Chapter 26: Coagulation Modifier Drugs

Question 1

anticoagulants

Answer 1

used prophylactically to prevent the formation of clot or thrombus

Question 2

antiplatelet drugs

Answer 2

inhibit platelet function and prevent platelet aggregation at the site of injury. (platelet aggregation is what can cause atherosclerosis)

Question 3

thrombolytic drugs

Answer 3

lyse (break down) existing clots. (increases bleeding, can be dangerous)

Question 4

antifibrinolytic

Answer 4

prevents lysis of fibrin and promotes clot formation

Question 5

Anticoagulants are also known as

Answer 5

antithrombotic drugs.

are high alert drugs!

Question 6

embolus

Answer 6

dislodged clot

Question 7

Anticoagulants have no direct effect on

Answer 7

a blood clot that is already formed

Question 8

What are the selected anticoagulants?

Answer 8

• warfarin sodium (coumadin)
• enoxaparin (lovenox)
• heparin
• dalteparin (fragmin)
• dabigatran (pradaxa)
• argatroban
• bivalirudin (angiomax)
• fondaparinux (arixta)
• rivaroxaban (xarelto)
• apixaban (eliquis)

Question 9

The ability of anticoagulants to prevent clot formation is of benefit in certain settings in which there is a high likelyhood of clot formation, these indications include:

Answer 9

• MI
• unstable angina
• atrial fibrilation
• indwelling services such as mechanical heart valves
• major orthopedic surgery
• prolonged immobilization

Question 10

What are the adverse effects of anticoagulants?

Answer 10

• bleeding (esp. w/ increased dosages. may be localized or systemic)
• may also cause: heparin-induced thrombocytopenia (HIT); thrombocytopenia, purple toes (warfarin); hematoma.

Question 11

Heparin

Answer 11

• monitored by activated partial thromboplastin times (aPTTs)
• parenteral
• short half-life (1-2 hours)

Question 12

the effects of heparin are reversed by

Answer 12

protamine sulfate

Question 13

Enoxaparin and dalteparin

Answer 13

(low-molecular-weight heparins)

• do not require laboratory monitoring
• given subcutaneously
• do NOT rub after administration

Question 14

Warfarin

Answer 14

• given orally

- monitor prothrombin time and INR: (PT-INR)

Question 15

the effects of warfarin are reversed by

Answer 15

vitamin k

Question 16

Antiplatelet drugs

Answer 16

work to prevent platelet adhesion at the site of blood vessel injury, which occurs before the clotting cascade

Question 17

What are the selected antiplatelet drugs?

Answer 17

• aspirin
• clopidogrel (plavix)
• glycoprotein Ilb/Ilb inhibitors: eptifibatide (integrilin)

Question 18

Indications of antiplatelet drugs

Answer 18

• reduce risk of fatal and nonfatal strokes

- acute unstable angina and MI

Question 19

What are the adverse effects of antiplatelet drugs?

Answer 19

• thrombocytopenia
• anemia
• bleeding
• GI symptoms

Question 20

What are the main categories of coagulation modifier drugs?

Answer 20

1. anticoagulants
2. antiplatelet drugs
3. hemorheologic drugs
4. thrombolytic drugs
5. antifibrinolytic drugs

Question 21

What are the selected thrombolytic drugs?

Answer 21

• streptokinase and urokinase

- alteplase (activase)

Question 22

What is the mechanism of action for thrombolytic drugs?

Answer 22

• activate the fibrinolytic system to break down the clot in the blood vessel
• activate plasminogen and convert it to plasmin, which can digest fibrin
• reestablish blood flow to the heart muscle via coronary arteries, preventing tissue distruction

Question 23

Indications of thrombolytic drugs

Answer 23

• acute MI
• arterial thrombosis
• DVT
• occlusion of shunts or catheters
• pulmonary embolus
• acute ischemic stroke

Question 24

What are the adverse effects of thrombolytic drugs?

Answer 24

-bleeding: internal, intracranial, superficial
-other effects include:
nausea, vomiting, hypotension, anaphylactoid rx’s
cardiac dysrhythmias (can be dangerous)

Question 25

What is the selected antifibrinolytic drug?

Answer 25

aminocarroic accid (amicar)

Question 26

What is an indication for antifibrinolytic drugs?

Answer 26

excessive bleeding

Question 27

Discuss the nursing process focus on patient-centered care pgs 426-433.

Answer 27

Assessment, Nursing Diagnosis, Planning, Implementation, Evaluation

Question 28

partial thromboplastin times (aPTTs)

Answer 28

a blood test that measures the time it takes your blood to clot.
can be used to check for bleeding problems.

Question 29

International normalized ratio

Answer 29

based on the ratio of the patient’s prothrombin time and the normal mean prothrombin time.

Question 30

prothrombin time (PT)

Answer 30

• blood test that measures how long it takes blood to clot

- also used to check whether medicine to prevent blood clots is working.