Anticoags, Antiplatelets, and Thrombolytics Flashcards
prevent the formation of clots that inhibit circulation
anticoagulants
prevent platelet aggregation, clumping together of platelets to form a clot
antiplatelets
called clot busters, attack and dissolve blood clots that have already formed
thrombolytics
combines with antithrombin III, which accelerates the anticoagulant cascade of reactions that prevents thrombosis formation. By inhibiting the action of thrombin, conversion of fibrinogen to fibrin does not occur, and the formation of a fibrin clot is prevented
heparin
lab tests for heparin
PTT and aPTT
control PTT: 60-70 sec (therapeutic 1.5-2x longer)
heparin can decrease platelet count
HIT
antidote for heparin
protamine sulfate
derivatives of standard heparin and the equivalent of anticoagulation can be achieved with a lower risk of bleeding
lab values do not need to be monitored
LMWH (dalteparin, enoxaparin)
half-life 2-4x longer than heparin
mostly used after hip and knee replacement
synthetically engineered antithrombotic designed to be effective as a once daily subq injection
selective Xa inhibitor
prevent DVT and PE after orthopedic/abdominal therapy
parenteral anticoagulants that directly inhibit thrombin from converting fibrinogen to fibrin
direct thrombin inhibitors: parenteral anticoagulants II
argatroban, dabigatran, -rudin
oral anticoag that inhibits hepatic synthesis of vitamin K, thus affecting clotting factors II, VII, IX, X
warfarin
prevent thromboembolic conditions
need regular lab draws
lab values to monitor on warfarin
PT and INR (2-3 therapeutic)
desired level of INR for pts with a mechanical heart valve
2.5-4.5 (book)
3-5 (lecture)
antidote for warfarin
vitamin K (24-48 hrs to be effective)
ACUTE BLEEDING: fresh frozen plasma
when smoking on warfarin you may need an ___ in dose
increase
used to prevent thrombosis in the arteries by suppressing platelet aggregation
prevent stroke or MI
antiplatelet drugs
aspirin, clopidogrel
deficient blood flow
ischemia
death of tissue
necrosis
occlusion of an artery or vein caused by a thrombus or embolus, results in ischemia that causes necrosis of the tissue distal to the obstructed area
thromboembolism
converts plasminogen to plasmin, which destroys the fibrin in the blood clot
thrombolytics
when should a thrombolytic be administered
within 3-4 hrs of onset (AMI)
within 3 hrs of thrombotic stroke
name thrombolytics
tPA, alteplase, tenecteplase
induce fibrinolysis (fibrin breakdown)
antidote for thrombolytic (tPA)
aminocaproic acid (amicar)
inhibit plasminogen activation
what can happen if thrombolytics are administered through an intracoronary catheter after MI
reperfusion dysrhythmia or hemorrhagic infarction
