Anticoagulants

Question 1

Bivallirudin is used to treat

Answer 1

given in combo with aspirin to prevent clot formation in pt. undergoing angioplasty and preventing ischemic complications

Question 2

Advantages of Bivilirudin over Heparin

Answer 2

causes fewer bleeding complications

Question 3

AE: Bivalirudin

Answer 3

Back pain, Nausea, Hypotension, Headache

Question 4

Reasons not to use Bivalirudin

Answer 4

We do not know effects of use w/ GP IIb/IIIa inhibitors (antiplatelet drugs most commonly used in angioplasty) and it’s expensive

Question 5

antidote for warfarin

Answer 5

Vitamin K

Question 6

what vitamin reduces effect of warfarin ? List sources of vitamin

Answer 6

Vitamin K: Mayo, canola and syobean oli, green leafy vegetables

Question 7

How does warfain work?

Answer 7

It inhibits the enzyme needed to convert vit. K to active form. which decreases clotting factors 7, 9, 10, and prothrombin

Question 8

How do we monitor effects of warfarin

Answer 8

monitor (PT) prothromin time (Norm 12) treatment w/ warfarin prolongs. Also INR. INR low then increase warfarin

Question 9

.warfarin and heparin contrindicated in pt. with…

Answer 9

indwelling epidural catheter assoc. w/ epidural hematoma

Question 10

AE warfarin and heparin

Answer 10

Bleeding is major complication. risk increases w/ aspirin

signs of bleeding; low bp, increased HR, bruising, red or black stools, pelvic or lumbar pain)

Question 11

Treatment for Heparin OD

Answer 11

Stop drug. Heparin has a short half-life. Large doses use protamine sulfate

Question 12

Enoxaprin(Lovenox) is used to treat:

Answer 12

prevention of DVT following hip and knee replacement. Also for Pulmonary embolism

Question 13

Advantage of Enoxaprin over heparin

Answer 13

Does not need to be monitored by lab and can be given at home

Question 14

Enoxaprin should never be given with what drug

Answer 14

Heparin

Question 15

Warfarin interacts with_____which cause increase bleeding

Answer 15

Herbals such as capsicum, feverfew, garlic, ginger, ginko

Question 16

Why can Heparin not be given orally?

Answer 16

Cannot cross membranes d/t size. Does not cross placenta or enter breast milk. Give IV or subQ

Question 17

alteplase used for

Answer 17

opeing a clogged artery (breaks down fibrin)

Question 18

advantage of alteplase

Answer 18

no allergic reaction and short half-life (5min) can readminister immediately after reinfarction.

Question 19

appropriate sites for injection of heparin and enoxaprin (LMWH)

Answer 19

upper, outer area of arm, thigh, and subQ fatty area across lower abdomen and between illiac crest(avoid area 2” from umbilicus)

Question 20

anticoag of choice in pregnancy

Answer 20

Heparin

Question 21

oral anticoagulant

Answer 21

warfarin

Question 22

altepres route

Answer 22

IV Do not use IM