Anticoags, Antiplatelets, and Thrombolytics

Question 1

prevent the formation of clots that inhibit circulation

Answer 1

anticoagulants

Question 2

prevent platelet aggregation, clumping together of platelets to form a clot

Answer 2

antiplatelets

Question 3

called clot busters, attack and dissolve blood clots that have already formed

Answer 3

thrombolytics

Question 4

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

Answer 4

heparin

Question 5

lab tests for heparin

Answer 5

PTT and aPTT
control PTT: 60-70 sec (therapeutic 1.5-2x longer)

Question 6

heparin can decrease platelet count

Answer 6

HIT

Question 7

antidote for heparin

Answer 7

protamine sulfate

Question 8

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

Answer 8

LMWH (dalteparin, enoxaparin)

half-life 2-4x longer than heparin

mostly used after hip and knee replacement

Question 9

synthetically engineered antithrombotic designed to be effective as a once daily subq injection

Answer 9

selective Xa inhibitor

prevent DVT and PE after orthopedic/abdominal therapy

Question 10

parenteral anticoagulants that directly inhibit thrombin from converting fibrinogen to fibrin

Answer 10

direct thrombin inhibitors: parenteral anticoagulants II

argatroban, dabigatran, -rudin

Question 11

oral anticoag that inhibits hepatic synthesis of vitamin K, thus affecting clotting factors II, VII, IX, X

Answer 11

warfarin

prevent thromboembolic conditions

need regular lab draws

Question 12

lab values to monitor on warfarin

Answer 12

PT and INR (2-3 therapeutic)

Question 13

desired level of INR for pts with a mechanical heart valve

Answer 13

2.5-4.5 (book)
3-5 (lecture)

Question 14

antidote for warfarin

Answer 14

vitamin K (24-48 hrs to be effective)

ACUTE BLEEDING: fresh frozen plasma

Question 15

when smoking on warfarin you may need an ___ in dose

Answer 15

increase

Question 16

used to prevent thrombosis in the arteries by suppressing platelet aggregation

prevent stroke or MI

Answer 16

antiplatelet drugs

aspirin, clopidogrel

Question 17

deficient blood flow

Answer 17

ischemia

Question 18

death of tissue

Answer 18

necrosis

Question 19

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

Answer 19

thromboembolism

Question 20

converts plasminogen to plasmin, which destroys the fibrin in the blood clot

Answer 20

thrombolytics

Question 21

when should a thrombolytic be administered

Answer 21

within 3-4 hrs of onset (AMI)

within 3 hrs of thrombotic stroke

Question 22

name thrombolytics

Answer 22

tPA, alteplase, tenecteplase

induce fibrinolysis (fibrin breakdown)

Question 23

antidote for thrombolytic (tPA)

Answer 23

aminocaproic acid (amicar)

inhibit plasminogen activation

Question 24

what can happen if thrombolytics are administered through an intracoronary catheter after MI

Answer 24

reperfusion dysrhythmia or hemorrhagic infarction