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ClinMed Final > Anticoagulants > Flashcards

Anticoagulants Flashcards

1
Q

What is another name for an anticoagulant?

A

Blood thinner - but blood is not becoming thinner

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2
Q

What are the two purposes of anticoagulants?

A
  • Decrease bloods ability to clot
  • Help prevent or treat life-threatening conditions caused by a clot
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3
Q

Do most drugs help facilitate break down of existing clots or prevent clots from forming (or getting bigger)?

A

Prevent clots from forming (or getting bigger)

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4
Q

Most anticoagulation drugs do not preform what action?

A

Facilitate break down of existing clots

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5
Q

Anticoagulation drugs help to prevent or treat life-threatening conditions caused by a clot such as… (there are 4)

A
  • Ischemic strokes
  • Myocardial infarctions
  • Pulmonary embolisms
  • Venous thrombi
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6
Q

What are conditions that may cause blood clots?

A
  • Atrial fibrillation
  • Heart valve surgery/ replacement
  • Joint replacement/ orthopedic surgery
  • Blood clotting disorders
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7
Q

There are three kinds of drugs that affect blood clotting, what are they?

A
  • Anticoagulants
  • Antiplatelets
  • Fibrinolytics (Thrombolytics)
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8
Q

What treats venous abnormal clot formation such as deep vein thrombosis (DVT) and thromboembolisms?

A

Anticoagulants

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9
Q

What is a thromboembolism?

A

A DVT (clot) that travels through the venous system to the right side of the heart and into the lungs to cause a pulmonary embolism

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10
Q

What prevents excessive clotting by inhibiting platelet activity?

A

Antiplatelets

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11
Q

What often forms by abnormal platelet aggregation?

A

Arterial thrombi

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12
Q

What is used to treat arterial clots such as coronary artery occlusions and cerebral infarctions?

A

Antiplatelets

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13
Q

What facilitates the breakdown and dissolution of already formed clots?

A

Fibrinolytics (Thrombolytics)

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14
Q

What converts plasminogen to plasmin to help break down fibrin?

A

Fibrinolytics (Thrombolytics)

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15
Q

What are the three ways of administration of anticoagulants?

A
  • Parenteral
  • Subcutaneous
  • Oral
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16
Q

What is a parenteral anticoagulant and how is it administered?

A
  • Heparin (prevents clots from getting larger)
  • Through IV
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17
Q

What is a subcutaneous anticoagulant and how is it administered?

A
  • Low molecular weight heparin
  • Lovenox
  • Arixtra
  • Under the skin via needle
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18
Q

What is an oral anticoagulant and how is it administered?

A
  • Vitamin K antagonist (Coumadin aka Warfarin)
  • Administered through the mouth
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19
Q

Why is vitamin K so important when it comes to Coumadin (Warfarin)?

A
  • Vitamin K aids in the clotting process
  • Coumadin (Warfarin) takes vitamin K out of the problem
  • Patient needs to be monitored for vitamin K ingestion as it is in most foods
  • It takes hours to days to deplete the body’s stores of vitamin K
20
Q

What is the preferred test for patient on vitamin K antagonist (VKA) such as Coumadin?

A

INR - International Normalized Ratio

21
Q

What is INR?

A

Derived from prothrombin time - indirectly measures time it takes a sample of blood to clot through assessing level of several clotting factors

22
Q

INR is a ratio, what is this ratio?

A

INR = patient PT / control PT
- (PT = prothrombin)

23
Q

What is a normal INR and what does it mean?

A
  • Normal = 1
  • Takes the same time for patients blood to clot as it does for the control sample to clot
24
Q

What is a therapeutic INR?

A

INR 2-3 = takes 2-3x as long to clot

25
Q

If a patient has a high INR they are at risk for what?

A

Increased risk for uncontrolled bleeding

26
Q

If a patient has a low (near 1) INR what does that mean?

A

They have an INR with no therapeutic effect

27
Q

If someone has a high INR do they have a low vitamin K level or a high vitamin K level?

A

Low vitamin K level

28
Q

What medication MUST you monitor INR with?

A

Coumadin/ Warfarin

29
Q

There are newer anticoagulants called direct thrombin inhibitors, how are most of these administered?

A

Parenterally (IV or Subcutaneously)

30
Q

What are some Factor Xa inhibitors and how are they administered?

A
  • Fondaparinux (Arixtra): subcutaneous
  • Apixaban (Eliquis): Oral
  • Rivaroxaban (Xarelto): Oral
31
Q

What prevents excessive clotting caused by increased platelet activity?

A

Antiplatelets

32
Q

What are examples of antiplatelet drugs?

A
  • Aspirin (most common)
  • ADP receptor blockers
  • Glycoprotein 2b-3b blockers
33
Q

What are some adverse effects that antiplatelets can cause?

A
  • Increased risk of bleeding
  • GI irritation (with aspirin)
  • Kidney and liver damage
34
Q

Fibrinolytic agents (Aka clot busters) have what kind of time window to be the most effective?

A

Must be administered within a 3 hour window of symptom onset

35
Q

What are the two kinds of fibrinolytic agents?

A
  • Streptokinase
  • TPA (Tissue Plasminogen Activator) (Alteplase)
36
Q

What is the mechanism of action of Streptokinase?

A
  • Nonenzymatic protein substance that forms a complex with plasminogen
  • Converts plasminogen to plasmin
37
Q

What can streptokinase be used for?

A

Lysis of acute DVT, pulmonary emboli, and acute arterial thrombi

38
Q

What are the side effects of streptokinase?

A

Bleeding

39
Q

How do you administer streptokinase?

A

Through an IV

40
Q

What are the contraindications of streptokinase?

A

Bleeding, hemorrhagic stroke

41
Q

What is the mechanism of action of TPA?

A

Recombinant human thrombolytic enzyme that activates plasminogen bound to fibrin

42
Q

What can TPA be used for?

A

DVT, multiple pulmonary emboli

43
Q

What are the side effects of TPA?

A

Bleeding

44
Q

How do you administer TPA?

A

Through an IV

45
Q

What are contraindications to TPA?

A

Bleeding and hemorrhagic stoke

ClinMed Final (4 decks)

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