23
Q

apixaban & rivaroxaban antidote

A

andexxa

24
Q

aspirin MOA

A

blocks prostaglandin synthesis through the COX enzyme pathways (+blocks platelet aggregation)

25
Q

aspirin indications

A

prevent/treat MI, prevent ischemic stroke

26
Q

aspirin SE

A

-GI distress
-bleeding
-drowsiness/confusion

27
Q

aspirin nursing considerations

A

-can be bought OTC
-reye’s syndrome so can’t give to children

28
Q

aspirin contraindications

A

thrombocytopenia, active bleeding, blood cancers, traumatic injuries, GI ulcers, vit K deficiency, recent hemorrhagic stroke

29
Q

aspirin antidote

A

desmopressin (DDAVP)

30
Q

clopidogrel & ticagrelor MOA

A

anti-platelet ADP inhibitor (alters the platelet membrane so it doesn’t receive the signal to aggregate)

31
Q

clopidogrel & ticagrelor indication

A

reduce risk of stroke, prophylaxis of TIAs, post MI

32
Q

clopidogrel & ticagrelor contraindications

A

thrombocytopenia, active bleeding, blood cancers, traumatic injuries, GI ulcers, vit K deficiency, recent hemorrhagic stroke

33
Q

clopidogrel & ticagrelor SE

A

-chest pain
-edema
-flu like symptoms
-abdominal pain
-diarrhea
-nausea
-epistaxis
-rash
-pruritus (nose bleed)

34
Q

clopidogrel & ticagrelor nursing considerations

A

BBW (clopid): pt w/ certain genetic abnormalities, who may have higher rate of CV events due to reduced conversion to its active metabolite
BBW (tica): increased bleeding risk w/ aspirin doses over 100mg (so can give w/ baby aspirin)
-clopid effectiveness is reduced by amiodarone, CCB, NSAIDS and PPIs

35
Q

clopidogrel & ticagrelor antidote

A

DDAVP or platelet transfusion

36
Q

direct thrombin inhibitors (argatroban & bivalrudin) MOA

A

inhibit thrombin (factor IIa)

37
Q

direct thrombin inhibitors indications

A

treat HIT, and for pts undergoing procedures (PCI) who are at high risk for HIT

38
Q

direct thrombin inhibitors SE

A

bleeding

39
Q

direct thrombin inhibitors nursing considerations

A

-only IV
-labs (anti Xa and H&H, platelets)

40
Q

class: glucocorticoids

A

-hydrocortisone
-prednisone
-dexamethasone

41
Q

hydrocortisone

A

synthetic, identical to cortisol w/ some aldosterone activity

42
Q

hydrocortisone SE

A

large amounts = toxic

43
Q

what disease is prednisone usually given for

A

COPD

44
Q

glucocorticoids MOA

A

mimics glucocorticoid burst by adrenals at dawn

45
Q

glucocorticoids SE

A

-increased intraocular pressure
-fluid retention
-high BP
-mood swings
-wt gain (centralized)

46
Q

long term side effects corticosteroid use

A

-clouded eyes
-high BS
-increased risk of infections
-thinning bones
-suppressed adrenal gland hormone production
-thin skin, bruising, slow wound healing

47
Q

nursing considerations for glucocorticoids

A

do not stop abruptly
-take at same time
-monitor wt and BS

48
Q

class: mineral-corticoids

A

fludrocortisone

49
Q

fludrocortisone indication

A

combat salt wasting (inability to maintain Na+ levels high despite adequate renal function)

50
Q

class: anti platelet

A

-clopidogrel
-ticagrelor
-aspirin

51
Q

class: coumarin

A

warfarin

52
Q

class: anti coag

A

-apixaban
-rivaroxaban

ABSN (35 decks)

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