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Pharm > 8: Coagulation and Hyperlipidemia > Flashcards

8: Coagulation and Hyperlipidemia Flashcards

1
Q

hemostasis

A

blood coagulation; normal clotting factors in the blood that are necessary to prevent excessive hemorrhage when blood vessels are damaged

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2
Q

thrombogenesis

A

thrombus formation caused by overactive clotting, which can lead to vessel occlusion

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3
Q

what types of drugs prevent clot formation?

A

anticoagulants and antiplatelets

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4
Q

what type of drug removes clots?

A

fibrinolytics

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5
Q

why is lowering plasma lipid levels important?

A

this prevents atherosclerosis that can be caused by hyperlipidemia

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6
Q

how does tissue plasminogen activator (tPA) break down a clot?

A

tPA converts plasminogen to plasmin, which breaks down the fibrin mesh and destroys the clot

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7
Q

examples of anticoagulants

A

heparin, warfarin (coumadin), direct thrombin inhibitors, factor Xa inhibitors

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8
Q

what is the primary drug for the initial treatment of venous thrombosis?

A

heparin

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9
Q

how must heparin be administered?

A

parenterally, usually through an IV

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10
Q

when is coumadin used?

A

long-term prevention of venous thrombosis

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11
Q

what is the difference in timing of the effects of heparin and coumadin?

A

heparin takes effect almost immediately, coumadin takes several days to be effective (patient may take heparin while waiting for coumadin to set in)

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12
Q

what is acceptable clotting range for INR?

A

clotting INR range: 2-3

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13
Q

adverse effects of anticoagulants

A
  • hemorrhage
  • back pain or joint pain (sign of internal bleeding)
  • thrombocytopenia (decreased platelets)
  • GI distress
  • skin reactions
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14
Q

what is the function of antiplatelet drugs?

A

prevent excessive clotting caused by increased platelet activity (primarily for preventing arterial clots)

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15
Q

what is the effective dose for aspirin?

A

75-325 mg/day

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16
Q

how does aspirin affect strokes and DVT?

A
  • helps prevent ischemic strokes
  • may increase risk for hemorrhagic strokes
  • can be used to prevent DVT
17
Q

when are ADP Receptor Blockers used?

A

to prevent thrombosis in patients who are at risk for an MI or ischemic stroke (those with unstable angina, a-fib, etc.)

18
Q

what is the function of Glycoprotein IIb-IIIa Receptor Blockers

A

they inhibit the ability of fibrinogen to activate platelets by blocking the receptor site on the platelet membrane

19
Q

adverse effects of antiplatelet drugs

A
  • increased risk of bleeding (frequent bruises)
  • hypotension
  • GI distress
  • aspirin: gastric irritation, toxic to liver and kidney
20
Q

function of fibrinolytics

A

they facilitate the breakdown and help to dissolve clots that have already formed, used for re-opening blood vessels

21
Q

fibrinolytics and MI

A
  • can reestablish blood flow when used at onset of MI (effective for 12 hours)
  • decreases morbidity and mortality following an MI
  • admin one hour after onset reduces mortality by 50%
22
Q

when are fibrinolytics contraindicated?

A
  • history of hemorrhagic stroke
  • active internal bleeding
  • other factors that increase risk for hemorrhage
23
Q

what else can fibrinolytics be used for?

A
  • dissolve DVTs
  • PEs
  • treat shunts and bypass grafts that have been occluded
24
Q

what form of fibrinolytic activates plasmin to break down clots?

A

tissue plasminogen activator (t-Pa)

25
Q

adverse effects of fibrinolytics

A
  • hemorrhage
  • excessive bleeding during wound care dressing changes
  • itching
  • nausea
  • headache
  • allergic reaction (anaphylaxis)
26
Q

what is hemophilia?

A

unable to synthesize adequate amounts of specific clotting factors, so joint problems may development due to intra-articular bleeding

27
Q

what does liver need in order to produce clotting factors?

A

adequate vitamin K

28
Q

what is hyperlipidemia?

A

abnormally high concentration of lipids in the blood, which causes atherosclerosis, and is the primary cause cardiovascular disease

29
Q

which is good cholesterol and which is bad?

A

HDL = good
LDL = bad

30
Q

what are lifestyle modifications for hyperlipidemia?

A

low fat diets, weight reduction, regular exercise, smoking cessation

31
Q

what is the mainstay medication for treating high cholesterol?

A

statin drugs (lipitor, crestor)

32
Q

what is the function of statin drugs?

A

breakdown of LDL, decrease triglycerides, and increase HDL

33
Q

what is the main function of fibric acids?

A

decrease triglyceride levels

34
Q

adverse effects of lipid-lowering drugs

A
  • GI distress
  • liver dysfunction, gallstones, pancreatitis
  • CV: arrhythmias
  • myopathy
  • rhabdomyolysis
35
Q

rehab implications for lipid-lowering drugs

A
  • increased risk of bleeding (careful with wound care and manual techniques)
  • may see improved wound healing with fibrinolytics
  • hemophilia – hips, knees, ankles, shoulders
  • nonpharmacological – diet, exercise

Pharm (18 decks)

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