Anti-coagulant, Anti-platelet, & Thrombolytic Flashcards
What are anticoagulants used for?
primarily to prevent thrombosis in veins and the atria of the heart
What does a vitamin K antagonist due?
prevents synthesis/formation
If you are taking heparin, what is wrong?
You already have a problem. heparin is not a preventative drug
What is Heparin used for?
Preferred in pregnancy
MI, PE, Massive DVT
What is the MOA of Heparin?
Helps antithrombin inactivate clotting factors
What is Heparin an IV drug?
because of its short half life
What are the adverse effects of heparin?
Bleeding
Heparin-Induced Thrombocytopenia
What do you want to assess before administering Heparin?
BP HR CBC Hematocrit aPTT
If a patient has these in their PMH then they should not get Heparin?
Severe thrombocytopenia
Lumbar puncture
Surgery of the eye, brain, spinal cord
What is the reversal agent to heparin?
Protamine Sulfate
What is the difference between Heparin and Lovenox?
Heparin:
Inactivates Fact Xa and Thrombin
Short 1/2 life
Inpatient only
Lovenox: Less likely to develop HIT Longer 1/2 life SubQ ONLY Safe for outpatient use
What is another name for Warfarin?
Coumadin?
Name a Vitamin K antagonist
Warfarin
What is Warfarin used for?
Outpatient use for long-term Prophylaxis of thrombosis
Prevents venous clots and AFib clots
What is the MOA for Warfarin?
Blocks Vitamin K-dependant clotting factors and prothrombin from forming
What is warfarin bound too?
Albumin
Why is Warfarin not meant for medical emergencies?
Because it has a delayed onset
What are the adverse effects of Warfarin?
Fetal hemorrhage
Hemorrhage
Bleeding
If a patient has this in their PMH they should not be prescribed Warfarin.
Severe thrombocytopenia
Pregnancy
Vitamin K deficiency
Liver disease
What is the reversal agent to Warfarin?
Vitamin K (phytonodione)
What is the MOA of Direct Thrombin Inhibitors?
Direct, reversible inhibitor of free and bound thrombin
What is Dabigatran (Pradaxa) used for?
Prevents clots related to AFib, DVT’s, Knee of Hip replacement
What is an adverse effect of Dabigatran (Pradaxa)?
Bleeding
What is Argatroban used for?
Prophylaxis and treatment of thrombosis in patients with HIT
What are the prototypes of Direct Factor Xa Inhibitors?
Rivaroxaban (Xarelto)
Apixaban (Eliquis)
What is the MOA of Rivaroxaban and Apixaban?
Selective inhibition of factor Xa
What are antiplatelets used for?
To prevent thrombosis in arteries
What drug class is Clopidogrel (plavix) under?
Antiplatelet
What is the MOA of Clopidogrel (Plavix)?
Irreversibly blocks ADP receptors preventing platelet aggregation
What are the adverse effects of Clopidegral (Plavix)?
Bleeding
Thrombotic Thrombocytopenia Purpura (TTP)
What do you assess prior to administering Clopidegral?
Genetic testing
PMH: Active bleed, Undernourished
What do you evaluate after administering Clopidogrel?
S/S of bleeding
What are Glycoprotein IIb/IIIa Receptor Antagonists often referred as?
Super Aspirins
What are Glycoprotein IIb/IIa Receptor Antagonists used for?
Prevent ischemic events in patients with ACS or undergoing PCI
What are the two prototypes of Glycoprotein IIb/IIa Receptor Antagonists?
Abciximab (Reopro)
Eptifibatide (Integrilin)
