Chapter 13 lecture notes

Question 1

What is hemostasis?

Answer 1

Blood’s ability to form a clot to stop bleeding from the arteries and veins of the body.

Question 2

What type of drugs prevent clot formation?

Answer 2

Antiplatelet drugs and Anticoagulants

Question 3

What drugs dissolve a clot that is already formed?

Answer 3

Thrombolytics

Question 4

When bleeding occurs in the body, three mechanisms reduce blood loss, what are they?

Answer 4

1. Vascular spasm
2. Formation of a platelet plug (Platelet Inhibitors work here)
3. Blood clotting (coagulation) (anticoagulants work here)

Question 5

Vascular spasm

Answer 5

When blood vessel is severed, it snaps back (retracts), smooth muscle contracts and the lumen becomes smaller resulting in less blood loss - drugs are not apart of this mechanism of clotting.

Question 6

Platelet plug

Answer 6

2nd step in hemostasis occurs when platelets become activated & begin to get sticky & adhere to the inner walls of damaged blood vessels to form a platelet plug.

Question 7

Coagulation

Answer 7

Blood Clotting
-blood congeals to form a clot around the platelet plug.
-Made possible by:
   >presence of clotting proteins
   >occurs in a cascade

Question 8

What does cascade mean in coagulation?

Answer 8

as one clotting protein becomes activated and triggers the next protein, and the next, and the next, and so on…

Question 9

Fibrinolysis

Answer 9

Fibrinolytic system comes into play after the damaged blood vessel is repaired & the body works to dissolve the blood clots that are no longer needed.

Question 10

What is plasminogen?

Answer 10

substance in blood activate plasminogen to become plasmin which is the enzyme that dissolves clots

Question 11

TPA

Answer 11

Tissue Plasminogen Activators
Drugs that dissolve clots
“Clot busters”

Question 12

Clotting in an unbroken artery or vein is called??

Answer 12

Thrombus and the abnormal disease process that accounts for it is called Thrombosis.

Question 13

Abnormal thrombi are usually initiated by…

Answer 13

roughened, diseased surface of a blood vessel. Can occur from atherosclerosis, trauma, or infection.

Question 14

Stasis blood flow means??

Answer 14

When blood flow slows down, can also cause blood clots.

Question 15

What 4 factors help keep blood flowing normally??

Answer 15

Undamaged blood vessels
smooth surfaces
good circulation
non-sticky platelets

Question 16

Embolus

Answer 16

Is a piece of the atherosclerotic thrombus, blood clot, air bubble, or piece of fat or other debris that is transported by the bloodstream.

Question 17

Drug therapy in this chapter is aimed ate preventing…

Answer 17

1. platelet activation on top of unstable thrombi.

2. and so they cannot break away and obstruct blood flow at sites far from their formation.

Question 18

What are the 3 different types of anti-clotting drugs?

Answer 18

1. Platelet Inhibitors
2. Anticoagulants
3. Thrombolytics

Question 19

Platelet Inhibitors

Answer 19

hinder the ability of platelets to get sticky and form a platelet plug.

Question 20

Anticoagulants

Answer 20

Of the “deep clotting cascade” hinders one or more steps in the cascade of soluble clotting factors that lead to formation of thrombin.

Question 21

Thrombolytics

Answer 21

“clot busters” drugs that dissolve clots after it has already formed.

Question 22

Antiplatelet drugs are used to:

Answer 22

1. Prevent or treat superficial venous thrombosis, mild cases of DVT
2. Prevent “mini strokes” called TIAs
3. Prevent and treat angina
4. make platelets less sticky

Question 23

What are the different platelet inhibitor drugs?

Answer 23

Aspirin/NSAIDS - relieve angina & prevent heart attacks & stroke.
Plavix/Clopidogrel - 2nd best selling drug world wide,

Question 24

Any bleeding seen from platelet inhibitors is called?

Answer 24

“Superficial bleeding”

Question 25

Coumadin

Answer 25

anticoagulants adverse effects which include bleeding into the joints, abdomen, or brain

Question 26

Superficial bleeding complicates administration of _____ ___ ______ ______ being administered.

Answer 26

aspirin-like platelet inhibitors

Question 27

Anticoagulants are powerful drugs used to:

Answer 27

1. Provide anticoagulation during hemodialysis & cardiopulmonary by pass (CPB)
2. Prevent or treat DVT or pulmonary embolism (PE)
3. prevent or treat stroke & recurrence
4. prevent or treat MI & recurrence

Question 28

How do Anticoagulants work??

Answer 28

work by interrupting one or more of the coagulating cascades (clotting steps)

Question 29

Heparins

Answer 29

Mostly used in the hospital,only use them for a few days,Administered by IV (olden days)
Affect the intrinsic pathway of the cascade

Question 30

Coumadin

Answer 30

Affect the Extrinsic Pathway of the cascade

Question 31

Lovenox

Answer 31

Heparin that is given to out patients

Question 32

Clot busters are not…

Answer 32

Anticoagulants

Question 33

We only give thrombolytics for…

Answer 33

stroke and heart attack