Anticoagulant Anti platelet Thrombolytics Flashcards
thrombus
blood clot
arterial thrombus
adhesions of platelets to the arterial wall; composed of white clots (platelets) and red clots (Rbcs)
venous thrombi
develop at sites where blood flow is slow; venous stasis initiates this; long tails that break and can cause pulmonary embolism
venous clots are from
platelet aggregation within fibrin that attaches to RBCs
the body will work to remove the clot through
plasmin; enzyme that degrades fibrin meshwork of clot
treatment for thrombus
anticoagulants
antiplatelets
thrombolytics aka fibrinolytic
anticoagulants
suppress coagulation, suppress fibrin production, factors II VII IX X
best against VENOUS
antiplatelets
inhibit platelet aggregation, best against ARTERIAL
thrombolytics aka fibrinolytic
promoting lysis of fibrin promotes clot deterioration
anticoagulants inhibit
the synthesis and activity of clotting factors; does not dissolve clots that are already formed
anticoagulant types
Heparin Enoxaparin Warfarin Dabigatran Rivaroxaban Apixaban
Heparin
activate antithrombin and Xa; preferred for PE, DVT, open-heart surgery, renal dialysis, DIC; also for MI; IV or SUB 1.5 half life works within minutes
heparin adverse effects
hemorrhage (protamine sulfate fixes); avoid antiplatelet drugs (aspirin clopidogrel); hep induced thrombocytopenia (monitor platelets 2-3x a week)
heparin education
dosed in units sub q prophylax Iv acute PTT (40 seconds normal) Tx (60-80 seconds) anti xa; platelet counts
Protamine Sulfate is the
antidote to Heparin
Anticoagulants: Low Molecular Weight Heparins
inactive Xa no affect on thrombin; lower bleeding risk; 1st line DVT; half-life 6x longer 1-2x a day;
enoxaparin
dalteparin
Anticoagulants: warfarin (Oral)
decrease prothrombin and factors VII IX X (vit K); vit k antag, high protein-bound, delayed; DVT PE prosthetic heart valves a FIb
warfarin half life
6 hr to 2.5 days; peak can take several days; if stopped effects continue for 2-5 days
Anticoagulants: warfarin (Oral) labs
PT for time of blot to clot; INR no INR without PT; normal INR about 1; TX INR 2-3
warfarin side effects
Hemorrhage
Antidote: VITAMIN K
Can cause fetal hemorrhage in pregnancy
Anticoagulants: warfarin (Oral)-Education
take vitamin K; dark greens, mayo, oil; soft bristle toothbrush and electric razor; report signs of bleeding; wear alert band, no new meds
warfarin drug interactions
blood thinners, antibiotics, OTC pain relievers, and seizure medications
Patient’s taking carbamazepine will need to increase their dose
Anticoagulant (Oral): Direct Thrombin Inhibitors
direct inhibition of thrombin; rapid onset EMPTY TUM; no need to watch blood levels; low bleed risk; no food interactions
Dabigatran etexilate (oral)
Dabigatran etexilate (oral) uses
A-fib DVT/PE prevention VTE prophylaxis following Knee or hip replacement NO MOISTURES 13hr half life
