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Nanju > Ch 32 Coagulation > Flashcards

Ch 32 Coagulation Flashcards

0
Q

What does venous thrombosis Iead to?

A

PE
post phlebitic syndrome ( a syndrome occurring within 1 yr of a DVT with chronic, potentially disabling leg swelling, pain, venous dilation and skin induration.

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1
Q

What is arterial thrombosis the most common cause of

A

MI
Strike
Limb gangrene

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2
Q

Hemostasis

A

A series of events that occurs to prevent blood loss after a injury

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3
Q

Thrombolytics

A

Dissolve clots

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4
Q

Anticoagulants

A

Prevents clots only

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5
Q

Hemophilia

A

Uncontrollable bleeding

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6
Q

Where are most clotting factors produced

A

In the liver, therefor cirrhosis and hepatitis would prevent the synthesis of clotting factors

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7
Q

Are clotting factors active

A

They are inactive in the blood until a injury activates them

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8
Q

What does plasmin break down

A

Fibrin
Fibrinogen
And other plasma proteins

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9
Q

How is a arterial thrombus formed

A

It is formed under high flow conditions

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10
Q

How are venous thrombus’ formed

A

They are formed from stasis of the blood

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11
Q

What is a embolism

A

It is any dissolved matter carried in a blood or lymph vessel to another location where it lodges and occluded the vessel.

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12
Q

What does hyper coagulability result from

A

It results from either a increase in platelets or an increase in the activity of clotting factors or both.

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13
Q

Why does excessive bleeding occur

A

Because the body cannot form a stable clot in response to injury

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14
Q

Intrinsic factor

A

All the clotting factors already present in the blood

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15
Q

Vitamin k

A

Given as a injection for thin blood it helps with the viscosity of the blood

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16
Q

Where is vitamin k synthesized

A

In the colon bowels

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17
Q

What ration is heparin always given

A

1:1 ratio

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18
Q

What may continued use of heparin lead to

A

Osteoporosis

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19
Q

When administering Coumadin what labs should be monitored

A

PT which is an extrinsic factor

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20
Q

Coumadin is linked to what

A

Vitamin k

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21
Q

What is the treatment of a overdose of heparin

A

Protamine

Which is an intrinsic factor measure PTT

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22
Q

Can aspirin and warfarin be given together

A

Yes

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23
Q

What is the normal PT

A

11-16 seconds

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24
Q

What does vitamin k do

A

It helps clot the blood it is a fat soluble vitamin

25
Q

What is clopidogrel ( plavix)

A

It is an anti platelet that decreases the ability of platelets to stick together. Severe neutropenia is a adverse effect

26
Q

For clot formation what is needed

A

Fibrin

27
Q

What is the shelf life of all blood products

A

4 hrs or less.

28
Q

What are hemostatic drugs

A

It stops blood loss by enhancing blood coagulation( the goal is to form fibrin to stop blood loss) there are two types; systemic and topical.

29
Q

What is parenteral heparin

A

It is an anticoagulant that interferes with the final steps in the clotting cascade
It rapidly promotes the inactivation of factor X which in turn prevents the conversion prothrombin to thrombin

30
Q

What route is heparin given

A

IV
SC
Metabolized in the liver and excreted in the kidneys

31
Q

What are adverse effects of heparin

A

Bleeding and thrombocytopenia

32
Q

What lab should be monitored on heparin therapy

A

aPTT

33
Q

What is the antidote for heparin

A

Protamine sulfate

34
Q

What is warfarin used for

A

It is used prophylactically for ppl with long term risk for thrombus formation

35
Q

What is the pharmacodynamics of warfarin

A

It competitively blocks vitamin k at its sites of action

36
Q

What are adverse effects of Coumadin

A

Bleeding and HEMMORRHAGE

37
Q

What should be monitored in a pt receiving warfarin

A

PT

INR

38
Q

What is the antidote for warfarin

A

Vitamin k

phytonadione

39
Q

What are low molecular weight heparin used for (LMWH)

A

Prevention of DVT
PE after surgical procedures known to increase the risk of such complications

The anticoagulant effect is increased by digitalis, tetracyclines, nicotine, and antihistamines

40
Q

What are adverse effects of LMW

A

Life threatening bleeding
Anemia
Thrombocytopenia
Local pain or discomfort

41
Q

What are contraindications to heparin and LMWH

A 
Active HEMMORRHAGE
GI ulcerations
Hemophilia
Thrombocytopenia 
Polycythemia Vera
Severe liver or kidney disease
HTN
Recent brain, spinal cord injury, or hemorrhagic stroke
Caution is exercised in ppl with diabetes, HTN, endocarditis,
42
Q

Name LMWH

A

Dalteparin
Enoxaparin
Fondaparinux
Tinzaparin

43
Q

What is the prototype anti platelet drug

A

Clopidogrel ( plavix). Aspirin
It is used to reduce atherosclerotic events
It is administered orally metabolized in the liver

44
Q

What are adverse effects of anti platelet drugs

A

Bleeding
GI distress
Neutropenia

45
Q

What are drug interactions of anti platelet drugs

A 
Tamoxifen 
Tolbutamide 
Warfarin 
Torsemide 
Fluvastatin 
And many NSAIDS
46
Q

Clopidogrel should be cautioned in children younger than what

A

18

47
Q

What is the most serious adverse effect of clopidogrel

A

Neutropenia

48
Q

What is the prototype Thrombolytic drug

A

Alteplase, recombinant ( activate, cathflo, activase)

49
Q

What does Thrombolytic drugs do

A

Converts plasminogen to plasmin

It is used in thromboembolic conditions

50
Q

Thrombolytic drugs are what type of drug

A

They are given in emergency situations and can have life threatening adverse effects the pt should be hooked to a cardiac monitor both during the treatment and afterwards

51
Q

What pregnancy category is alteplase

A

C

52
Q

What are clotting factors

A

They treat deficiencies of normal clotting factors replacement of theses factors is the treatment of choice
Prototype drug: anti hemophilia factor
It is essential for the conversion of prothrombin to thrombin.

53
Q

What are adverse effects of the antihemophillic factor

A

Anaphylaxis, urticaria, nausea,,and chill

54
Q

How should AHF be stored

A

It should be refrigerated until used before reconstitution, warm the concentrate and the diliuent to room temp… After dilution, administer within 3 hours to prevent bacterial growth
Instruct client to observer for bleeding gums, skin, urine, stool, or emesis.

55
Q

What are hemostatic drugs

A

They stop blood loss by enhancing blood coagulation

56
Q

What do systemic hemostatic drugs do

A

They interfere with the breakdown of clots

57
Q

What do topical hemostatic agents do

A

They are used to control small amounts of bleeding for oozing, usually following surgery.
Prototype drug; aminocaproic acid ( Amicar)

58
Q

What are adverse effects of aminocaproic acid ( hemostatic drug)

A

GI distress
Headache, dizziness, seizures, hypotension, arrhythmias, tinnitus, nasal congestion, vomiting, abdominal cramps, diarrhea, diuresis

59
Q

What are drug interactions of hemostatic drugs

A

Oral contraceptives

Estrogen

60
Q

How can one minimize adverse effects of hemostatic drugs

A

Monitor vital signs
Administer via IV pump
Monitor I&O neurological status

Nanju (15 decks)

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