Anticoagulants, Antiplatelets, Thromobolytics Flashcards
thrombus formation
- break in the endothelial lining
- increased receptor activation
- thromboxane
- adenosine diphosphate
intrinsic pathway thrombus formation
damage to blood vessel
extrinsic pathway thrombus formation
damage to tissue outside vessel
anticoagulant indications: venous thromboembolic disease
- active DVT
- active PE
- prophylaxis of DVT
anticoagulant indications: arterial thromboembolic disease
- mechanical heart valves
- irregular heart rhythms
- transient ischemic attacks
anticoagulant indications: more
- maintenance of vascular grafts
- ICD
- prevent new clots (does NOT dissolve current clots)
PTT
Partial Thromboplastin Time
PTT: normal range
25 - 40 seconds
PTT: therapeutic range
55 - 70 seconds
PTT: protocol driven
4-6 hours commencing infusion
4-6 after changing dosing regimen
(but changes per hospital)
heparin-induced thrombocytopenia
HIT - allergy can be induced by heparin where antibodies attack platelets thus creating thrombocytopenia, platelets clump together are deactivated and are microemboli (think fingers and toes)
8% of patients develop antibody
1-5% patients on heparin develop thrombocytopenia
HIT treatment
- dc all heparin
- non-heparin based anticoag (EVERYWHERE - some IV lines and other devices have it embedded, beware)
- avoid platelet transfusions (makes embolic shower worse)
prothrombin time
?
international normalization ratio
ratio of patient clotting to the “normal” client
- weekly to monthly blood tests depending on what we’re treating
international normalization ratio: normal
0.8 - 1.3
