Ch 26 Coagulation Modifier Drugs

Question 1

Hemophilia

Answer 1

Natural coagulation and hemostasis factors are limited or absent
Patients with hemophilia can bleed to death if coagulation factors are not given.
factor7 &8

Question 2

Anticoagulants

Answer 2

prevent clot formation
-heparin iv first
reasons to take
-Atrial fibrillation
-MI
-prevent dvt
risk for bleeding
LMWHs are contraindicated in patients with an indwelling epidural catheter risk of epidural hematoma
-Systemic-hypotension,tachycardia,loc altered,bleeding stool or urine

Question 3

Antiplatelet

Answer 3

prevent platelet stick together
-aspirin-Effects last the life span of a platelet, 7 days
stroke prevention
-clopidogrel -Altering the platelet membrane so that it can no longer receive the signal to aggregate and form a clot

Question 4

Thrombolytic drugs-plase

Answer 4

Lyse (break down) existing clots
reasons to take dvt,pe,mi
bleeding adverse effects
Internal- hypotensension
Intracranial-headache
-Short half life (5 mins
-Given with heparin to prevent reocclusion of the affected blood vessel
Cathoflo Activase
Flush clogged IV or arterial lines
Tenecteplase (TNKase)
Given IVP after MI

Question 5

Antifibrinolytic

Answer 5

Promote blood coagulation
drugs to make clot happen for excessive bleeding
-tranexamic acid (Cyklokapron)
-desmopressin
Contraindicates with contraceptive

Question 6

Heparin

Answer 6

Intravenous (IV) protamine sulfate: 1 mg of protamine can reverse the effects of 100 units of heparin for toxcity
aptt is assess
-Sash 100/ml
25-28 half inch -5/8 inch

Question 7

warfarin

Answer 7

Most commonly prescribed oral anticoagulant

Pt and inr
vitamin k
May take 36 to 42 hours before the liver can resynthesize enough clotting factors to reverse the warfarin effects
Pt normal 11-13
Detramential inr greater than 3.5 more bleeding there’s going to be
2.5-3.5 on anticoagulant higher than normal
-warfarin resistance will occur for up to 7 days
IV vitamin K: risk of anaphylaxis. Risk is diminished by diluting it and giving it over 30 minutes

Question 8

Low-molecular-weight heparins (LMWHs)

Answer 8

enoxaparin (Lovenox)
dalteparin (Fragmin
Given subcutaneously in the abdomen
Rotate injection sites
Avoid aspiration
Do not massage after injection*

Question 9

Garlic
Ginger
Ginkgo

Answer 9

increase bleeding when given with warfrain