Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Antiplatelets and Anticoagulants > Flashcards

Antiplatelets and Anticoagulants Flashcards

1
Q

in event of ruptured plaque in the arterial walls enumerate homeostatic action of the body in blood clotting

A
  1. vasoconstriction - reduce blood loss by activating platelets, stimulates endothelial cells to release chemical mediators, and pain reflex
  2. platelet plug formation - platelet aggregation formation by temporarily seals the broken blood vessel by:
    • exposing collagen fibres (damaged endothelium)
    • platelets sticks to collagen fibres
    • plasma protein (von Willebrand’s factor) act as a glue to bind collagen fibres and platelets
    • platelets are activated by releasing chemicals such as ADPs (recruiting more platelets in the area), serotonin and thromboxane A2 to enhance vascular spasm (vasoconstriction) and platelet aggregation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

explain intrinsic and extrinsic pathways of blood clotting

A

intrinsic - when vessel endothelium ruptures exposing collagen fibres and platelet aggregation process occurs

extrinsic - trauma to tissue cells causing blood loss therefore platelet aggregation process starts

both pathways activates:
1. Factor X
2. Prothrombin
3. Thrombin (from prothrombin activator)
4. Fibrinogen
5. Fibrin (strands glue the platelets together and form a web like fibrin mesh)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

difference of arterial and venous thrombosis

A

arterial - mainly caused by ruptured accumulated plaque in the arterial walls causing thrombus
venous - mainly caused by DVT when arterial walls are damaged causing the formation of thrombus

both blocking blood flow to vital organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

drugs used to prevent platelet aggregation and inhibit thrombus formation in the arteries. Therefore treating CADs

A

Antiplatelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

antiplatelet meds

A

aspirin
clopidogrel
ticagrelor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

pharmacodynamics of aspirin

A

inhibit prostaglandin production by preventing COX
Low dose: inhibit COX 1 - platelet aggregation effect
High dose: inhibit COX 2 - antipyretic and analgesic benefits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

adverse effects of aspirin

A

GI upset
increased bleeding risk - (haemophilia or bleeding disorder)
dizziness, vertigo, deafness - older pts
bronchospasm - asthma pts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

clopidogrel and ticagrelor pharmacodynamics

A

inhibits ADP activation to prevent fibrinogen-platelet binding further reducing platelet activation and aggregation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

nursing considerations for antiplatelets

A

can cause thrombocytopaenia (low blood platelet counts) and excessice haemolysis
educate pt about excessive bruising and bleeding
DO NOT GIVE AT LEAST 5 DAYS prior to invasive surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Anticoagulants MOA

A

prevent recurrence or repeated venous thromboembolism
stroke prevention in AF
management of STEMI and nonSTEMI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Parenteral and oral anticoagulants

A

parenteral: heparin, enoxaparin
oral: warfarin, dabigatran

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

2 types of heparin

A

unfractioned heparin and low molecular weight heparin (enoxaparin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

pharamacodynamics of unfractioned heparin

A

activates antithrombin II which inactivates factor Xa and IIa

kinetics: rapidly anticoagulates with short onset of action

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

indications of unfractioned heparin

A

pulmonary embolism and DVT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

unfractioned heparin contraindication

A

pregnancy (heparin doesn’t cross placenta, can increase perinatal mortality for women and risk of maternal osteoporosis
CAUTIO FOR BLEEDING

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

adverse effects of unfractioned heparin

A

excessive bleeding
thrombocytopenia
allergies
hyperkalaemia (inhibits aldosterone stimulation)

17
Q

pharmacodynamics of enoxaparin or low molecular weight heparin

A

binds and activates antithrombin III which inactivates factor Xa ONLY

kinetics: longer onset duration compared to standard heparin (less monitoring reqd)

18
Q

adverse effects

A

similar to heparin but less common

considered safer to pregnancy compared to heparin

19
Q

warfarin (oral anticoagulant) pharmacodynamics

A

inhibits epoxide reducatase (enzyme reduces inactive Vit K) therefore reduces active Vit K in the liver.
since Vit K synthesise clotting factors II, VII, IX and X

20
Q

precautions for warfarin

A

CAUTION with other anticoagulants or antiplatelets - ASPIRIN AND NSAIDs can prolong bleeding time
USE paracetamol instead as analgesic

monitor:
hematuria (urine in blood)
nosebleeds
gingival bleeding
bruising

21
Q

warfarin interactions

A

most antibiotics such as erythromycin and metronidazole (influence GIT bacterial production of Vit K and inhibits warfarin metabolism)

Tramadol - inhibits warfarin metabolism

22
Q

nursing considerations for warfarin

A

educate timing and rationale for blood tests
monitor excessive bruising, bleeding in BMs, vomit, urine and nose
asses internal bleeding : low BPs, abdominal pain (painful, stiff and swollen)
educate drug interactions

23
Q

Direct oral coagulants

A

dabigatran and rivaroxaban

24
Q

dabigatran pharamacodynamics

A

direct inhibitor of factor IIa
prevents systemic embolism in AF

25
Q

dabigatran contraindications

A

enoxaparin
concurrent use of aspirin, NSAIDs and SSRIs (increase bleeding times)

26
Q

rivaroxaban pharmacodynamics

A

inhibits factor Xa
prevents systemic embolism in AF and venous thromboembolism (from hip or knee surgery)

27
Q

rivaroxaban contraindications

A

aspirin, NSAIDs, grapefruit and garlic

28
Q

Thrombolytic or fibrinolytic drugs MOA and types

A

act as thrombolytics (break and dissolve blood clots blocking blood flow) by activating plasminogen to form plasmin degrading fibrin breaking up thrombi
non-fibrin specific - streptokinase
fibrin specific - tenecteplase and alteplase

29
Q

thrombolytics treats

A

acute MI

30
Q

tenectoplase (fibrin specific fibrinolytic) pharmacodynamics

A

activates plasminogen to convert into plasmin degrading the fibrin matrix (fibrin blood clots) or stimulates fibrinolysis (breakdown of fibrin blood clots)

31
Q

contraindication of tenecteplase

A

recent hemorrhage, trauma or surgery
coagulation defects
should not be mixed with other anticoagulants

Pharmacology (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions